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Panic Attacks

The DSM describes a panic attack as a discrete period of intense fear or discomfort, in which four (or more) of the following symptoms develop abruptly and reach a peak within 10 minutes:

  1. palpitations, pounding heart, or accelerated heart rate
  2. sweating
  3. trembling or shaking
  4. sensations of shortness of breath or smothering
  5. feeling of choking
  6. chest pain or discomfort
  7. nausea or abdominal distress
  8. feeling dizzy, unsteady, lightheaded, or faint
  9. derealization (feelings of unreality) or depersonalization (being detached from oneself)
  10. fear of losing control or going crazy
  11. fear of dying
  12. paresthesias (numbness or tingling sensations)
  13. chills or hot flushes


  • See a physician to rule out any physiological causes of your symptoms
  • Make an appointment with a psychologist, such as myself, or other psychotherapist to explore and work through the underlying cause of your anxiety

TIPS TO COPE WITH OR REDUCE THE INTENSITY OF PANIC ATTACKS (After seeing your physician to rule out a physiological cause):

  • Get to know the first sign that a panic attack is coming on
  • At the first sign- tell yourself:  This is just a panic attack.  It will only last 10 minutes.  I can get through this.  These de-escalating thoughts can help reduce the intensity of a panic attack.  (escalating thoughts, such as, “I’m going to die!  I’m going crazy!” can make the panic attack more intense.) 
  • If you are having trouble breathing, close one nostril each time you exhale. 
  • If it is possible, move about or even run in place
  • Talk to someone to get your mind off of your symptoms and anxious thoughts
  • Do something that requires focused concentration like planning your day’s activities


  • Reduce or eliminate your caffeine intake gradually
  • Engage in regular aerobic exercise such as running, walking briskly, biking, etc.
  • Do a few minutes of deep breathing three times per day, or any time you begin feeling anxious.
  • Begin relaxation exercises such as yoga, or mindfulness practices