Episodes of extreme anxiety can manifest differently. Many Christian counselors refer to these episodes as panic attacks. While the panic attacks may only be momentary, their effects can last for hours. Panic anxiety disorder is indicative of a longer-term condition, in which the attacks become a consistent, recurring reality.

How to Spot Extreme Anxiety

The most common signals of a severe anxiety attack according to my own observations and the Mayo clinic are as follows:

• Chilled or flushed skin
• Pain in the chest
• Headaches
• Lightheadedness, dizziness
• Feelings of detachment and/or a sense of being outside of reality
• Tingling and/or a feeling of numbness
• Upset stomach, stomach pain, or cramps
• Hot flashes
• Nausea/vomiting
• Hyperventilation/tightness in the throat/Shortness of breath
• Shaking or trembling
• Perspiration
• Rapid heartbeat
• Fear of losing control or death
• A sense of danger, doom or, destruction
• Bodily weakness
• Confusion
• Feeling out of control
• Racing thoughts
• Feelings that give you the sense you are dying
• Intense pain
• Falling sensation
• Tightness
• Feeling like you can run 100 miles per hour
• Inability to focus

Treatment Options for Overcoming Extreme Anxiety

Dr. Archibald Hart lists 12 steps of recovery from a severe anxiety attack:

• Recognize your identity in Christ and remember the promises God has made in Scripture
• Call on the name of Jesus. Recognize your dependence on him and pray for the Spirit to fill you internally and surround you externally.
• Take thoughts of fear captive. God is our mighty fortress, and we need to invite him in to overcome our overwhelming fears.
• Don’t live in the land of “what ifs.” Stay in the land of what is. Remember that, “If God is for us, who can ever be against us?” (Romans 8:31b; NLT).
• Don’t give in to internal passivity or apathy. Do not accept the lie that your anxiety is in control. Instead, acknowledge your lack of control to God. Surrender to him and share your fear and struggle with a Christian counselor. A Christian counselor has training and is prepared to help you work through your anxiety.
• Empower yourself with knowledge. Understanding is your friend. Medications can also be your ally. The more knowledge you have of your own body, the easier you can find solutions. The better you understand the attacks, the better you will be able to articulate your needs to others trying to help you overcome these attacks.
• Refuse to be overcome by despair. Acknowledging the problems and your needs is not weakness, but the gateway to freedom. As you learn more about the issue, you will be able to experience greater liberty.
• Be gentle with yourself. Self-accusation gives the enemy more room. Your illness does not define you and is not your fault. You only have control over how you respond to it.
• While these problems are serious and require attention, remember they do not define you.
• Be cautious and avoid falling into a victim mentality. Take action and remind yourself you are in control. Ask yourself, “What can I do about it?”
• Support is pivotal. Seek out a good, godly support group, who will lift you up and keep you from falling into despair. Isolation only makes anxiety problems worse.
• Never, never, never give up on God, yourself, your supportive family, your friends, or on your church community during a crisis.

Remember these key points when experiencing a severe anxiety attack:

• Don’t run from your fears or symptoms. Running likely will make things worse because it can aggravate your symptoms leading you to either fight, fly, or freeze. These impulsive/reactionary responses may make things worse. Prepare to face the issues head-on.
• Listen to what your body is telling you during an attack. Remember the symptoms will pass, and you will be okay. Don’t give into fear. Instead, notice that the feelings you are having are a sign that something else is going on. Something you can work to resolve.
• Go through the anxiety attack. Don’t resist it. If you go through it and give yourself space to experience it, you won’t magnify the negative psychological and physical results. Breathing/relaxation exercises will help you weather the attack well.

Breathing Techniques to Manage a Severe Anxiety Attack

Two types of prayer and meditation have been essential practices of Christians for nearly two millennia:

First is a type of prayer focusing on concentrative meditation. This practice is rooted in an intentional reflection on an object or thought in order to experience it more deeply. Limiting distraction is the key to this form of prayer and meditation. I, personally, enjoy concentrating on God’s word. By planting it in my heart and thoughts, I am more aware of his purposes throughout my day, week, month, and year.

The second type of meditation/prayer is more cognitive in nature. It includes listening to another’s teaching. Good avenues for this are Christian preaching, seminars, and lectures. In this form of meditation, you listen for God’s truth in someone else’s experiences and teaching. Sometimes, this practice is referred to as the art of mindfulness because it is more a discipline of listening prayer than a petition to God.

