THE 90-SECOND ANXIETY PROTOCOL 

Your Complete Emergency Reference Guide 

THE SCIENCE (Remember This) 

• Stress hormones metabolize in exactly 90 seconds 

• After 90 seconds, anxiety continues only if you feed it with anxious thoughts 

• Quick intervention = prevents the anxiety spiral 

IMMEDIATE RESPONSE (0-30 Seconds) 

Use ANY technique the moment you notice anxiety symptoms 

4-7-8 BREATHING 

• Exhale completely 

• Inhale nose (4 counts) 

• Hold breath (7 counts) 

• Exhale mouth "whoosh" (8 counts) 

• Repeat 3-4 cycles 

COLD WATER RESET 

• Splash cold water on face 

• Or hold ice/frozen peas on temples 

• 30 seconds triggers dive reflex 

• Instantly slows heart rate 

MUSCLE CLENCH-RELEASE 

• Clench ALL muscles for 5 seconds 

• Include fists, face, shoulders, legs 

• Release everything at once 

• Repeat 2-3 times 

5-4-3-2-1 GROUNDING 

• 5 things you can SEE 

• 4 things you can TOUCH 

• 3 things you can HEAR 

• 2 things you can SMELL 

• 1 thing you can TASTE 

BILATERAL TAPPING 

• Cross arms over chest 

• Tap alternating shoulders 

• 1 tap per second for 30 seconds 
• Or march in place 

SUSTAINED TECHNIQUES (30-90 Seconds) 

Continue after immediate response to complete the cycle 

BOX BREATHING + VISUALIZATION 

• Inhale (4) → Hold (4) → Exhale (4) → Hold (4) 

• Visualize drawing a protective box 

• 4-6 complete breath cycles 

• Box becomes stronger with each breath 

BODY SCAN INVENTORY 

• Start at head, scan downward 

• Notice tension without changing it 

• "My shoulders are tight, my jaw is clenched" 

• End at toes with full body awareness 

COGNITIVE REFRAME STATEMENTS 

Choose ONE that resonates: 

• "This feeling will pass in 90 seconds" 

• "My body is responding to a false alarm" 

• "I am safe in this moment" 

• "I've survived 100% of my anxiety attacks" 

• "This is my brain trying to protect me" 

MOVEMENT DISCHARGE 

• Walk, stretch, bounce gently 

• Focus on physical sensations 

• 60-90 seconds of movement 

• End with 3 deep breaths 

SENSORY ANCHORING 

• Hold a prepared, calming object 

• Focus on texture, temperature, and weight 

• Recall associated calm memories 
• Continue until anxiety subsides 

ADVANCED TECHNIQUES (For Severe Episodes) 

VAGAL NERVE STIMULATION 

• Hum loudly (30-60 seconds) 

• Massage neck sides downward 

• Sing or chant 

• Splash cold water on wrists 

BILATERAL EYE MOVEMENT 

• Move eyes rapidly left-right 

• Follow finger for 30 seconds 

• Pause, assess anxiety level 

• Repeat if needed 

ENERGY REDIRECTION 

• Recognize anxiety as mobilized energy 

• Do jumping jacks, pushups, dance 

• Full intensity for 60-90 seconds 
• Appreciate your body's power 

YOUR PERSONAL PROTOCOL 

Fill this out and keep with you 

1. My go-to IMMEDIATE technique: 
2. My go-to SUSTAINED technique: 
3. My ADVANCED technique for severe anxiety: 
4. My anxiety warning signs: 
5. Physical: _________________________
6. Mental: __________________________
7. Behavioral: ______________________ 

QUICK TRACKING 

Rate anxiety before/after (1-10 scale) 

PRACTICE TIPS 

DAILY PREPARATION: 

• Practice 1 technique when calm (5 minutes)  

• Review protocol card  

• Cary sa ensory anchor object 

WEEKLY ASSESSMENT: 

1. Which techniques work best for you?  
2. What situations challenge you most?  
3. Is your confidence improving?  
4. Do you need professional support? 

SUCCESS INDICATORS: 

1. Faster recognition of anxiety onset  
2. Immediate technique application  
3. Reduced anxiety duration  
4. Increased confidence in self-regulation  
5. Less fear of anxiety itself 

REMEMBER THE GOAL 

You're not trying to eliminate anxiety forever. You're learning to interrupt it within 90 seconds before it becomes a spiral. 

