Masking Up When You’re Freaking Out

Ever had a panic attack while wearing a COVID mask? Fun times! Here’s how to regain your calm.

by Eddie McNamara Health Writer

The absolute worst part of a panic attack is feeling like you can’t breathe. Struggling for air kicks off a survival mechanism in the brain, so you hyperventilate. Shallow panic breathing isn’t a great substitute for regular breathing—what you’re actually doing is depriving your brain of even more oxygen. This inefficient exchange of breath can cause you to feel faint (or even scarier, feel like something terrible is going to happen or you’re going to die). Now imagine trying to breathe during a panic attack with someone’s hand over your mouth and nose. That’s what panic breathing feels like with a mask on.

On my walk to get a COVID-19 test the other day, I experienced my 50th and 51st panic attacks with a mask on. (I’ve been keeping track.) They are terrible. I’m not going to try and tell you that they’re anything less. But I’d still rather be living my life with the risk of an occasional masked-up panic attack than avoid living it at all. Look, it’s bad enough that we’ve had to sit out a year of living due to the pandemic and mismanaged response. The weather’s going to be nice pretty soon—let’s enjoy it. All I’m saying is that it’s good to be prepared. Here’s what to do when you inevitably have a panic attack with a mask on.

Be Rational

When you start feeling your heart race and have difficulty breathing due to a panic attack, that mask isn’t going to make it feel any better, but medically speaking, it’s not going to make it any worse either. Really. People have completed marathons with a mask on.

Even though it feels like it might, that little square of paper or fabric isn’t going to take you out. You’re wearing a mask because you need to be. When removing it physically isn’t an option, unmask yourself mentally. Tell yourself, “These feelings come from a panic attack. I’ve had dozens, hundreds, maybe thousands of these before and they always pass. I will slow my breathing and take deep breaths. This will calm me.”

Then (critical point here), follow your own advice. If I can take deep belly breaths through a mask, so can you. Breathe mindfully. Your heart rate will slow down and your brain will get the oxygen it needs.

Take a Few Mask-Free Breaths

Not advisable on a crowded subway platform or shopping mall elevator, but if you’re outside or in a fairly empty space, find yourself around 10 feet of social distance and breathe normally without your mask on. I don’t actually take my mask all the way off—I pull it an inch away from my face and get a good couple of breaths in.

Technically, this isn’t much different that breathing in a mask, but logic goes out the window during a panic attack. When your mind is at ease your body tends to follow. I’ve only resorted to this a couple of times during severe symptoms of panic, but it helped me.

Break the Pattern

Stop whatever you’re doing in your moment of panic. If you’re rushing to catch a bus, stop, chill, and get the next one. It’s most likely not that important to get on that exact bus. The rest of the world isn’t perfect either, so feel free to join the club and give yourself a break.

If you’re at your desk banging away at an assignment and are overcome with anxiety, physically get up and go somewhere safe. Then, let the panic attack do its thing until it passes. Maybe you stop off by a vending machine and get yourself a sugary or salty treat. Fill up your water bottle. By the time you’re finished drinking, the panic is probably nearly gone.

Befriend the Fear

This is the most difficult and (of course) most effective strategy—at least for me. When you’re all masked up because you have to be and a panic attack strikes, don’t go into fight, flight, or freeze mode. Go into fun mode. Welcome the waves of panic. People spend good money on drugs to feel as amped up in the body and loopy in the head as you do right now. Feel the feelings for what they are in the moment, not what you’re afraid they mean.

Focus on the sensation of your racing heart, sweaty hands, short breaths, and then ask for some more. When you invite the symptoms of panic in, they’re not as scary as when you resist them. They’re nothing more than physical sensations that eventually go away, like when riding a roller coaster. With no frightening story attached to the sensations, you can get closer to enjoying the ride.

And once it’s all over, you’ll probably need a fresh mask. Panic attacks have a way of getting things sweaty.

Eddie McNamara
Meet Our Writer
Eddie McNamara

Eddie McNamara is a 9/11 first-responder and former cop turned vegetarian chef and author. He's been living with panic disorder and PTSD for 17 years, and he'll be sharing his experiences, thoughts, and seriously hard-won advice every month. Check out all his columns for "Panic in the Streets."