One of biggest challenges to having panic attacks is the anxiety that leads up to it. If you’ve been diagnosed with Panic Disorder, or if you have panic attacks on a regular basis, you might have experienced the debilitating anxiety that comes with not knowing when another panic is going to happen. It’s sometimes called pre-panic anxiety, and it is one of the symptoms that frequently accompanies panic attacks.

Yet, there are some steps you can take to assist you with managing and even reducing this kind of anxiety before the attack. Essentially, you’ll want to become more aware of any patterns associated with your panic attacks. And you’ll also want to learn and practice relaxation techniques. These two main points can help reduce your overall experience of anxiety and panic attacks. However, let’s take a look at this a little more deeply:

1. See if you can identify when a panic attack is about to occur. Although it might be challenging, you might be able to identify signs that an attack is imminent. For instance, perhaps you notice that you have an attack whenever you fear falling down. The point is that if you’re able to identify an oncoming attack, you can take steps to make it easier on you. For instance, you can stop what you’re doing and breathe. Or you can go somewhere to avoid embarrassment that might come from having an attack with others around.

2. The environment might be the trigger.  There can be many reasons that trigger an attack, including what’s going on inside, such as thoughts, feelings, or a memory. At the same time, there may be something going on around you that could be the trigger. This could be the environment itself or something in the environment, such as a person, a noise, or a scent. This may be another reason to change your environment when you feel an attack coming on.

3. Focus on your breathing. Once you start to feel the anxiety of an imminent attack, take long, slow, and deep breaths. Inhale and exhale to the count of four seconds. This extended breathing does two things. It relaxes the body and it directs your attention on your body and instead of any anxious thoughts you might have.

4. Recite a prayer, mantra, or even the alphabet in your mind.  Just as you did with the breathing, you can recite something in order to change your thinking. Often, it is a thought that can begin the attack in the first place.

5. Keep a journal. Keep track of your attacks in a journal. Write down when you had them and what you suspect may have been the trigger. As you continue to observe your attacks, you may become more and more aware of what triggers them.

6. Practice relaxation techniques. Experiencing panic attacks as well as anxiety before an attack takes place can mean that you’re feeling uncomfortable much of the time. However, with relaxation techniques you can reduce your overall experience of anxiety. Relaxation techniques such as yoga, meditation, deep breathing, and progressive muscle relaxation – when practiced regularly – are ways to lower your overall experience of anxiety.

If you feel that your panic attacks and your pre-attack anxiety are too much for you to handle, talk to an adult you trust so that he or she can connect you with a mental health professional.