BONUS: SITUATION-SPECIFIC QUICK GUIDES 

AT WORK: 

1. 4-7-8 breathing (silent) 
2. 5-4-3-2-1 grounding 
3. Bathroom cold water reset 

IN PUBLIC: 

1. Bilateral tapping (discrete) 
2. Cognitive reframe statements 
3. Sensory anchoring 

AT HOME: 

1. Cold water immersion 
2. Movement discharge 
3. Vocal vagal stimulation 

BEFORE SLEEP: 

1. Body scan inventory 
2. Box breathing + visualization 
3. Progressive muscle relaxation 

DRIVING (SAFELY PULL OVER): 

1. 4-7-8 breathing 
2. Muscle clench-release 
3. Grounding techniques 

Practice Schedule 

Week 1-2: Foundation Building 

• Practice your chosen techniques daily for 5 minutes when calm 

• Create physical anchors (keep your sensory anchor object with you) 

• Rehearse your protocol mentally 

Week 3-4: Application Training 

• Use techniques during mild anxiety (practice opportunities) 

• Refine your technique selection based on what works best 

• Begin teaching techniques to trusted friends or family 

Week 5-8: Mastery Development 

• Apply techniques during moderate anxiety situations 

• Develop confidence in your ability to self-regulate 

• Consider professional support if techniques aren't sufficient 

Progress Tracking Methods 

Daily Tracking: 

• Anxiety level before technique (1-10 scale) 

• Technique(s) used 

• Anxiety level after 90 seconds (1-10 scale) 

• Overall effectiveness rating 

Weekly Assessment: 

• Which techniques worked best? 

• What situations challenged your skills most? 

• How is your confidence in managing anxiety changing? 

• Do you need to adjust your protocol? 

Integration with Daily Routines 

Morning Preparation: 

• Review your protocol card 

• Practice one technique while calm 

• Set intention to use skills if needed 

Throughout the Day: 

• Notice early anxiety signals 

• Apply techniques immediately 

• Celebrate successful self-regulation 

Evening Reflection: 

• Review any anxiety episodes 
• Acknowledge successful technique usage 
• Plan improvements for tomorrow 

Anxiety Doesn't Have to Control You

Stress hormones only last 90 seconds in your body unless you fuel them with anxious thoughts. By responding quickly with the right immediate, sustained, or advanced technique, you can stop an episode before it spirals.

If anxiety is impacting your life, our Ultimate Guide to Anxiety Diagnosis and Treatment in Colorado can help you understand your options and take the next step toward lasting relief. Axis Integrated Mental Health specializes in evidence-based treatments tailored to your needs. Book your appointment today and start taking back control of your mind and your life.

Additional Resources 

1. Gut-Brain Anxiety Relief: 12 Natural Strategies (2025 Guide)
2. What is Complex PTSD?
3. Evidence-based Anxiety Treatments in Colorado 
4. Anxiety vs Irritability: What’s the Difference? 
5. What is the Anxiety Microbiome?

Frequently Asked Questions

1. How can I stop anxiety in 90 seconds?
Anxiety peaks when stress hormones are active, which lasts about 90 seconds. If you intervene immediately with techniques like 4-7-8 breathing, cold water reset, or grounding, you can prevent an anxiety spiral.

2. What is the best immediate technique for panic attacks?
The 4-7-8 breathing method is highly effective. Exhale fully, inhale for 4 counts, hold for 7, and exhale for 8. Repeat 3–4 cycles to calm your nervous system and slow your heart rate.

3. How do grounding techniques help with anxiety?
Grounding uses your senses to anchor you to the present moment, interrupting anxious thought loops. The 5-4-3-2-1 method engages sight, touch, hearing, smell, and taste to shift focus away from fear.

4. What are advanced anxiety relief techniques?
Advanced options like vagal nerve stimulation, bilateral eye movement, and energy redirection can be used during severe anxiety episodes. They work by activating the parasympathetic nervous system or discharging excess adrenaline.

5. How can I create my own personal anxiety protocol?
Identify your go-to techniques for mild, moderate, and severe anxiety. Track which methods work best, note your early warning signs, and practice daily while calm so the response becomes automatic.