I tried medication years ago and it only helped depression without touching anxiety. After some severe reactions I didn’t want to keep trying meds and stuck with therapy that helped but was not enough. Got a new therapist using a different approach called Dialectical Behavior Therapy which is an offshoot of C.B.T with a focus on developing skills like emotion regulation and distress tolerance. I am on St John’s ward for depression but no other mentally effecting substances. It has done me a world of good even though I still have far to go; it has helped me be capable of dealing with stuff that would have left me in total meltdown.
The most important thing I have been taught is something common to trauma therapy as well as helping anxiety – grounding in the present combined with deep breathing along with happy/safe place imagery. Deep breathing alone never worked much for me. Blocking out the world to try to not notice whatever was triggering me didn’t work. Trying to completely block negative thoughts didn’t work. Deep breathing into the belly (never high in the chest as that provokes anxiety, try it and see for yourself) plus paying detailed attention to what is going on around me, physical sensations – texture of clothing against my skin, the feeling of gravity, sounds, naming items around me to myself, noticing and naming any smells in the area. Combine that with deep breathing to a count in 2 3 4 5 out 2 3 4 5, correcting cognitive distortions as they occur like I will never get better with something like I only need to deal with right now not tomorrow or later. And go back to the breathing and to the noticing of surroundings and body sensations (even unpleasant ones, oh look my stomach is cramping I will try to relax it, my jaw is clenched which gives me a headache so I will open my jaw slightly and try to relax the muscles as much as I can, etc.)
If that is not enough to stop the ramping up of panic I go to a safe place or happy memory and pay as much attention to details as I can. With depression it was hard to think of something good to focus on as it drains the happiness out of everything even what were extremely happy moments in the past. Eventually I thought of something not extremely happy but something that makes me as happy as I can be right now which is cuddling with my cats. The purr, the different textures of their fur (some silkier, some courser), the feel of their weight in my arms, the colors of their fur and eyes and paw pads, the contented feeling that I make them happy so if nothing else I can honestly say I am a good cat caretaker, things like that. If the best thing you can think of is some minor happy or merely pleasant moment use it and see if it helps. I was shocked the first time I did this it stopped a full blown panic attack in the office of a therapist I had only seen a few times. One of my worst fears is to be seen being overly emotional in public so in addition to avoiding anxious situations due to how freaking awful panic and anxiety feels there is the bonus fears like making a spectacle of myself. In any case in spite of a highly charged (for me) situation it totally stopped a full blown panic attack.
For these techniques to work best practice them daily and start using the breathing and grounding when any anxiety appears or other unpleasant, if comparatively mild, emotions such as feeling frustrated being stuck in traffic or heck just stubbing your toe. The more you practice, even if just for a literal minute, at self calming the more it becomes a habit. It takes time for this to get fully effective just like when exercising you can’t just run a marathon. You have to start walking if you haven’t been exercising at all and slowly work your way up. Or think of working on abs you can’t start with 100 sit-ups if you haven’t done any exercise. You have to start with a few several times per week and slowly increase because your body just can’t go from 0 to 100%. It is the same with any self-calming technique – it takes time to build new connections in the brain so your first reaction starts to be clamming deep abdominal breaths instead of oh no here comes another panic attack!