Anatomy of a Panic Spiral (and How to Snap Out of It)


These are not good times for someone like me who struggles with anxiety. Struggles in the best of times.

Since the pandemic began in earnest here, I’ve gotten caught up in panic spirals several times. By “panic spirals” I mean attacks of escalating panic (I hesitate to call them panic attacks because I’m not sure they meet the diagnostic criteria).

One of the most helpful things a therapist told me about anxiety is that in essence, it is the inability to tolerate uncertainty.

And uncertainty usually sets the panic spiral in motion. To illustrate, I’ll break one of mine down for you. Then I’ll share some practices that help me to “snap out of it” (without getting slapped a few times by Cher). Because all of us experience panic from time to time. And Cher isn’t always around to smack us.

From Certainty to Uncertainty

Back in March, I was able to keep myself fairly calm with the belief that COVID-19 was a risk mostly to adults 70 years or older. Maybe also some younger people with comorbid conditions. I’m not in either of those categories, so, y’know — whew. Certainty.

Then we started learning that the initial assumptions were wrong. And along comes this interesting Commentary piece on Medscape. The article made me understand — really understand — the variance. The high variance. The Russian roulette of COVID-19.

I am prone to catastrophizing. The article planted a little seed of uncertainty. WHOOSH — let the panic spiral begin.

Every so often I would feel a bit short of breath. My immediate thought? This is it. I have it. My next stop is the ICU.

These catastrophic thoughts would kick fight or flight into full gear. Which made the shortness of breath worse. Which fed the catastrophic thoughts. And so on, and so on — spiraling out of control.

Snapping Out of It

Fortunately, there are several practices that can short-circuit these spirals. 

The important first step is to notice that you’re being carried away by the spiral, farther and farther into a scary place. You need to come back to the present.

A simple way to come back is to notice things. This practice has different forms, but all of them involve engaging at least some of your senses (seeing, hearing, smelling, touching, tasting) and noticing what is happening right now. In the “3 x 3” practice, you engage in three of your senses and name three things you notice for each of them (e.g., three things you see, three things you hear, three things you smell). There’s also a “5 x 5” version that includes all of the senses, noticing five things for each. Sometimes you pick just one sense and notice X number of things.

As psychologist and mindfulness teacher Elisha Goldstein explains, this practice interrupts the automatic catastrophic thinking that fuels anxiety.

Once you have pulled yourself out of the catastrophic thinking, you can turn to calming down both your body and your mind. 

You can breathe deeply in the 4-2-6 pattern.

You can place one or both hands over your heart, feeling the warm and gentle touch of your hands on your heart center. (A more elaborate version of this is described here.)

You also can remind yourself of what is true in the moment. You can say to yourself, “Right now, I am healthy. Right now, I am safe.”

With practice, you’ll catch the panic spiral earlier and earlier and restore yourself to calm sooner and sooner.


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