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A panic attack can be one of the scariest moments of your life. Your heart starts racing. You begin to sweat. You may feel hot... or cold. The room begins to spin, and you feel that you're losing control. You were fine a minute ago and now you feel like something is wrong, you feel panic and fear set in. If you’ve experienced this before you know you’re having a panic attack, but you wonder why it still feels this scary. If you don’t know what a panic attack is and you’re feeling this way, it can be terrifying, you may even think that you’re having a heart attack and that death is imminent. Fortunately it’s not a heart attack, and you’re not going to die. You can learn to recognize that you’re having a panic attack and  use several strategies to help you better manage the symptoms.

Panic attacks represent an overdrive of your body’s fight or flight response kicking in. While situations like being chased by a lion are rare in modern life, your body is still wired to respond with this fight or flight system, even when the precipitating event is far from life threatening. 

There are several physical symptoms associated with this response, many of which are shared with other health conditions, like a heart attack. Many of the strategies listed later on help target these physical symptoms

Racing heart or feeling that your heart is going to burst

If you’ve had panic attacks before, here are 5 tips to help you make it through them and get back to your life. 

The most important thing to know about panic attacks are not deadly and that they the symptoms will get better with time. Symptoms usually come on fast and tend to peak within around 10 minutes, but when you're in the middle of one, it can feel a lot longer. Just being aware of these facts can be extremely reassuring. When our mind can’t explain something, it can turn to the worst case scenario (“I must be dying”). Knowing that panic attacks will not kill you and that they’ll be over soon can help empower you to follow the below steps and help reduce your panic symptoms. 

This sounds cliché, but it actually works. The intense fear that you experience during a panic attack causes you to take quick shallow breaths causing you to hyperventilate. This can leave you feeling dizzy, lightheaded, and make it feel like your heart is racing. If you feel a panic attack coming on, or are in the middle of one, deep breathing can help.

One form of deep breathing you can try is called box breathing or square breathing. It's super simple, making it easy to remember when you are in the midst of a panic attack.

Deep breathing helps by forcing you to slow your breath which can also help reduce or eliminate other symptoms. It also helps by giving you something to focus on. Close your eyes and picture a calming scene or even just the numbers as you count them.

If you're in a busy place or one with a lot of stimuli, try to find a quiet place to go. Stepping away from bright lights, lots of sounds, and other people can help you to focus on your breathing and calm down. It will also allow you to focus on yourself without having to deal with people asking you questions like, "Are you OK?"

If you aren't able to change where you are, try closing your eyes. If you have headphones that you can put in with some calm music, give that a try. Doing this will help you to shut out the world around you and focus on slowing things down for yourself.

Mindfulness is more than just a popular buzzword showing up all around social media, it can play an important role in helping you feel better and less anxious. Several types of therapy even use mindfulness as a core component of treatment (such as some forms of CBT). 

If you're having a panic attack, it can help keep you grounded. To practice mindfulness, focus on the present moment and what your senses are taking in. What can you see? What can you hear? Are there any smells that you notice? What can you feel?

Don't try to pretend that you aren't experiencing feelings of fear or panic. Simply allow them to be: don't fight them, and don't judge them. This is a skill that therapy can help you develop. There are also mindfulness apps that you can try. A few popular ones include:

If you struggle with panic attacks, don’t be afraid to reach out for help. This can be as simple as discussing your struggles with a trusted friend. At Mantra, we believe in a comprehensive approach to mental health challenges like anxiety. Meditation can be combined with the gold-standard therapy (CBT) to manage panic disorder. If those don’t work, medication can help reduce your symptoms and get you back to your life. This will help you overcome your struggles with anxiety and panic, and let you get back to accomplishing your personal and professional goals.

What to do when you are having a panic attack

If you're reading this, you probably fall into one of two groups. You’re either wondering how to find a therapist for the very first time or you've already met with one and were left disappointed with how it went. You’re not alone: it can be difficult to know if the person you’re considering will be right for you. 

Still, it’s very important: research shows that the #1 most important predictor of a therapy working well is that the patient (you) feels that the therapist understands you and that you’re working towards the same goals. We call this the therapeutic alliance. Finding someone you can trust and can share personal details about your life, including thoughts, feelings, and struggles, can be a life-changing experience that provides dividends in the future. 

