You Can’t Heal What’s Still Bleeding
"If I have a panic attack, what do I do?"
"I get so worked up before ____ event. What can I do when it happens?"
I get messages like this all the time. And each time I get one, I can so relate because this was me not that long ago.
And what I want to say to them (and to you, too, if this is you right now) is: the answer is two-fold. Because when someone is in the midst of these constant reactions, you just want them to stop. But to get it to stop, you first have to learn what to do in the moment, and then eventually you need to do some deeper work to prevent this cycle from continuing.
It’s just like how an ER doc doesn’t ask "how do we heal this long-term" when someone comes through the door bleeding. They focus on one thing: how do we stop the bleeding right now? Everything else waits. You can't set a broken bone or start physical therapy, on someone who's still losing blood on the table.
Nervous system work starts the exact same way.
What's actually happening
So let's start there. Because before we talk about anything else, I want you to understand something about what's happening in your body when you're mid-panic, or spiraling before something that hasn't even happened yet: it's not a malfunction. It's not proof something is wrong with you.
Your nervous system is a prediction machine, not a truth machine. It's constantly scanning for danger based on what it's learned from your past, and firing off a response before you've even consciously registered what's happening. A racing heart before a hard conversation. A full-body spiral before an event that's still days away. That's not your body failing you; that's your body doing exactly the job it was built to do. It's just responding to an old map instead of what's actually in front of you.
So what do you actually do
I wish I could give you one tool that addresses everything, but there’s more nuance than that. Because what helps when you're in a full shutdown looks different than what helps when you're wired and can't sit still, which looks different again if you're the type who smiles and says "I'm fine" while internally you're anything but. Different states need different tools, so you first need an understanding of what state you’re in to know how to help your system move through it.
If you don't know which state you tend to fire off first, take this Nervous System State Quiz. It'll tell you which state you go to most often, and what actually helps that specific state. It's free, it takes a couple of minutes, and it's the kind of thing I wish I'd had years ago, instead of trying every regulation tool on the internet, wondering why half of them didn't do anything for me.
One note here: if panic attacks are frequent, or severe, or you're white-knuckling through most days, please don't carry that alone. Working alongside a licensed professional can be invaluable.
Where most people stop
Ok. So say you've got your tool. You've learned what helps when you're activated, and it works.
I think of this like the Advil-and-a-headache relationship. You get a headache, you take an Advil, and it works! The pain goes away. You get your day back. But then a few days later, another headache. So you reach for another Advil again. And so it goes.
And in the short term, there's nothing wrong with that. Sometimes exactly what you need is something to break you out of the pain cycle. Or at least help you get through it until you can find the deeper cause. So the point is not to throw out your Advil or stop trying to address things in the moment. In nervous system work, that is exactly where we start.
But too often this is where I see people stop. Because they get some relief, they don’t ask what’s going on underneath. They have a symptom, treat the symptom, then go on with their day. And even when that symptom keeps showing up, they just continue on with the same in-the-moment solution.
The real question underneath all of this isn't "what do I do when I'm activated." For things to change, you must also ask "why do I keep getting activated by the same things, over and over." And that is when we move on from triaging to growing our capacity.
The rain barrel
Here's how I think about capacity: picture a rain barrel.
The barrel catches whatever life rains down on you — stress, a hard conversation, a deadline, a comment that got under your skin. A small barrel fills fast. It doesn't take much rain before it's overflowing. A bigger barrel can catch the exact same storm and barely notice it.
Growing your capacity doesn't mean less rain falls on you. Life doesn't stop happening. It means building a bigger barrel, so the same amount of life doesn't send you over the edge nearly as easily.
Building capacity is often slower and less visible than triage. It’s not the “regulation techniques” you see online. You build capacity the same way you build anything durable: slowly, and in doses your system can actually handle. In nervous system work, we call this titration. Small, controlled amounts of stress, applied on purpose, so your system learns it can hold a little more than it thought — and then a little more than that.
I wrote a whole piece a few weeks back on this exact idea HERE about how even healthy things, like cold plunges or fasting or intense workouts, can backfire if you throw them at a system that doesn't have room for them yet. If you want the deeper dive on dosing and timing, you can read more about that there.
The barrel and the dose are related. You can only add to your capacity in amounts your current barrel can actually hold.
Capacity isn't a number that only goes up
One more thing about capacity: it’s not fixed, and it doesn't just climb steadily upward forever.
Capacity is simply where you are right now. And "right now" changes. I have more capacity today than I did a few years ago… measurably more. But if a major life event happened tomorrow, my capacity would shrink, at least for a while, no matter how much work I've put in up to this point.
And I've lived this. There have been seasons where I could hold a lot without overflowing, and then life happened, and suddenly I couldn't hold nearly what I could the month before. But that's not backsliding. It’s not proof that you’ve somehow done it all wrong. That's a smaller barrel meeting a bigger storm, temporarily. Being honest about where you actually are right now, instead of where you think you "should" be by now, is part of this work too.
