I was 25 years old when I scored my dream job—working as an editor on the outskirts of Washington, D.C. After growing up in California, I fell head-over-heels in love with the East Coast and decided to start putting down some roots. Until I landed in the ER at 3:00 a.m. one morning with what I thought was a heart attack.

I hadn’t slept in three days, and my heart was racing, burning, palpitating. Even when I lay motionless in bed, I felt like I was running a marathon. I gasped for breath. I was exhausted.

Docs ran multiple tests and X-rays, but in the absence of anything conclusive they sent me on my way: “This can happen to people with long-and-thin frames like yours.” I left the ER that day with no idea how to slow my body long enough to get a few hours of sleep. Soon I had to quit my job and fly home to California.

That was a dark season of my life, to be sure. And it was the beginning of a new reality for me. Eventually my “heart-attack–insomnia” bouts were diagnosed as panic attacks, and for the past 16 years they have dotted the landscape of my life.

Grief and grace

Panic attacks have been a source of both grief and grace. Grief, because they are terrifying, painful, disorienting and exhausting. Grace, because through them God has humbled my proud heart and taught me to trust in myself less and trust in him more. When Asaph said, “My flesh and my heart may fail me, but God is the strength of my heart and my portion forever,” I get it.

I’ve learned a lot along this broken way. I’ve been able to identify the biggest triggers for my panic attacks. I’ve come to understand the great need I have for healthy life habits. I’ve passionately pursued emotional and relational maturity in areas of my life where I’ve long been deficient. And I’ve learned that we are wholistic creatures—God made us both body and soul. Imagine sharing the gospel with a starving person without first meeting their physical needs. It would be unkind and ineffectual, to say the least. In a similar way, if you’re in the midst of panic and I tell you “Don’t be anxious for anything” before I address your physical symptoms, I ultimately fail to care for you. First let’s deal with the panic, then your heart will be calm enough to hear life-giving truth.

Perhaps the most beautiful thing I’ve learned is that in Christ, God is happy to be with me, even in the most terrifying moments of anxiety. He is here. He has everything I need for this.

Some helpful handles

God hasn’t given me a shortcut through panic. He cares more for my long-term growth than for quick-fixes that bring momentary relief but leave me unchanged. God is bringing much beauty out of my ashes, and if some of that beauty can spill over onto you, this 16-year journey would be well worth it. Along the way he has graciously equipped me with some very helpful handles that minimize the frequency and severity of my panic attacks. I want to share some of these with you. I’m not a doctor, so I’ll leave issues of medication, exercise and diet in the hands of the professionals. But these are simple means of turning to God (physically and emotionally) in order to not just survive anxiety, but to also know and love him better through it.

Life-giving friends: Typically when I’m in the throes of panic, there are layers of stressful people and circumstances in my life. Avoiding those circumstances and people may not be possible (nor even wise), but I can counterbalance them by spending extra time with joyful, life-giving friends. These are dear ones who are tender to my weaknesses and love me in all my mess. They lower their expectations. They light up when they see me. Time with them reminds me of who I am, who God is and that there’s life beyond this panic. I notice that my heart rate slows, my shoulders relax and my obsessive thoughts lose momentum. God has made us for joyful relationship, and the worst thing I can do when I’m navigating extreme anxiety is to isolate myself.
A thankful heart: One of the greatest helps in dealing with panic has been practicing appreciation in three specific ways. I borrowed these from two must-read books: Joy Starts Here by Jim Wilder and Transforming Fellowship by Chris Coursey.

Appreciation memories. When I’m riddled with anxiety, I recall two specific memories of when I experienced amazing peace and joy (I’ve named them “Panera Bread” and “D.C. Trip”), and I re-live them in as much detail as I can: where I was; what I smelled, heard, saw, tasted; who I was with, and so on. Doing this reminds me (1) what it feels like to be calm, (2) that God has been so good to me before, and (3) that this momentary panic is not the end of the story.

List of 10. I keep a list of 10 things I’m grateful for. It includes my morning cup of coffee, the beautiful view from my bedroom window, the daily routines I enjoy with my family and the grace I receive from my husband every day. I rehearse it when my thoughts feel panicky. The goal is to practice gratitude with such frequency (some suggest five minutes, three times a day) that my brain learns a new normal, and my body can begin to return to an appreciative and calm state more quickly over time, with practice.