There are well over 100,000 licensed therapists to choose from in the United States, and the Bureau of Labor Statistics expects that number to continue growing in the years to come. But how do you know if the person is right for you? You don’t have to settle for anything less than a stellar therapist – these practical tips will help you find the right one.

1. Find out who they are and their area of expertise

One of the first things you should look for when choosing a therapist is someone with experience in the challenges you’d like to focus on. Depending on what your goals are, the type of therapy you need will likely be different. For example, Cognitive Behavioral Therapy (CBT) is an effective treatment for anxiety and also benefits those with ADHD. A therapist who has treated many people ADHD may l recognize that you need help with behavioral management techniques, such as learning time management skills. So if you have anxiety or ADHD, consider looking up therapists who are trained in CBT. 

Take time to check out their website. Does the writing style sound like someone you’d want to hear from in person? If so, that's a good sign. When you talk to them for the first time, ask them about their experience. Hearing them share their experience will give you a sense of what it might be like in the room. Remember to take online reviews with a grain of salt. Sometimes disgruntled former patients are the most likely to leave a review, resulting in skewed results. Still, a common theme in reviews may tip you off to how others have experienced this therapist. 

The bottom line here is that you NEED a therapist that will be available to work within basic parameters that work for you. A booked schedule may be a sign of a great therapist, but consider whether you can honestly wait for up to 6 weeks for an appointment. Cost and location matter too. If the visits are way out of your price range or way out of your way, it may not be a realistic choice for you. Ask what their availability will be like once you establish care and what types of contact they work with. If they don’t accept text or email contact at all, consider whether that will work for you. 

Now that you’ve found someone with the right expertise and availability to see you, you may be asking what separates a good from a great therapist. A great therapist will make you feel comfortable and feel like you can trust them. You may not feel like you can reveal your most personal details right away, but you should feel like you can talk to this person openly and that there is potential to continue to build on that initial trust. Great therapists create a non-judgmental atmosphere where you feel safe and heard. This is the foundation for a productive therapeutic relationship (Cabaniss et al, 2016), which will create optimism and an environment where you can work collaboratively to set clear goals and make the positive changes you want in your life. Trust your gut: you know what it feels like when you're with someone who makes you comfortable. 

No one is perfect, and that applies to therapists too. Invariably, at some point your therapist will say or do something that you find off-putting. In this situation, the key is to try to bring it up in an honest way and see if you can sort it out together. Discussing conflicts with your therapist will teach you something about yourself, and it may ultimately result in a stronger sense of trust as well. 

That said, not every therapeutic relationship can or should be repaired, which brings us to our last tip…

4. Don’t be afraid to switch therapists

You may need to give a therapist a couple of meetings before you are clear about how it feels to be in the room with them. If you have a bad feeling based on more than one visit, and you aren’t able to sort it out with them, it may be time to find a different therapist. You don't have to keep meeting with someone that you don't vibe with. Don't be afraid to ask them for a referral or find another one. A good therapist will try to refer you to someone else who can help. You'll know when you find the right therapist for you.

Therapy works – use these tips to find the right therapist for you and set yourself up for success. The journey is worth the ultimate results. 

Do you struggle with maintaining your focus? Dealing with ADHD as an adult can bring on a whole new set of challenges. For example, if you struggle with focus and concentration, getting through a full workday can be difficult. Research of adults in a simulated work environment shows that adults with ADHD struggle with concentration and hyperactivity when working. However, when they finish their work, they complete tasks just as well as adults without ADHD.  

This may be something you can relate with - you know you can get the job done, but you struggle to stay focused throughout the process. This can cost you both time and money. Here are our tips for improving focus, so you can show your best work (and your best self) on the job. 

Keep your priorities and goals in front of you. Take time to make lists of goals for your life, career, or even simply for the next week or day. Write them out in order of importance. This will help you prioritize and focus on the most important tasks. You should also put your list somewhere where you will see it often. This way you’ll be more likely to finish important pending tasks. Reviewing the list at the beginning and the end of the day to hold yourself accountable. 

Now that you know what you must get done, the next step is to work on when you want to get things done by setting frequent deadlines. Deadlines can help your focus by giving you a little extra pressure that can boost your productivity. If you find yourself struggling to complete tasks, those tasks may be too big or too broadly defined. Try breaking them up into smaller, easier-to-accomplish tasks. An MIT study found that deadlines improved both the time that individuals spent on the task as well as their performance. It also found that evenly spaced deadlines were most helpful.

