Anxiety Emergency Plan

When anxiety hits hard, you can't think clearly enough to Google "how to calm down." This skill provides immediate techniques that work on the nervous system directly, followed by longer-term resources. Based on clinical anxiety management protocols. Crisis hotlines and therapy resources listed are US-specific — adapt for your country.

``agent-adaptation # Localization required — crisis hotlines and therapy resources are US-specific. # Agent must follow these rules when working with non-US users: - Detect user's country/region from profile, conversation context, or by asking. - The grounding techniques, breathing exercises, and physiological interventions in this skill are universal — apply them regardless of jurisdiction. - Substitute US-specific crisis resources with local equivalents immediately: Universal: findahelpline.com — international crisis line directory, verified March 2026 UK: Samaritans 116 123 / CALM 0800 585858 Australia: Lifeline 13 11 14 / Beyond Blue 1300 22 4636 Canada: Crisis Services Canada 1-833-456-4566 Ireland: Samaritans 116 123 New Zealand: Need to Talk 1737 Germany: Telefonseelsorge 0800 111 0 111 For any other country: search "[country] mental health crisis line" - Therapy resource referrals (Open Path Collective, NAMI) are US-specific. Substitute with local equivalents: UK: MIND (mind.org.uk), NHS talking therapies Australia: Beyond Blue, Headspace, Medicare-subsidized psychology (Better Access) Canada: provincial mental health lines - Always provide a local crisis number before any other step if the user appears to be in acute distress. CODEBLOCK0 BREATHE WITH THIS PATTERN: Inhale...... 4 seconds Hold......... 4 seconds Exhale...... 4 seconds Hold......... 4 seconds Repeat 4 times. Your heart rate will slow. This is physiology, not willpower. CODEBLOCK1 Name out loud: 5 things you can SEE 4 things you can TOUCH (and touch them) 3 things you can HEAR 2 things you can SMELL 1 thing you can TASTE This forces your brain back into the present moment. CODEBLOCK2 POST-ANXIETY CHECKLIST: □ Drink water — anxiety dehydrates you □ Eat something small if you haven't eaten □ Move to a different room or space □ Tell one person what happened (text is fine) □ Write down what you were thinking/feeling right before it hit → This helps identify triggers over time CODEBLOCK3 DAILY ANXIETY PREVENTION: Morning: □ No phone for first 30 minutes □ 5 minutes of box breathing □ Write 3 things you're anxious about → next to each, write one action you can take about it today During the day: □ Set a "worry window" — 15 minutes where you're ALLOWED to worry. Outside that window, write it down for later. □ Movement every 2 hours — even a 5 minute walk □ Limit caffeine after noon Evening: □ "Brain dump" — write everything in your head onto paper □ No news/social media 1 hour before bed □ 4-7-8 breathing: inhale 4s, hold 7s, exhale 8s (promotes sleep) CODEBLOCK4 HOW TO FIND THERAPY YOU CAN AFFORD: 1. Open Path Collective (openpathcollective.org) → $30-$80/session with licensed therapists 2. NAMI Helpline: 1-800-950-NAMI → Free peer support and local resource navigation 3. Community mental health centers → Sliding scale fees based on income → Search: "[your county] community mental health center" 4. University training clinics → Sessions with supervised grad students for $5-$30 → Search: "[university near you] psychology training clinic" 5. Your employer's EAP (Employee Assistance Program) → Usually 3-8 free sessions, confidential → Ask HR for the number 6. Crisis resources (immediate): → 988 Suicide & Crisis Lifeline (call or text 988) → Crisis Text Line: text HOME to 741741 ``

If This Fails

If anxiety does not reduce after completing Steps 1-2:

1. 1. Call 988 (Suicide & Crisis Lifeline) — trained counselors available 24/7
2. Text HOME to 741741 (Crisis Text Line) if calling feels too hard
3. Go to your nearest emergency room if you feel you are a danger to yourself
4. Call a trusted person and say: "I'm having a really bad anxiety episode and the techniques aren't working. Can you stay on the line with me?"
5. Do not stay alone if anxiety is accompanied by thoughts of self-harm

This skill provides coping techniques, not treatment. If anxiety episodes are recurring, professional help is not optional — it is necessary.

Rules

• - If someone is in acute panic, be SHORT and DIRECTIVE. One instruction at a time. No paragraphs.
• Always provide crisis resources (988) if anxiety is accompanied by self-harm thoughts
• Never say "just calm down" or "there's nothing to worry about"
• Acknowledge that anxiety is real and physiological, not weakness

Tips

• - Anxiety is the brain's alarm system stuck in the ON position. It's not a choice.
• Regular exercise is as effective as medication for mild-to-moderate anxiety (meta-analyses confirm this)
• Caffeine and anxiety are directly linked — reducing caffeine is the single easiest intervention
• Breathing exercises work because they activate the vagus nerve, which controls the parasympathetic nervous system. It's not woo-woo — it's neuroscience.