3X3X3. When I’m ramped up and just can’t seem to slow down (and I’m dreading a sleepless, anxious night), I recall aloud, just before bed, three things I’m thankful for about that day, three things I’m thankful for about my husband, and three things I’m thankful for about God. This sounds ridiculously simple, but it has an immediate effect on me.

A relaxed body: Sometimes a full-body massage can work wonders in the midst of panic. A panic attack can create a corkscrew of physical tension, and a massage can immediately release some of that pressure. There are also fantastic “tapping” and pressure-point techniques that help calm my body. And sometimes I simply need a strong hug or a firm grip on my arm to slow my heart rate. Moderate exercise and sweating help me as well (even a 20-minute walk and a few lunges or light weights), but nothing sustained or intense—as that can put more burden on my already overtaxed body. I’ve also used a breathing app to help me steady and deepen my erratic and short breaths during an attack.

Time outdoors: I’ve found that spending time outdoors—soaking up the sun and enjoying nature in all its beauty—is highly effective (and free!) therapy for both body and soul. I’ve come to love hiking. I’ve become an avid bird-watcher (ahem, the very person I used to chuckle at), and I often linger while looking at a flower, a sunset, a tree. I take deep breaths as I study the intricacies of my Creator’s handiwork. If God cares this much for a flower of the field or a bird of the air, if there is such design and purpose in a tiny part of his creation—imagine how much more he cares for me, how much greater his purposes are for me.
Immanuel journaling: During periods of intense anxiety and panic, I have the tendency to read Scripture and pray with a fearful and distracted spirit. In order to move out of fearful mode into relational mode with God, I use a journaling technique that helps me quiet my heart so I can engage with God, sense his nearness and hear his voice. Once I’m calm, prayer and the Word seem to more easily have their effect on me.
Lifestyle adjustments: In describing his struggle with anxiety and depression, J.P. Moreland wrote,

I once heard a Christian psychologist say that we were made to live in a camel culture: slow-paced, relational and no electric lights to keep people up beyond sundown and deprive them of the eight and one half hours of sleep they need each night. But ours is no camel culture. We live in a rapid-paced, highly stressful society. We are constantly surrounded with noise, cell-phones, television. . . . As a result, anxiety and depression are epidemic in America.

Several years ago I woke up to the fact that I was living beyond my means. I was a debtor to sleep. I could no longer keep up with a huge social circle and constant activity. I’d long cheated my body of what it so desperately needed, and I was paying a high price. So here are some lifestyle choices I began to make, and I now prioritize.

• I keep a regular bedtime and make late nights the exception rather than the rule.
• I minimize screen time and try to avoid it altogether before bed.
• I read inspiring, hopeful books.
• I avoid caffeine and eat food that works with my body, not against it.
• If our calendar is getting cluttered, and I’m becoming task-driven instead of relationally driven, I cut back on my commitments. (And I make sure I have as many joyful commitments as I do draining ones.)
• I get alone with God most mornings. This is my ultimate lifeline (Deut. 32:47).

Imitation: It’s one thing to read about how to do this stuff—it’s quite another to have someone model it for you. I am forever grateful for a few friends (both living and passed) who have shown me what it looks like to walk through life’s sorrows and stresses, to be prone to anxiety in its extreme forms and still be able to return to joy and peace in Jesus.

Motivation: I won’t pretend that these skills and habits have been easy to learn and implement. Most of my journey has been uphill. But as I have given myself, day in and day out, to working at my deficits, God has met me in amazing ways. As I address these very real issues of chemical imbalances, personality tendencies and stress factors, I’m motivated by more than just a desire to rid my life of panic attacks (although that would be nice!). Rather I long “to grow up in every way into Christ” so that I can increase my capacity to care for people, so I can suffer well and handle more of life’s challenges without losing my joyful identity.

God never gives up on his children. I’m 41 years old and learning things I should have known 20 years ago. But God’s timing is perfect, and he has used panic attacks as cords-of-kindness, to draw me to him and make me love him as I never could have imagined.

I led them with cords of kindness,

   with the bands of love,

and I became to them as one who eases the yoke on their jaws,

   and I bent down to them and fed them.

Hosea 11:4

A form of this article originally appeared here.