When living with ADHD it's easy to get distracted from what you're doing. The more organized you are, the easier it will be to stay focused. Here are a few more tips to help you stay organized:

Live by the rule "a place for everything and everything in its place.” This way you don't waste time having to look for things you need or figuring out where to put them. A classic example is to always put your wallet, keys, and phone in the same place when you get home, and keep them in the same place in the car or office. 

Compile all appointments into one calendar. Keeping everything in one place will help you to stay on top of the tasks you need to be on top of and any appointments/commitments that you have. 

Go paperless and try using an organization app like Evernote. You can create online notebooks and notes for the different areas of your life. Everything is searchable, making it very easy to find what you need. 

How many times do you suddenly realize that you have been mindlessly scrolling on Instagram or Reddit for the last 20 minutes? If something like this happens to you, here are a few tools that may be useful depending on which device you’re using:

“App Limit” on iPhone (Settings > Screen Time)

Setting your phone to “do not disturb” mode

Are your emails pinging on your computer (or phone) non-stop and distracting you constantly? Schedule email downloads for 3 set times a day. Deal with your emails at that time and move on. You’ll find that you’ll be less distracted and more productive.

Work in a loud office? Are your workers gossiping non-stop in the next cubicle over? Buy yourself noise-canceling headphones and wear them without listening to music. This will give you much-needed quiet and make your colleagues less likely to interrupt you (if music works for you, by all means go ahead).

If you are struggling to stay focused and avoid distractions during meetings, conferences, or even conversations, try taking notes on paper, not digitally. A Harvard study found that students that took notes on paper tested better than those that took notes on a laptop. You can always add these notes to your digital note taking app later.

Two of the most important areas of self-care to target that can make a quick impact on your ability to focus are sleep and exercise. 

Insomnia (difficulty sleeping) affects up to a third of the adult population and affects two thirds of people with ADHD. Getting enough sleep and feeling rested is important for you to be able to focus during the day. It’s important to make sure you are going to sleep early enough that you can achieve 7-8 hours of sleep each night. 

You might have heard that exercise is good for helping boost your mood, but did you know that it can help your ability to focus and recall information as well? There have been many studies completed that show that physical exercise can improve cognitive functions including those such as attention and memory. So, whether it's a short run, strength training session, yoga, or a 1-hour walk, get exercise on your schedule. It will help clear your mind and release endorphins that can improve your mood and help keep you focused. Most jobs are fairly sedentary. If this is the case with your job, make sure to get up and move around a little for every 2 hours that you are sitting.  

Making a lot of changes at once can be overwhelming (and even counterproductive). We recommend starting with one change discussed in this article and try that for a week. Once it’s a seamless part of your daily routine, try adding another skill. If you are continuing to struggle after making changes, don't be afraid to reach out for help from a therapist or wellness coach. 

Prescription medications do work for anxiety symptoms, but they aren't the answer for everyone. Some people don’t like the idea of taking medications or want to try more other reasonable alternatives first. Finally, some people have had partial benefit from medications and are looking for other options to keep feeling better. Here we outline some of the best non-medication options for anxiety. 

CBT, or Cognitive Behavioral Therapy, is one of the most effective treatments for anxiety. The basic idea is to identify the thoughts, feelings, and behaviors that result in cycles of anxiety in order to develop skills aimed at interrupting this cycle. CBT teaches you to gain control of anxiety by identifying negative thought patterns. Then, your therapist teaches you to change behavior and develop new coping skills. There is evidence that Computer-Based CBT (cCBT) is effective in treating anxiety, but extensive studies have not yet been done to see if the results are the same as face-to-face therapy. That said, if you don't have access to face-to-face sessions, it may be worth trying. 


CBT isn't the only form of therapy that can help anxiety. Other options include Psychodynamic therapy and Acceptance and Commitment Therapy (ACT). 

Some herbs and supplements have been found to have positive effects on reducing anxiety. These generally come with less risk of serious side effects, but it's important to remember that even natural forms of treatment can have side effects. One study found that Omega-3 Fatty Acids were able to reduce anxiety symptoms by 20 percent. Other supplements and herbs that could be helpful include:

Supplements like Zinc, B6, B12, and Vitamins A, C, E, and D 

Some of the most popular alternative treatments for anxiety are below. 

