6 Steps for Getting Out of a Panic Spiral

Easing panic about pain and life stressors can help you break the pain cycle.


Chronic pain and anxiety tend to go hand in hand. The late NYU physician Dr. John Sarno links the two in his book "The Divided Mind." And when I first came across his work, it immediately made sense. As a long-time migraine sufferer, my most common headache trigger is what I call “the panic spiral.”

Maybe you know what I’m talking about. The panic spiral is like a traffic jam of anxiety triggers in your mind. It might start with an overwhelming to-do list of family obligations, which then collides with a seemingly insurmountable pile of paperwork from your boss, and… do you feel what’s happening in your body just reading this? The panic spiral can hamstring your logical reasoning, limit your sense of what’s possible, and even bring on physical constriction and pain.

If you’re all too familiar with this scenario, you might be wondering, “How do I make the panic spiral STOP?”

Before we can tackle this beast, we need a little background on how the nervous system functions - because it's the key to understanding what you're experiencing. You see, when the nervous system perceives a stressor, it "hijacks" the brain. It takes the controls away from the prefrontal cortex - that lovely lobe at the front of your brain responsible for curiosity, creativity, empathy and logic. And it puts the amygdala, or "Lizard Brain," into the pilot's seat. That's the emergency responder part of our brain, developed way back in the days of our reptilian ancestors. And we need it to deal with immediate and temporary emergencies - like being caught in a burning building or being chased by a hungry tiger.

The problems arise when this primitive part of the brain mistakes an everyday stressor for a legitimate survival threat. And once the Lizard Brain jumps into the pilot’s seat, it does not like to give back the controls. You can't reason with it, it's prone to black and white thinking, and it's only response to the situation at hand is to lash out, run away, shut down or submit to injustice.

Sound familiar?

So how do we get out of Lizard Brain mode and gain back our resourceful thinking and clarity – so that we can find productive solutions and relief from tension and pain? I’m going to share with you a 6-step process that I developed through my own personal healing journey and that I now teach to clients.

Getting Out of the Panic Spiral

Step 1 - Notice your state. Identify the first physiological clues that your nervous system has been activated.

Do your neck and shoulders tighten or does your breath become shallow? Maybe you get sweaty palms or a certain feeling in the pit of your stomach? Some people find that it starts with “brain fog,” while others go straight into a headache or back pain. Stress shows up in our bodies in a variety of ways. Learning your early warning signs can empower you to take the next step before panic and pain become full-blown.

Step 2 - Establish safety. Hit the pause button on stressors for just a few minutes.

The simplest way to take a break from anxiety is to identify its primary trigger and literally walk away from it. For example, if your boss is stressing you out, step outside the office for a moment and take a walk – or at least a bathroom break. Even if your anxiety centers on something you can’t literally get away from – like intrusive thoughts about the past – getting up and changing scenery can sometimes create a temporary sense of space between you and your worries. You only need a brief window of safety to move into the next step.

Step 3 - Reset your brain. Practice a mind-body technique that interrupts the panic spiral.

Here’s the thing about anxiety: It usually centers on anticipating future stress or ruminating on past stress. So, one way to calm the Lizard Brain and give back control to the prefrontal cortex is to connect with the present moment by noticing your felt sensations in real time. This can be done through mindful breathing, wiggling your fingers and toes, stretching or shaking out your body, splashing cool water on your face, or whatever feels right to you.

Step 4 – Identify your feelings and needs. Uncover the underlying causes of the panic spiral. Once you’ve turned down the alarm bells going off in your head, you can invite your prefrontal cortex back onto the scene by putting language to your feelings. A handy tool for this is the list of universal feelings from the Center for Nonviolent Communication. Just scan the list of words and see what fits your current state.

While the feelings you’re having may be unpleasant, you can think of them as helpful messengers alerting you to some vital needs that require your attention. Those needs might be as simple as eating an overdue meal or catching up on sleep. But did you know that things like compassion, understanding and support are also on the list of universal needs?

As you scan the list of needs, think about each need as having its own fuel tank. And just like a car, when your fuel tanks get depleted over time by cumulative stress and exertion, you’ll eventually get an “emergency low” alert. The panic spiral is your signal that you’re running on empty and it’s time to pull over and fuel up!

Once you get clear about the unmet needs underlying the panic spiral, you can set about addressing them in these final steps:

Step 5 - Set boundaries. Get clear about your limits and how you’ll protect yourself. This can be tough for panic-prone folks, because difficulty setting boundaries is often a key driver of the panic spiral. But that’s why this step is crucial! And you can take it one piece at a time. First, just concentrate on articulating your boundaries on paper. Later you can put them into action.

Here’s an example: The situation – an overscheduled weekend. What is my limit or breaking point? More than 3 social events in one weekend. How will I protect myself? I will cancel two of the five events I planned to attend – even if it means disappointing someone.

Writing it down helps make it concrete. And it holds you accountable – to yourself!

Step 6 - Take action. Create a game plan to consciously address your needs.

Pick out just one of the needs you identified in step four. Then ask yourself: What person, place or activity in my life nurtures this particular need? When will I connect with that person, place or activity? Make a plan, put it on your calendar and follow through. As you do, visualize your need’s fuel tank getting filled back up drop by drop. And you don’t need perfection – just getting past the “emergency low” mark will do.

If this process sounds like a lot, remember that these are tools, not rules. Use what works for you and feel free to discard the rest. You may want to try out the entire sequence once or twice and then decide which pieces work best for you.

And if it feels too daunting to try this on your own, enlisting the support of a coach, counselor or trusted friend can be a great idea. Sometimes just having a benevolent sounding board will help you gain perspective and clarity – not to mention empathy. At the end of the day, the panic spiral is no match for a fuel tank full of self-compassion!

About Anna Holtzman, Mental Health Counselor

Anna Holtzman is a mindbody-oriented Psychotherapist and Life Coach. She works with clients locally in New York City and remotely by phone or video chat. She can be found on her website.

Please note: This article is made available for educational purposes only, not to provide medical advice. The views expressed in this article are those of the author, which do not necessarily represent those of Curable or other contributors to the Curable site.

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