Two moments, years apart
Let me give you an example of what the difference between triage and capacity actually looks like.
A few years ago, I did an Instagram Live to maybe a few hundred followers. I was nervous before I even started it, but then I completely fell apart once it started. I had tunnel vision almost immediately. My chest got tight. I actually thought I might pass out. I ended up pretending I was having technical issues so I could shut it down and get off camera. That was a full shutdown response, and in that moment, the only thing that mattered was triage — I sat there afterward and gently brought myself back. I put my feet on the floor and felt them press into the ground. I noticed the sensation of the chair underneath me. I started telling my system, over and over, that I was safe, that I could come back into my body, that there was nothing here to run from.
Now compare that to last week. I taught a class on the nervous system and posture to an audience of about four thousand people. The host decided, a minute before we started, to scrap my slides and my script and just have a casual conversation instead. A few years ago, that would have sent me into full on panic mode. This time… nothing. Zero anxiety the whole conversation. Instead I was able to stay present and engaged the whole time.
That's capacity. I didn’t have to convince my nervous system I was okay. I just was. And I didn't get here by accident. Some of it came from the deeper work I've done over the years. But a lot of it came from something much simpler: exposure. Every time I spoke publicly and it went fine, I was handing my nervous system a little more evidence that this wasn't actually dangerous.
And a lot of why I grew in capacity in this area was because after that Instagram Live shutdown, I set a goal to go live once a week for a year. I knew if I could increase my exposure, my reaction would get better. The first few lives were rough; I needed a full script, and I was still shaking through most of them. But within a couple of months, I was going live with nothing but a few scribbled notes, and no anxiety at all. My system had learned it wasn't a threat. Not because I told it that. Because I showed it, over and over, until it believed me.
Why the order matters
This is why the order matters here, not just the tools.
If I had tried to force capacity-building in the middle of that first shutdown — if I'd pushed myself to keep talking through the tunnel vision, told myself to just push through it — it wouldn't have built capacity. It would have just confirmed to my nervous system that this really was dangerous, because I ignored every signal it sent me. Capacity work doesn't work on a system that hasn't learned how to get back to baseline yet. Triage isn't a detour from the real work. It's what makes the real work possible in the first place.
So how do you actually build it
Practically, how do you build capacity?
One of the most effective ways I know is teaching your nervous system that uncomfortable is not the same thing as dangerous. Think about most of what you react to in a given week. It's rarely a physical threat. It's most often discomfort — an awkward conversation, an unfamiliar situation, or a change in your routine. But when your capacity is low, discomfort often reads to your nervous system as a threat, so it responds as if it was. When you can retrain your system that uncomfortable is actually survivable, safe even, you widen what you're able to hold. More of life becomes available to you, instead of something to brace against.
One of my favorite ways to practice this is cold exposure. Cold showers, specifically. I love it for a few reasons.
It's accessible. Almost everyone already has a shower, no equipment, no membership, no special trip required.
You're in complete control the entire time. You decide how cold, how fast, how long. That control matters more than people realize; it's part of what makes it something your system can actually learn from, instead of something that just happens to you.
It works even when you start small. When I first tried this, I was so cold-intolerant I could only handle lukewarm water for a few seconds. But it still worked.
One important caveat: this does not work by jumping straight into ice-cold water. There's a specific way to approach it, and skipping that part just triggers a threat response without teaching your system anything, which is the opposite of what you're going for. This is exactly why I put together a free guide walking through how to do this well. Grab that before you just hop in and crank the dial.
If you want to try this with company instead of alone, we're running a Cold Shower Challenge together in October inside Rooted + Rising Collective, my free community. You'll have people doing it alongside you, learning as they go, cheering each other on. It's good timing too — easing into cold exposure now, before winter actually arrives, tends to make the cold season itself a little more bearable. JOIN US HERE.
And one more note: cold exposure isn't right for everyone. If you have a cardiovascular condition, are pregnant, have Raynaud's, or anything else that gives you pause, check with your doctor before you start. That's in the guide too, but it's worth saying here as well.
Some things to think on
Now that you understand the difference between triage and capacity, here are a few questions to ask yourself:
When I feel activated, do I actually know what helps my system, or am I reaching for whatever's worked for someone else?
Am I only ever triaging, or am I also doing something that grows what I can hold?
Where have I mistaken relief for real healing?
What's one small, survivable dose of discomfort I could practice with this month?
If you're someone who’s messaged me asking what to do when you panic, I hope this gave you a direction to start down. But I also hope you hear the other part too. Triage will get you through the moment. It's not where this work ends. Somewhere underneath "what do I do right now" is a bigger question waiting: "how do I build a system that doesn't need rescuing so often?" That's the work that changes everything. It's slower, and it's less dramatic, but it's also the only thing I've ever seen actually change the pattern instead of just managing it.
Wherever you're starting from — the quiz, the guide, the challenge in October, or just sitting with your feet on the floor for a minute — there's no wrong door. Just start wherever you are.