Aromatherapy is healing treatments through the use of essential oils. Oils are extracted from natural plants. Then you can use them by inhaling them using diffusers, inhalers, or spritzers. You can also apply them on your skin through oils or creams. 

Studies have found that aromatherapy can help to lower anxiety levels. One study found that the use of aromatherapy decreased anxiety in patients before operations. Some oils found to be effective include bergamot, clary sage, lavender, sweet orange, ylang ylang, and rose.  


Mindfulness is when your mind fully engages with what's happening in the present. When you practice mindfulness, you don't pass judgment on your feelings. Instead, you observe them. 

One study that reviewed 47 trials with over 3,500 participants found that mindfulness medication provided moderate levels of improvement in anxiety. Results persisted beyond 8 weeks, demonstrating some durability in the effect. 

Some forms of therapy, including MBCT (Mindfulness-Based Cognitive Therapy) and ACT, include learning the practice of mindfulness. But you can also learn how to practice mindfulness meditation on your own. If you're interested in learning how, there are plenty of apps. One example is Stop, Breathe & Think. 



Having good self-care habits can improve your mental health and reduce your anxiety. This includes habits like:

All these things can help you to lower your stress and anxiety levels and boost your mood.


Journaling can be an effective addition to your treatment for anxiety. It allows you to track your symptoms and feelings as well as spot patterns in your life. Generating a personal narrative is a key component to many psychotherapies, so it makes sense that journaling might provide benefits in terms of personal growth. Finally, you can also use journals to track your homework and progress from CBT sessions with your therapist. 


Finding the right treatment for anxiety for you

Every situation is unique. The above options may help you improve and manage your anxiety alone, or they may represent a complement to other parts of your treatment. If you're on prescription medicine, these other treatments can still be beneficial. If you’ve tried these methods and remain with persistent, distressing worry or anxiety, it may be time to try medications. Often, medications can help turn the volume of anxiety down so that it becomes easier to practice mindfulness or participate in therapy. 

The most popular non-medication treatments for anxiety

When you think of ADHD, you may you have to take prescription medications to improve your ability to focus and function each day. It’s true that many people find relief from ADHD symptoms that way. But what if you want to avoid medications? There is evidence that alternative ADHD treatments may be beneficial for you. Here we highlight the top 5 supplements with solid evidence to help ADHD. 

When it comes to alternative ADHD treatments through supplements, Omega 3s have the strongest evidence base for showing symptom improvement. Research has found that they can help improve symptoms of, "hyperactivity, impulsivity, attention, visual learning, word reading, and working/short-term memory." 

You can find Omega-3 Fatty Acids naturally in some foods. This includes things like fish, seaweed, chia seeds, hemp seeds, flaxseeds, walnuts, edamame, kidney beans, and soybean oil. 

Most people get the Omega-3s that they need from the food they eat. However, there's a lot of promising research showing that with the correct ratio of Omega-3 and Omega-6 fatty acids, ADHD symptoms can be reduced.

A common symptom of adults with ADHD is difficulty with sleeping, which makes sense because the symptoms don't go away at night. You may struggle with falling asleep, restless sleep, staying asleep through the night, or waking up in the morning. No matter what, we know that poor sleep leads to exhaustion and lower executive functioning the next day. 

Your body naturally produces melatonin from the pineal gland. This helps to control your sleep-wake cycle. If things are working as they should, your body would create higher levels of melatonin at night to help you sleep. However, you can also take melatonin as a supplement to promote positive and natural sleep cycles. 

Melatonin increases naturally around sunset, telling your body that bedtime is coming in the next few hours. Taking 5-6mg of over-the-counter melatonin around 8-9pm (assuming you aim to sleep around 11pm-12am) has been shown to improve sleep quality and duration. Please remember melatonin can cause you to feel a little sleepy, so it’s best to avoid driving after taking it. Research has found that taking melatonin as a supplement can help you to fall asleep faster and stay asleep better overnight. This should also help you to wake up feeling more rested and ready to tackle the day in the morning. 

“Worth a shot:” Supplements with moderate evidence for ADHD

These supplements can be helpful in ADHD patients, especially if they naturally have lower levels of these nutrients in their bodies.

It's rare for people living in the United States to be deficient in Zinc. However, it is possible if you have a poor diet or eat a vegetarian diet. Studies in children have found that those that had strong symptoms of ADHD tended to have lower levels of Zinc. Some research has shown there could be a positive connection between taking a Zinc supplement and experiencing a reduction in hyperactivity and impulsivity. 

