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Facing Panic Attacks Head On

panic attackA couple of days ago, Laura wrote a blog on how anxiety can morph into panic. Many people experience episodes of mild to moderate panic here and there—a few of the common triggers for such episodes include looming deadlines, upcoming parties, and presentations to work groups. However, some people experience panic at a much more intense level, to the point that they actually develop a full blown Panic Disorder.

True panic attacks of this sort involve anxiety and fear of stunning intensity. The actual attacks usually peak within ten minutes and slowly fade, but it’s common for people to actually think they could die during one of these attacks. Common symptoms of these attacks include:

  • Profuse sweating
  • Rapid, irregular heartbeat
  • Shortness of breath or sense of suffocation
  • A sense of unreality or detachment
  • Fear of impending death without any real basis
  • Nausea
  • Fear of losing control or “going insane”
  • Trembling and shaking
  • Chills and hot flashes
  • Dizziness

When such attacks reoccur, the person worries about future attacks, has considerable concerns about the meaning of the attacks, or changes his or her behavior in order to avoid attacks, the odds are that a Panic Disorder is in play. Frequently, but not always, people with Panic Disorder also have Agoraphobia (fears of being in places that would be difficult or highly embarrassing to leave or escape from), but that’s a topic for another blog.

Trust me; if you’ve never had a panic attack, you don’t want to. But if you have such attacks from time to time or if you worry a lot about getting them, what can you do? Well, there’s a reason we titled our blog Anxiety and OCD Exposed. The term “exposed” or “exposure,” forms the foundation for most treatments of anxiety.

First, as with most emotional problems, you should see a physician to rule out physical problems that could be causing your anxiety. Try to avoid the temptation, however, of going to the doctor over and over and over again. In all but the rarest exceptions, a thorough physical once a year should be sufficient for moving ahead with exposure therapies.

Second, look for a cognitive behaviorally trained therapist who has expertise in treating Panic Disorder with Exposure techniques. That therapist will work with you on developing a hierarchy of items that tend to trigger your concerns about having panic attacks. You will gradually work your way through the easiest items, up to the most difficult.

In addition, your therapist may suggest exposure to the actual sensations of panic attacks themselves. This task is accomplished by intentionally bringing on these sensations by engaging in various tasks such as:

Breathing through a straw: You’ll usually breathe this way for about a minute each time. You feel like you aren’t getting enough air, your heart may race, and you may have feelings of choking, all of which mimic some types of panic for many people.

Spinning yourself around: This strategy induces dizziness and lightheadedness as well as an increased heart rate. Generally, sixty seconds or so works for this technique as well.

Hyperventilation: You breathe in and out very rapidly for about a minute which often induces feelings of shortness of breath, dizziness, of a racing heart.

There are various additional techniques for creating similar sensations. By repeating these exercises over and over again, you gradually learn that you won’t go crazy; you’re not going to die, and most importantly, that you can cope with anxious feelings. That knowledge allows you to quit worrying about having panic attacks which usually helps them fade from the scene.

Panicked woman photo available at Shutterstock

Facing Panic Attacks Head On

Charles H. Elliott, Ph.D.

Charles H. Elliott, Ph.D. is a clinical psychologist and a Founding Fellow in the Academy of Cognitive Therapy. He is also a member of the faculty at Fielding Graduate University. He specializes in the treatment of adolescents and adults with obsessive compulsive disorder, anxiety, anger, depression, and personality disorders. Dr. Elliott is coauthor of: Overcoming Anxiety For Dummies (2nd Ed), Obsessive Compulsive Disorder For Dummies, Seasonal Affective Disorder For Dummies, Anxiety and Depression Workbook For Dummies, Depression For Dummies, Why Can't I Get What I Want?, Why Can’t I Be the Parent I Want to Be?, and Hollow Kids: Recapturing the Soul of a Generation Lost to the Self-Esteem Myth. His website is:

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APA Reference
Elliott, C. (2011). Facing Panic Attacks Head On. Psych Central. Retrieved on May 31, 2020, from


Last updated: 13 Dec 2011
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