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Managing Panic Disorder in Public

How to Cope with Your Symptoms Outside Your Home

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Updated June 04, 2013

Written or reviewed by a board-certified physician. See About.com's Medical Review Board.

Anxiety disorders, including panic disorder, are characterized by extreme fear and nervousness. The symptoms of panic disorder are often difficult to manage, and dealing with panic attacks and agoraphobia is even more challenging when in public. The following offers some easy tips to help you manage your panic disorder symptoms in public.

1. Start Focusing on Your Breathing Process

When symptoms begin to arise, your breath is often the first change that occurs to your body. Shortness of breath, or hyperventilation, is one of the most common physical symptoms of panic and anxiety. But experiencing accelerated breathing in public can make you feel alarmed and potentially increase your feelings of anxiety.

Breathing exercises can help you to slow your breath down, eliciting feelings of calm and relaxation. Deep breathing can also greatly help keep other symptoms from escalating, such as rapid heart rate or chest pain. But in order to be prepared to use this technique during a panic attack, it's important that you practice at times when you're not experiencing high anxiety. For example, you may want to start your day off with a few minutes of deep breathing, use it to recharge in the afternoon, or practice this exercise in the evening to unwind from the day and prepare for a better night’s rest.

Learn More:

Deep Breathing for Panic Disorder

2. Increase Your Awareness

Panic attacks are often accompanied by unpleasant thoughts and fear-based perceptions. When symptoms escalate, you may become afraid that you'll need immediate medical care, such as fearing that you're having a heart attack. The more you focus on these negative thoughts, the further your fears and symptoms may intensify. You can become so afraid of your symptoms that you believe you're going to lose control, go insane, or even die.

These distressing thoughts and symptoms are often amplified when experiencing a panic attack in public. In order to gain control over these thoughts, you must first become aware of them. Practicing mindfulness is a way that you can learn to acknowledge your thoughts without letting them take over your emotions and behaviors. Through mindfulness practices, you can increase your self-awareness to become better prepared to handle your symptoms in public.

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Mindfulness for Panic Disorder

Mindfulness Meditation Exercise

3. Don’t Go At It Alone

When faced with public situations that trigger anxiety and panic attacks, it can be extremely beneficial to deal with it while accompanied by a trusted loved one. Through social support, you can feel more secure and relaxed in public. Prepare the person you're with by explaining your symptoms and fears to them. Come up with a game plan that can include recognizing your symptoms as they occur, utilizing coping strategies to get through a panic attack, and preparing to leave a place or situation if needed.

Learn More:

Explaining PD to Family and Friends

4. Visualize a Positive Outcome

If you dread being in public, you may have already made up your mind that the experience can only be negative. However, the way you feel in public may be influenced by your negative perceptions and predictions. Visualization is a technique you can use to overcome these limiting beliefs and increase your self-reliance while being in public.

Visualization involves closing your eyes and envisioning yourself in different circumstances. Through visualization, you can imagine what it would be like to successfully manage your anxiety while in public. Similar to day dreaming, this exercise allows you to tap into your senses and imagination to see yourself achieving positive outcomes. For example, you may visualize yourself utilizing your coping techniques to face public situations with more relaxed confidence. By visualizing success, you may feel more ready to deal with your symptoms in public.

Learn More:

Visualization for Panic Disorder

5. Agoraphobia and Avoidance

Panic disorder is currently diagnosed as occurring with or without agoraphobia, a separate condition that is characterized by extreme fear. A person with agoraphobia is afraid of having a panic attack in public places or situations in which it would be difficult and/or embarrassing to flee.

Often times, a person with agoraphobia will develop extreme avoidance behaviors in which the person sidesteps many circumstances in order to feel safe. For example, many people with agoraphobia avoid public transportation and crowds. In more severe cases, a person can become homebound with agoraphobia.

If you believe agoraphobia is preventing you from feeling comfortable in public, it's important to seek out professional help. The sooner you begin an appropriate treatment plan, the quicker you will be able to manage your condition.

Learn More:

Panic Disorder with Agoraphobia

Finding Help for Panic Disorder

6. Take it Slow and Set Goals

Those with panic disorder with agoraphobia should take caution at rushing into feared situations. When learning to more confidently deal with your symptoms in public, set a realistic goal for how long you want to be in a public situation. Be sure to limit the time you are out, take it slow, and gradually work up to longer exposures.

A technique known as imaginal desensitization can be a helpful way to gradually overcome avoided situations. This self-help technique can help you unlearn fears and overcome situations that seem to trigger panic and anxiety. Through the use of visualization, imaginal desensitization allows one to gradually face and overcome fears associated with managing panic disorder in public.

Learn More:

Desensitization for Panic Disorder

Dealing with panic disorder in public can be challenging, and your anxiety about it may never completely go away. However, you can learn to more effectively manage your symptoms in a way that will allow you to feel more safe and secure when facing public situations.

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