There is nothing wrong with Christians practicing breathing exercises to bring about calm and serenity. One of my favorite techniques is to practice breathing exercises while focusing on God’s goodness through prayer.

The ancient texts of Ayuryoga and Ayurveda describe methods of breathing and meditation, which cure many health problems. Much detail is found in ancient science explaining the benefit and practice of such techniques.

Four Ancient Indian Breathing Practices and Techniques

1. Sama Vritti (Equal Breathing Technique)

Sama means equal. Vritti means the state of being. Our bodies are used to shallow breaths. By practicing equal breathing you can calm yourself, increase your focus, and reduce stress and anxiety.

Method: This technique is a great place to start when it comes to breathing exercises. It only takes a deep breath to rejuvenate your body and spirit. To begin the sama vritti, inhale for a count of four and then exhale for a count of four. As you adjust to this practice aim for longer breaths, ideal six to eight counts per breath

Tips: Breathe through your nose. It adds natural resistance and is a basis of pranayama breathing.

When: The beauty of Sama vritti is it can be done anywhere, at any time. It is particularly effective at helping you quell seemingly uncontrollable thoughts. In other words, if things feel out of control, stop and breathe. It will help slow your racing thoughts and concentrate on what is happening around you.

2. Nadi Shodhana (Alternate Nostril Breathing)

This breathing technique, also known as the silent breathing technique, unites and balances the left and right hemispheres of your brain. This is another good practice for beginners, often recommend during pregnancy. It can help you relax and improve blood circulation.

Method: Begin in a seated position. Cover your right nostril with your right thumb and inhale deeply through your open nostril. At the peak of inhalation, pause to close off the left nostril with your ring finger, then exhale through the right nostril. Continue this pattern of inhaling through the right nostril then exhaling through the left.

Tips: The pacing of your breathing is key to this practice. Breath slowly, concentrating on the coldness of your inhalation and the warmth of your exhale.

When: The Nadi shodhana is effective at restoring focus when you struggle to do so. Try it before a meeting in the afternoon when you feel distracted. Nadi shodhana is said to “clear the channels and meridians in our body and make people feel more relaxed if done with control. At a slower pace, this is a great sleep inducer.” It may be a helpful practice to incorporate into your nightly routine.

3. Sohum Meditation (Abdominal Breathing / Ocean Wave)

This practice is reminiscent of an ocean wave. Anyone can do it. You just have to imagine a wave hitting the shore, and the tide drawing it back out to sea.

Method: Place one hand on your chest and the other on your belly. Breathe deeply, through the nose, inflating the diaphragm to stretch out the lungs. Take 2–3 seconds pause between inhalation and exhalation.

Tips: This is particularly helpful for pregnant women who are nurturing a growing little one because it provides ample oxygen and detoxes your whole body.

Doing 8-10 reps of slow, deep breaths for five minutes a day will help lower blood pressure and release tension. It is also a good way to improve your lung capacity, digestion, and regulate the rhythm of your heart.

When: Try this practice before any circumstances that cause you stress. Though it takes some time, learning to control your breath will come with practice.

4. Anuloma Viloma (Intermediate Level Of Nadi Shodhana)

Very similar to the alternate nostril technique, the anuloma viloma has a slight twist. Instead of steady breathing, the air is forced in. So rather than slow, controlled breathing, your breathing should be loud and more intense. Some ancient texts report this practice heals many forms of internal disease and many people experience a lot of health benefits when it is practiced regularly.

Method: Begin by sitting in a comfortable position. Blow your nose in advance to remove any mucus. Close your right nostril with your thumb with your elbow in line with your right shoulder, parallel to the floor. To begin, start seated comfortably. Now, inhale and force air through your left nostril. Then close your left nostril and exhale from your right nostril, followed by another inhale.

Tips: It is a great way to start your day, but be careful because it can make you feel lightheaded if you aren’t experienced.

When: The Anuloma viloma is best practiced on an empty stomach, early in the morning or mid-afternoon. It will give you a boost of energy to either start or get you through your day.

Breathing exercises have been shown to effectively treat anxiety attacks. While they can be used during an attack, they are also recommended as preventative care. It is also very easy to integrate Christian prayer and meditation into these practices in order to make them even more life-giving. God is always speaking, we just need to make space to listen, even when we feel overwhelmed.

If anxiety attacks are a recurring problem for you, reach out to a professional Christian Counselor. Severe, frequent symptoms may be best treated by a psychiatrist, but a Christian counselor would also be very helpful on your road to wholeness and healing.