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Tips from the Arena: Addressing Underlying Causes of Panic Attacks

Panic attacks are debilitating at worst and frustrating at best. Oftentimes, life will seem completely “normal” and all of a sudden, panic strikes – your heart starts racing, you feel like you’re going to faint or you can’t breathe; you feel a sense of impending doom; you are not “in reality,” or feel that you have lost control of yourself.

Sometimes panic strikes as you anticipate a scary or nerve-wracking experience, such as an approaching test, job interview, or public speech.

There are many coping strategies you can use in the moment to help you manage yourself during a panic attack, these include controlled breathing, muscle relaxation techniques, thought-stopping, and grounding exercises, such as mindfully noticing your surroundings.

Some typical grounding exercises include looking around your environment and noticing everything that meets particular criteria, such as identifying everything blue, or everything that starts with the letter “c.”

Counting exercises are helpful as well, for instance, counting backwards from 100 by 3s.

Coping strategies help you manage your panic attacks, but what more can you do to help reduce their frequency?  You can learn to understand their meaning.  What is your body reacting to?  Why are you panicking?

The following suggestions have been found to be effective in minimizing the incapacitating effects of panic, particularly if the panic is related to some event you are anticipating. They are simple, straight-forward, and practical.

When you notice that you are beginning to panic, stop, take a deep breath, and ask yourself these questions if you are able:

  • What is it about this situation that I am afraid of?
  • Am I afraid of being physically constrained? (This could relate to feeling constrained in your life.)
  • Am I afraid of being in front of a lot of people? (This could relate to feeling vulnerable, and/or reveal concerns about honesty and being accepted.)
  • Once you identify what it is about the situation that frightens you the most, ask yourself what qualities about your situation frighten you in particular (vulnerability, being constrained, etc.)
  • Ask yourself what other situations in your life trigger these same kinds of feelings. This can help you identify life situations that need to be addressed. Try to identify how the small “micro” events could be representatives of some bigger “macro” life situations.

AFTER your attack, for instance, the next day (sometimes the symptoms are so overwhelming that they preclude any kind of reflection in the moment,) ask yourself these same questions.

Use your journal. Write down any revelations you have about the events that trigger panic attacks.  Write about the similarities between the different types of events that trigger attacks, and the connections to the situations in your life.  This type of personal reflection is necessary for healing.

Journaling can consist of writing or even speaking out loud (alone is fine.)  You can create a safe, private place, with your favorite chair for having this alone time to journal.

Writing is recommended because you can sometimes go back over these journals and remind yourself that these events or triggers are important representations of situations in your life that you are addressing and working through.

These are all part of the crawl back…


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Tips from the Arena: Addressing Underlying Causes of Panic Attacks

Sharie Stines, Psy.D

Sharie Stines, Psy.D. is a recovery expert specializing in personality disorders, complex trauma and helping people overcome damage caused to their lives by addictions, abuse, trauma and dysfunctional relationships. Sharie is a counselor at LIfeline Counseling & Education Inc., in Southern California ( Lifeline Counseling is a non-profit organization 501(c)(3) corporation. Sharie is also an abusive relationship recovery coach -


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APA Reference
Stines, S. (2017). Tips from the Arena: Addressing Underlying Causes of Panic Attacks. Psych Central. Retrieved on November 11, 2018, from