Anxiety Emergency Plan

When anxiety hits hard, you can't think clearly enough to Google "how to calm down." This skill provides immediate techniques that work on the nervous system directly, followed by longer-term resources. Based on clinical anxiety management protocols. Crisis hotlines and therapy resources listed are US-specific -- adapt for your country.

- User is having a panic attack or severe anxiety right now - Can't calm down, can't breathe, heart racing - Feeling overwhelmed and doesn't know what to do - Needs grounding techniques immediately - Looking for anxiety management strategies - Wants to find affordable therapy or professional help

### Step 1: If anxiety is happening RIGHT NOW Speak calmly and simply. Don't explain theory. Give one instruction at a time. **Box Breathing (works in 60 seconds):** ``` BREATHE WITH THIS PATTERN: Inhale...... 4 seconds Hold......... 4 seconds Exhale...... 4 seconds Hold......... 4 seconds Repeat 4 times. Your heart rate will slow. This is physiology, not willpower. ``` **5-4-3-2-1 Grounding (for dissociation/derealization):** ``` Name out loud: 5 things you can SEE 4 things you can TOUCH (and touch them) 3 things you can HEAR 2 things you can SMELL 1 thing you can TASTE This forces your brain back into the present moment. ``` **Cold water reset:** - Put cold water on your wrists and the back of your neck - Or hold an ice cube in each hand - This activates the dive reflex and slows your heart rate ### Step 2: After the acute phase passes Once breathing is more normal (usually 5-15 minutes): ``` POST-ANXIETY CHECKLIST: □ Drink water — anxiety dehydrates you □ Eat something small if you haven't eaten □ Move to a different room or space □ Tell one person what happened (text is fine) □ Write down what you were thinking/feeling right before it hit → This helps identify triggers over time ``` ### Step 3: Build an anxiety toolkit For ongoing anxiety management: ``` DAILY ANXIETY PREVENTION: Morning: □ No phone for first 30 minutes □ 5 minutes of box breathing □ Write 3 things you're anxious about → next to each, write one action you can take about it today During the day: □ Set a "worry window" — 15 minutes where you're ALLOWED to worry. Outside that window, write it down for later. □ Movement every 2 hours — even a 5 minute walk □ Limit caffeine after noon Evening: □ "Brain dump" — write everything in your head onto paper □ No news/social media 1 hour before bed □ 4-7-8 breathing: inhale 4s, hold 7s, exhale 8s (promotes sleep) ``` ### Step 4: Find affordable professional help ``` HOW TO FIND THERAPY YOU CAN AFFORD: 1. Open Path Collective (openpathcollective.org) → $30-$80/session with licensed therapists 2. NAMI Helpline: 1-800-950-NAMI → Free peer support and local resource navigation 3. Community mental health centers → Sliding scale fees based on income → Search: "[your county] community mental health center" 4. University training clinics → Sessions with supervised grad students for $5-$30 → Search: "[university near you] psychology training clinic" 5. Your employer's EAP (Employee Assistance Program) → Usually 3-8 free sessions, confidential → Ask HR for the number 6. Crisis resources (immediate): → 988 Suicide & Crisis Lifeline (call or text 988) → Crisis Text Line: text HOME to 741741 ```

- If someone is in acute panic, be SHORT and DIRECTIVE. One instruction at a time. No paragraphs. - Always provide crisis resources (988) if anxiety is accompanied by self-harm thoughts - Never say "just calm down" or "there's nothing to worry about" - Acknowledge that anxiety is real and physiological, not weakness

- Anxiety is the brain's alarm system stuck in the ON position. It's not a choice. - Regular exercise is as effective as medication for mild-to-moderate anxiety (meta-analyses confirm this) - Caffeine and anxiety are directly linked — reducing caffeine is the single easiest intervention - Breathing exercises work because they activate the vagus nerve, which controls the parasympathetic nervous system. It's not woo-woo — it's neuroscience.