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3 Strategies to Manage OCD and Panic Attacks in Daily Life

By Stacy Quick, LPC

Nov 15, 20237 minute read

A quickening pulse, rapid breathing, spiraling thoughts—a panic attack can be intense, both mentally and physically. The sudden feelings of fear and anxiety involved in these episodes can also be accompanied by other strong physical reactions, like chills, shaking, or feeling faint. The unease of a panic attack makes many people feel out of control. It can be a frightening and distressing experience, and it might also be a familiar one for some people with obsessive-compulsive disorder (OCD).

Anxiety, the cause of panic attacks, can play a significant role in OCD. There are also enough similarities between anxiety disorders and OCD that OCD can be misdiagnosed as an anxiety disorder. Considering that panic attacks can occur in both conditions, and that a person can be diagnosed with both OCD and an anxiety disorder, gaining more insight into why panic attacks happen, their connection to OCD, and how they can be managed may prove to be helpful if you’re struggling with both OCD and panic attacks.

The connection between OCD and panic attacks

Once an obsession is triggered, for many people with OCD, immense anxiety also kicks in. While anxiety is an important feeling—it’s intended to keep us safe, and can be helpful in certain situations—OCD can turn it against us. Those suffering from OCD often report feeling a heightened sensitivity to anxiety or anxious feelings. It’s an aspect of the condition that’s referred to as distress intolerance. OCD wants us to believe that we cannot tolerate the discomfort caused by an intrusive thought, that we have to do something about it.

This sense of needing to get rid of unpleasant thoughts or feelings can feel overwhelming, and has the potential to trigger a panic attack. It may also drive people to engage in compulsions, physical or mental actions that they feel will help alleviate their distress.

Another common characteristic of OCD is fears related to being or becoming out of control. For people who experience them, these fears can make anxiety seem even more unsettling. They may seek to control their thoughts and when they are ultimately unable to, it may lead to a panic attack. Other individuals with OCD may struggle with fears focusing specifically on panic attacks, leading to an increased awareness of possible physical or mental signs of anxiety that can cause them further distress.

Being in a consistent state of anxiety and worry, as is common in OCD, can make it so that people live in a chronically heightened state of arousal. This combination of anxiety and distress intolerance can lead to an increased susceptibility to panic attacks. For effective symptom management, it can be helpful to recognize the commonalities and differences of OCD and panic attacks.

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Differences between OCD and panic attacks

The key difference between the anxiety surrounding the obsessions and intrusive thoughts of OCD and the anxiety involved in panic attacks is that OCD-related anxiety tends to be more chronic and less sudden. The intensity of anxiety in OCD may also be slightly lower, though still quite high and uncomfortable. Additionally, in OCD-related anxiety, there is generally a trigger, and in panic attacks, oftentimes there isn’t.

There can also be differences in the treatment of the two. Some strategies that can be helpful for coping with panic attacks may not be as helpful when dealing with OCD, and vice versa. It’s important to work alongside a specialist who can help you decipher when certain coping strategies may be helpful or counterintuitive based on your personal needs. The following strategies can be a good place to start when it comes to dealing with both OCD and panic attacks.

How you can manage panic attacks and OCD

Strategy 1: Try relaxation techniques.

Relaxation techniques can be helpful when dealing with panic attacks and many other mental health conditions. Some helpful techniques for panic attacks may include progressive muscle relaxation, breathing exercises, and mindfulness. However, when you’re looking to manage panic attacks alongside OCD, it’s important to approach this strategy carefully, as relaxation techniques aren’t always advisable for OCD.

This is because these techniques can involve trying to “do something” when you feel panicky—an approach that goes against the principles of exposure and response prevention (ERP) therapy, the gold-standard treatment for OCD. Because individuals with OCD often struggle with the belief that they cannot tolerate feelings of distress, it’s important to be conscious of whether or not these techniques are being used in a compulsive way to combat OCD. A specialist will have the expertise to help you determine if relaxation techniques could be helpful for you.

Strategy 2: Confront the feared situation.

One of the best ways to combat panic attacks both in OCD and in general, is, when it’s possible and safe, to face the fear head-on. It’s our natural tendency to fight or flee when we feel anxious, so this can seem incredibly difficult. It’s possible, though, and it’s incredibly powerful. The more you go about what you were doing before the panic struck, the more you allow yourself to see that what your brain is perceiving as a threat is not actually a danger to you, no matter how real the sensations and emotions may have felt.

When people experience panic, they have a tendency to attribute their feelings to danger in the environment that they are in. For example, if someone feels panic while grocery shopping, they may start to avoid grocery stores, or if they feel it while driving, they may start to attribute their unease to danger involved in driving. If they act on this tendency and begin to avoid the environments where they feel panic, it only makes this association stronger in their brains. Avoiding discomfort tells your brain that, yes, there really was a danger, when there wasn’t.

Riding a wave of uncomfortable emotions may not be an easy task, but it’s incredibly worthwhile. It can help you realize your own strength and take the burden of anxiety off of your shoulders. When you allow yourself to feel your feelings, let them pass, and see that nothing catastrophic actually happens, you learn that you can get through discomfort. The more you’re able to do this, the less likely panic attacks become in that particular situation.

Strategy 3: Don’t jump to conclusions.

When panic strikes, your brain might begin to think of all of the worst possible scenarios that could happen—and when you have OCD, that list can be extensive. The best way to handle any intrusive thought around a worst-case scenario is to passively acknowledge it, and then continue on with whatever you were previously doing.

I always say, “It can hang out if it wants to, and I will not pay attention to it.” Remaining non-judgemental and not labeling thoughts as “good” or “bad” is important. A thought is neutral, even if it goes against what you value. It doesn’t say anything about who you are as a person. It can also be helpful to recognize that these feelings of panic are inaccurate and not indicative of actual danger.

You may want to verbally remind yourself that you are safe and not in any immediate danger, but with OCD, self-reassurance is not recommended. This is because OCD is a disorder of doubt. To face that doubt, we want to accept the feelings of uncertainty and not rely on reassurance from ourselves or others as a compulsion. Allowing your thoughts to exist and knowing they will pass, that they don’t need a meaning attached to them, and that they don’t predict an outcome is a more effective way to respond to feelings of panic.

Getting support for OCD and panic attacks

Remember, you are able to handle anxiety. It may not be a comfortable experience, but it will be a temporary one. Panicky thoughts will pass on their own. That said, this can be difficult to recognize if you’re feeling overwhelmed by uncomfortable emotions. Thankfully, you don’t have to navigate OCD, anxiety, or panic attacks alone.

The support of a professional who is well-trained in both OCD and panic attacks can help you develop tools to manage anxiety and face discomfort. At NOCD, all of our licensed therapists specialize in ERP therapy, the most effective OCD treatment, and are all trained by the top OCD experts and researchers who’ve designed some of the world’s leading treatment programs.

NOCD Therapists are also trained to treat anxiety and panic. They can help guide you as you navigate the subtle differences between OCD and anxiety, while teaching you techniques to manage them both. If you’ve been struggling with OCD and panic attacks, book a free 15-minute call with our team to learn more about working with a NOCD therapist.

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