What to Do During an Anxiety Crisis at Work

When anxiety strikes at the worst possible moment

You’re in a meeting, at your computer, or talking to a colleague, and suddenly you feel it: your heart races, your palms sweat, your breathing tightens. Anxiety doesn’t pick convenient times. And when it shows up at work, the fear of being noticed makes everything worse.

These symptoms can occur during an anxiety crisis, but they can have other causes too. If they are new, very intense, include persistent chest pain, fainting, significant breathlessness, or worry you, seek urgent medical support. If a professional has already helped you recognise the pattern, these steps may help you regain your bearings while the peak passes.

The 5-step protocol (under 5 minutes)

Step 1: Name what’s happening (30 seconds)

If a professional has already helped you recognise this pattern, you might label it: “This feels like an anxiety crisis; I can give myself a few minutes.” Naming it does not replace an assessment or explain the cause of symptoms, but it can help you orient your attention while they pass.

Step 2: Ground your feet (30 seconds)

Press both feet firmly into the floor and notice the pressure on your soles. This sensory-orientation prompt may help bring attention back to the present. You can do it sitting or standing without drawing attention.

Step 3: Box breathing 4-4-4-4 (2 minutes)

A slow, comfortable breathing pattern can be a supportive tool. Do not force your breath or hold it if that feels uncomfortable:

1. Inhale counting to 4
2. Hold counting to 4
3. Exhale slowly counting to 4
4. Pause with empty lungs counting to 4

Repeat a few cycles only if it feels comfortable. You can also breathe gently while counting to five on the inhale and exhale; the NHS recommends adapting the pace to what you can tolerate.

Step 4: The 5-4-3-2-1 sensory technique (1 minute)

Without drawing attention, mentally identify:

• 5 things you can see (your screen, a pen, the window…)
• 4 things you can touch (the keyboard, the desk, your clothes…)
• 3 things you can hear (the air conditioning, distant voices…)
• 2 things you can smell (coffee, air freshener…)
• 1 thing you can taste (water, a sweet…)

This will not necessarily stop a crisis immediately, but it may help direct attention towards present sensations.

Step 5: Micro-action (30 seconds)

Do something small and concrete: take a sip of water, type one line of that pending email, or walk to the bathroom. The aim is to choose a manageable action, not to expect normal productivity in that moment.

What to do after the attack

The most common mistake is pretending nothing happened. When you have a moment alone:

• Note what triggered the anxiety — was it a specific situation, a thought, a memory?
• Look after basic needs — if you can, rest for a few minutes, drink some water, or eat something that feels manageable.
• Don’t judge yourself — having anxiety at work doesn’t mean you’re weak or can’t handle your job.

When to seek professional help

If anxiety crises repeat, you begin avoiding work situations, or anxiety affects sleep and relationships, it is worth speaking with a professional. Clinical guidance includes psychological interventions such as cognitive behavioural therapy according to individual assessment.

You don’t have to manage this alone.