How to Deal with Panic Attacks While in School

Our body's fight-or-flight response prepares us to handle dangerous situations by releasing chemicals into the bloodstream. This response is natural and helps us survive. The emotional and physical ways you react during fight-or-flight can be described as panic.^{[1]XResearch source} If you are an adolescent or teen with panic disorder, you may experience panic when you are not actually facing any immediate threat. We can't always control these panic attacks quickly or completely, but you can learn how to calm yourself and seek help while in school.

Part 1

Part 1 of 4:

Being Proactive

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1
Alert your teachers beforehand. In order to minimize any disruption during a class, tell your teachers that you have anxiety and tend to have panic attacks. Explain that some days you may need to go to the nurse or school counselor, or may need to get out of the room for a few minutes.
- Most teachers will quickly agree with doing anything they can to help you cope with a panic attack that occurs during the school day. However, it may be necessary to have your parents meet with or call the teacher to discuss this issue or bring in a signed note from your doctor.
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Map out a plan.^{[2]XResearch source} Once you give your teachers the heads up that you may experience a panic attack in their class, come up with a way to excuse yourself for a time-out without being disruptive. This allows you to leave the environment so you can practice calming techniques, but it also allows the teachers to continue working with the other students.
- Talk it over with each teacher to see what's the most appropriate way for excusing yourself. You might simply make eye contact with the teacher and point towards the door. You may ask "Sir, please can I go to the bathroom ?".
- Work with your teachers, school administrators, and school counselors to determine the best course of action. You may be able to take a seat near the door to avoid disrupting the class when you have to leave to deal with panic.
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Decide where you will go when panic strikes. How you cope with panic attacks during school will depend on the resources available to you. For example, you may be able to take a time-out in the school nurse or counselor’s office. Since many teens deal with anxiety and panic, these professionals will know what to do to help you calm down.^{[3]XResearch source}
- If it is not possible for you to visit the school nurse or counselor, you might discuss with your teachers or principal whether you can go into a restroom or walk outside for some fresh air for a few minutes.
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Have medication available, if necessary. If you find that many of your school classes and activities are constantly being missed or interrupted due to panic, you may require medications. With severe or seemingly uncontrollable instances of panic it may be helpful to take medications before or during the school day to reduce symptoms.
- Discuss the possibility of medications with your doctor to see if this is a good choice for you. Medications used for panic attacks include antidepressants, which must be taken for longer periods in order to experience any benefits, and benzodiazepines (or anti-anxiety meds), which can be taken during a panic attack to alleviate symptoms within 30 minutes to an hour.^{[4]XTrustworthy SourceHelpGuideNonprofit organization dedicated to providing free, evidence-based mental health and wellness resources.Go to source}
- Remember, medications alone will not get to the root of panic disorder. Most doctors advise a combination of medication, therapy, and lifestyle changes for best results. Also, keep in mind, that benzodiazepines can be highly addictive and they may affect your ability to drive safely, so use these meds with extreme caution.^{[5]XTrustworthy SourcePubMed CentralJournal archive from the U.S. National Institutes of HealthGo to source}

Part 2

Part 2 of 4:

