The first time, it hit me like a heart attack.

“G, check my pulse! G, am I having a heart attack!?”

I was sprawled out across the living room floor. My heart was leaping out of my chest. I couldn’t breathe. My pulse was racing. My head was dizzy and the whole world was spinning off its axis. I thought I was dying.

I was sure that this was it. Say parting words because death do us part.

That was my first panic attack during the day. It was February 2, 2019, just five minutes before a staff meeting video call.

I’ve had panic attacks during the late hours of the night. But they were nothing like this. Probably because it wasn’t nocturnal and I didn’t have the fatigue of the night dulling the full sensations of a full-fledged panic attack.

But it felt so real.

Since February 2019, was having more and more frequently recurring panic attacks. It felt like an endless cycle. The more cumulative attacks I had, the more likely they were going to happen in public places. And they did.

We went to dinner with other couples and in the middle of the meal, it hit me again. I looked at my plate full of food and felt lightheaded, my heart was racing, my mind was tripping. First I got up to use the bathroom. After splashing water over my face, I felt well enough to return to the table. I sat down, took another bite of food only for it to hit me again like a heart attack. I left the restaurant in a hurry, asking two people I knew to sit down with me: one a doctor and the other a friend.

Me: Check my heart rate. Am I having a heart attack?

Doctor: “No, you’re not having a heart attack.” What’s the lie?

Me: “I am having a heart attack.”

Doctor: Now, name the truth.

Me: “I am not having a heart attack.”

Saying this truth out loud was half the battle. But it didn’t stop the anxiety I was experiencing. It only allowed me to get through the next several attacks without freaking out way too much. But they still kept coming more frequently than before.

Panic attacks are very real for the person experiencing them. They are real not only because they are mentally real but physically real. A panic attack is the body’s natural response to high stress. We produce cortisol, epinephrine (adrenaline), and norepinephrine in response to threats (real or perceived). And this is why we go into fight, flight, or freeze mode.

In the cycle of panic attacks, each time we experience one, we worry about when the next attack will come, and this cycle worsens. So each “threat” seems more real and worsens the effects or symptoms we are feeling. That explains a lot. That explains how I went from the occasional panic attack in the middle of the night to “I am having a heart attack!” full-fledged panic during the middle of the day.

I still feel my heart racing and have shortness of breath sometimes. Of course, it's mostly mental. Physically I'm healthy as a horse. But occasionally I’ll still have this sense of crisis or panic.

So here are some things I do to prevent a full-blown panic attack and keep even low-grade anxiety at bay.

1. I exercise vigorously at least three times a week.

2. I go for regular walks throughout the day and turn some work meetings into “walking meetings” to encourage more movement in the day.

3. I try to get 8 hours of sleep every night.

4. I make time to socialize with a friend or group of friends regularly to provide a distraction from my anxiety and improve my mood.

5. I listen to music that relaxes me or play a podcast to take my mind off of triggers that have become the source of my anxiety.

6. I take antidepressants every night before bed and have an anti-anxiety medication that my psychiatrist has prescribed me on an as-needed basis. When I feel the symptoms of another panic attack, I can take this medicine to help provide relief.

7. I try to stick to a regular weekly schedule so that I don’t take too much on at one time. The same goes for taking on new commitments (writing assignments, travel opportunities, etc.), I remind myself that I have the freedom to say “no.”

8. I see a therapist. I’ve had EMDR therapy and regular talk therapy.

9. I’ve attended Cognitive Behavioral Therapy (CBT) clinics on how to understand, prevent, and handle anxiety.

10. I practice grounding and breathing techniques learned in therapy as practical tools to fight against an anxiety attack. 5-4-3-2-1 is helpful.

11. Sometimes I need a change of scenery, so I’ll drive to the beach or a favorite lake to embrace new smells and see new sights. Doing this can shift my thoughts and re-ground me. Hearing the ocean waves crashing down and feeling a cool breeze is especially calming and rejuvenating.

12. I take pauses throughout the day to pray to God and reflect on the day, assessing things like my general mood, asking if I slept enough the previous night and try to think of something to look forward to later in the evening or week.

13. I believe the gospel and apply the gospel message to my anxiety. When God invites us to pray to him whenever we are anxious, I remember his promise to give me peace (Philippians 4:4-6).

Unfortunately, even with good treatment and great care, I still battle anxiety.

Like depression, anxiety has become a close friend of mine.

But in Christ, I remember that my mental illness does not define me. My identity is not found in this momentary affliction, but it’s found in him. I might be anxious, I may be depressed, but no matter how I feel today or tomorrow, I take comfort in the fact that “I am not my own but belong, both body and soul, to my faithful savior Jesus Christ.” He will cure my anxiety and depression when he makes all sad things come untrue.