Similar to Zinc, research has shown that Iron supplements could be beneficial for you if you have naturally lower levels. Based on the research, those with ADHD have a higher likelihood of having low serum iron and ferritin levels. Increasing the levels in the body could help to alleviate your symptoms of hyperactivity, inattention, and impulsivity. That said, there is such a thing as “too much iron.” If you are thinking to take iron supplements, we recommend you get your levels checked by a doctor both before and after so that you can measure the improvement and ensure you’re iron levels don’t become too high. 

Ginseng has also been reported to improve cognitive function in those with ADHD. It's believed that the supplement helps by targeting hyperactivity and inattention. 

Balancing ADHD function improvement with reduction of symptoms

The alternative ADHD treatments discussed above can help you experience improvement in symptoms. You may find that your ability to focus is improved. However, this does not necessarily mean that you'll have an improvement in functioning as well.

This is why it's important to focus on using a combination of treatments. Learning time management skills or putting organizational systems in place can help you improve your executive functioning. and experience results that you won't find with medication or alternative supplements alone. See our blog with ADHD expert Dr. Ramsay to learn more. 

In this new edition of our expert interviews, we are welcoming Dr. John Russell Ramsay, PhD, associate professor of clinical psychology at the Perelman School of Medicine at the University of Pennsylvania, Co-director and Co-founder of Penn’s Adult ADHD Treatment and Research Program, and an advisor to Mantra Health.

I am with Dr. Russell Ramsay,. Dr. Ramsay, you wrote a book on non-medication treatments for Adult ADHD. How do you conceptualize ADHD as a disorder?

It is often not thought of this way, but ADHD itself is not a knowledge problem but rather a performance or implementation problem – recurring difficulties organizing and following through on tasks and goals despite knowing what needs to be done.

It’s my understanding that medications are highly effective for treating the symptoms of ADHD, including for adults. Don’t these medications usually treat these problems? 

Yes. Medications are very effective with symptom reduction, and for many adults these improvements set the stage for improved functioning. However, symptom reduction alone does not necessarily translate into improved time management, organization, or being less prone to procrastination. ADHD coping skills are not in the pills, as the saying goes.

So then, what are the new developments that may address these coping issues?

The psychosocial treatment of adult ADHD, specifically cognitive-behavior therapy or CBT, is well-established as an evidence-based treatment. CBT adapted to adult ADHD is designed to foster the development of coping strategies for managing ADHD that will most definitely improve functioning. There are no trade secrets about what works, but the central focus is on the implementation of these skills.

A recent study examined a course of group-administered CBT that was provided to two groups of adults with ADHD: one group was on a stable regimen of ADHD medications; the other group was not medicated. At the end of the 12-week group treatment, the CBT plus medication group improved at a significantly higher rate than the unmedicated group - no surprise there. But, during the 6-month follow up phase after treatment ended, the CBT + coaching group continued to improve and caught up to the CBT plus medication group in terms of improvements.

What do these results mean for adults with ADHD in their daily lives?

First, medications + CBT from the outset can provide improvements at a faster rate, but the skill-focused CBT for adult ADHD can also lead to improvements over time, which extend beyond treatment, which is important because ADHD requires ongoing efforts to manage. The take home message is that improving concentration with daily medications is great, but making changes to your time management or organizational system can improve your executive functioning over the long-term. 

Second, a unique feature of this particular CBT approach was that weekly group meetings were augmented with twice weekly, between-session phone contacts with a “coach” for about 10-15 minutes each to review any coping difficulties and help participants stay on track with their goals. This coaching feature was rated by participants as very helpful. If adopted elsewhere, this added step may improve outcomes for adults with ADHD. This is also consistent with the Mantra approach for integrating care and fostering follow through on patients’ behavioral health and overall wellness goals in daily life.

Dr. Ramsay, thank you for sharing this useful update. 

The Latest on ADHD coaching from Mantra Expert John Russell Ramsay, PhD

Parked Thoughts

Attention-grabbing articles, backed by research.

What to do when you are having a panic attack

How to find the right therapist for you

Top 5 Ways to Help You Increase Focus

The most popular non-medication treatments for anxiety

5 Supplements Proven to help ADHD

The Latest on ADHD coaching from Mantra Expert John Russell Ramsay, PhD