Getting Through an Attack

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If you are having a panic attack in a crowded hallway or class, calmly, but quickly, give your teacher the cue and then make your way to the nurse's or counselor's office or the restroom.
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Practice deep breathing. When your body is experiencing panic your heart starts beating rapidly, you may feel a pain in your chest, your hands may shake, you may feel short of breath and you may start sweating among other signs.^{[6]XTrustworthy SourceHelpGuideNonprofit organization dedicated to providing free, evidence-based mental health and wellness resources.Go to source} Getting control of your breathing can help you to calm down and reduce panic.
- Sit on a chair, the closed lid of a toilet, or on the floor with your back up against the wall. Place one hand on your chest and one on your belly. Take slow, controlled breaths in through your nose and out through your mouth.
- As you inhale the hand on your belly should expand, and it will collapse with each exhale. The hand on your chest should move only a little.
- Breathe in while you count to four, hold your breath for a few seconds, and then release the air as you count down from four. Keep repeating the cycle of inhaling and exhaling until you start to feel calmer.
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Distract yourself from the panic. Sometimes, you can control feelings of panic with distraction techniques. These strategies allow you to take your mind off of panic until the symptoms subside. A few distraction techniques you can try to relax include:^{[7]XResearch source}
- Counting. You can count square tiles on the bathroom wall. You can try counting backwards from 100, or work out the multiplication table in your head (e.g. 1x1=1, 1x2=2, and so on).
- Reciting. You can make up or recite the words to a poem, or go over the lyrics to a favorite song in your head.
- Visualizing. Use your mind and your senses to picture a place that makes you feel safe. This place can be a cabin on a lake, grandma's house, or an exotic waterfall. Call to your mind different sensations about the place. How does it sound there? What does it look like? What smells are associated with this place?
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Talk yourself through it. When you are feeling panicky, it's common to expect the worst. You can help yourself to overcome negative thinking and minimize your anxiety by thinking positive thoughts. Remind yourself that you always survive these attacks. Repeat a mantra aloud or in your head to positively counteract the thoughts and feelings of dread you experience during an attack.^{[8]XResearch source}
- "I am the picture of calm."
- "This will pass."
- "In a few moments, I will be just fine."
- "I am in control."
- "Anxiety can't hurt me."
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Get help if the anxiety continues. Ask a nurse or teacher to guide you through this experience if the attack is severe. If you wish, they may even let you contact your parents.
- You can say something like, “I am having a severe panic attack and my calming strategies are not working. Can you please help me calm down?”
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Continue your school day when it's over. Adolescents and teens who have panic disorder may miss lots of time from class or get behind on assignments. Having to leave the classroom environment to calm down can interfere with your schoolwork and make you even more anxious.^{[9]XResearch source}
- Try to get back to class once you're feeling like yourself again. Be sure to follow up with your teachers to see what you missed during your absence.
- As you become more capable of handling your anxiety at school, you may be able to do a number of these coping techniques while sitting in your desk. That way you don't have to worry about leaving class or missing too much of the lectures.

Part 3

Part 3 of 4:

Coping After a Panic Attack

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1
Communicate with parents and teachers.^{[10]XResearch source} Anxiety felt at school can stem from a variety of factors, including problems at home, high expectations to achieve, relationship or friendship issues, or trouble concentrating or focusing in the classroom environment. Students with panic disorder can easily fall behind other students because they may have to leave the classroom environment or miss school more than other students.
- You should make an extra effort to keep your parents and teachers in the loop of what's going on with you. If you feel like your workload is too stressful or unreasonable, think about dropping a course or an extracurricular activity.
- If your parents often pressure you to be high-achieving, speak with your school counselor about some ways you may discuss this issue with them. She may be able to help you find ways to talk to your parents and feel less pressure about their expectations of you.
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Speak out against bullying. Bullying can negatively affect those who are bullied, those who bully, and those who witness bullying.^{[11]XTrustworthy SourceStopBullying.govWebsite run by the U.S. Department of Health and Human Services providing information related to identifying and preventing bullyingGo to source} Kids who are bullied may experience symptoms of depression and anxiety, which means that instances of bullying could be the source of your panic at school.^{[12]XResearch source} Take a stand against bullies at school by:^{[13]XTrustworthy SourceStopBullying.govWebsite run by the U.S. Department of Health and Human Services providing information related to identifying and preventing bullyingGo to source}
- Raise your chin and make eye contact with the student who is bullying you. Tell the student in a calm, even voice to leave you alone. You can also choose to ignore the bully.
- If speaking up for yourself or ignoring the bully does not work, don't keep bullying to yourself. Tell someone as soon as possible. Tell a teacher, parent, older sibling, or school counselor about what is going on.
- You may also want to avoid the places at school where bullies gather.
3
Develop time management skills. The older you get, the more responsibilities you have in both school and at home. If you are not managing your time well, you could be putting yourself at risk for even greater anxiety. Here are some tips for better time management:^{[14]XResearch source}
- Break bigger projects down into smaller tasks, like dividing a book report down to reading the book, then reviewing the book and taking notes, then writing an outline, then a first draft, then editing and proofreading for a final draft.
- Make a list of what you need to get done and cross off as you go.
- Decide how much time you need to complete a task, set a timer and move on to a new task once the time has elapsed.
- Assess your weekly schedule to see if you have a balance between school, extracurriculars, and home life that makes sense to you.
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Make lifestyle changes. You may not see the connection, but your lifestyle habits can influence your anxiety. Making some small changes in the way you live can help you to reduce anxiety and live an overall healthier life. Lifestyle changes that may help prevent or minimize panic attacks include:^{[15]XResearch source}
- Exercise. Engage in regular physical activity to elevate your mood, such as walking, yoga, boxing, or any activity that gets your body moving.
- Diet. Eat a healthy, balanced diet of vegetables, fruits, lean protein, whole grains, and low-fat dairy. Avoid caffeine and alcohol as they may worsen symptoms.
- Sleep. On average, sleep 7 to 9 hours each night. Shut off electronic devices at least an hour before bed and try to go to sleep and wake up around the same time each day.
- Stress-management. Find relaxing activities to help you cope with stress and anxiety before they lead to panic. Call a friend. Take a warm bath. Go for a run or walk your dog around the block.
^{[16]XResearch source} The counselor at your school probably has a host of tips for helping you manage your anxiety. Check in with her regularly, if only for a brief chat or update. Teachers or other students may not have a good understanding of what you are experiencing, but a counselor can be a great source of support.

Part 4

Part 4 of 4:

Managing Panic Attacks While Away at College

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1
Take advantage of resources at your university. Most universities offer free counseling services to students, as well as basic medical services. You may even be able to find or start a support group for students with panic disorder.^{[17]XResearch source} Find out what resources your university has to offer that may provide you with some support while you are away from home.^{[18]XResearch source}
- Working with a counselor can help you to develop better ways to manage your anxiety and to get through panic attacks. Make an appointment at your university's counseling center as soon as possible.
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Talk to your professors. Unlike high school, in college it is not usually necessary to ask to leave class to go to the bathroom or to do something else. However, you may miss important points by leaving class to deal with a panic attack, or your professor may find it disruptive if you get up in the middle of a lecture and hurry to the door. That is why it is important to tell your professors about your condition and work out a plan to excuse yourself from class if needed.
- For example, you might meet with your professor after class and say something like, “I have a panic disorder, so sometimes I may need to leave class suddenly to calm myself down. I wanted to talk to you about ways that I can minimize disruptions if this happens during one of your classes. What do you suggest?”
- Make sure that you consider the class size and available exits. For example, your professor might suggest that you sit near the door in a small class or at the back of the lecture hall in a large class.
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Surround yourself with supportive people. If you find that certain classmates or friends intensify your anxiety, then try not to spend too much time with these people. Instead, try to spend time with people who have a calming presence. ^{[19]XResearch source}
- For example, people who have bad study habits (staying up all night before an exam, writing papers the day they are due, etc.) are likely to be anxious and panicky themselves. You should also avoid people who have poor stress management skills and who use drugs, alcohol, or other means to deal with stress.
- Try to spend more time with people who have good study habits and who practice healthy stress management techniques. For example, gravitate towards people who plan ahead for assignments, ask questions in class, and who manage stress in healthy ways, such as exercising and meditating.
- Consider joining a club to meet people who share your interests and passions. A club can be a great way to build your social connections and enjoy yourself outside of class, which may reduce your anxiety.^{[20]XResearch source}
4
Get organized. To reduce anxiety, take some extra time to get organized and plan ahead for stressful situations. Getting your books, notes, laptop, and other class materials ready ahead of time may help you to feel less anxious and reduce the chances of a panic attack.
- Keep track of important due dates and other deadlines in a planner. For example, as soon as you find out when a paper is due for a class, write down the due date in your planner along with any special details about the assignment that you need to remember.
- For example, if you have an exam coming up, then take about 10 minutes the night before the test to put everything that you will need into your backpack. Then, write the time and place of the exam in your planner or even on a piece of scrap paper as a reminder.^{[21]XResearch source}
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Take detailed notes during lectures. Taking notes can help you to stay focused on what your professor is saying and reduce the chance that you will start dwelling on thoughts that may lead to a panic attack. Make sure that you always have a pen and paper in front of you when you attend your classes and write down as much information as you can during class.^{[22]XResearch source}
- If you are having a hard time figuring out what kind of notes to write, then drawing in your notebook during the lecture may also help you to stay focused on something other than anxious thoughts.
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Take study breaks. It is important to avoid pulling all-nighters and cramming for exams, because this can increase your anxiety levels. Instead, try to study a little bit every day and take a break if you have been studying for a while. When you are studying, give yourself a short 10 to 15 minute break once every two hours. During your break you can:^{[23]XResearch source}
- call a friend or family member
- go outside for a quick walk
- eat a snack
- check your social media accounts
- watch some videos on the internet