Picture this:  You’re walking in the mall, trying to find the perfect gift for your partner and, all of a sudden, your vision narrows, your heart is thumping out of your chest, you’re sweating like no tomorrow, and your body starts shaking like crazy.  You sit down to try to catch your breath, but your breathing is shallow and fast, your chest tightens, and you think, “I must be having a heart attack.  Am I dying?!”

Perhaps you’ve had this experience or something similar.  Perhaps you’ve even gone to the emergency department thinking you’re having a heart attack or dying, and they told you that you’re *just* having a panic attack.  But how can a panic attack feel so bad, and more importantly, how do we stop them from happening?

First of all, anxiety, fear, and panic are normal emotions and they are not dangerous.  In fact, fear can be incredibly helpful.  If I were hiking on a beautiful autumn day, and a bear arrived unannounced and started to attack, I sure would want my fight-or-flight response to kick in so that I could book it out of there!  However, with panic attacks, what often happens is we have a “false alarm” or a “faulty switch” – the mind thinks there’s a threat and turns on our fight-or-flight response – but really there is no true threat.

So, what can we do?  We can change our interpretation of a situation and shift how we relate to physical symptoms such as racing heart, sweating, and shaking.  We can remind ourselves that:

  • Anxiety is normal and not dangerous 
  • I have never fainted from a panic attack before
  • I can still work while feeling anxious
  • Panic attacks will peak and pass (i.e., they are time-limited)
  • I can ride out the anxiety like a wave


Importantly, we want to change how we behave in response to anxiety or panic attacks.  We often act in ways that give us quick relief, but ultimately fuel our anxiety, keep us stuck in the anxiety cycle, and prevent us from leading the life we want.  Some behaviors that we can challenge ourselves to stop doing include:

  • Avoiding the places we fear or have had panic attacks before (e.g., avoiding crowded malls)
  • Escaping when we feel signs of anxiety or panic (e.g., leaving a party as soon as we feel sweaty)
  • Checking where exits or bathrooms are in case we need to escape
  • Carrying around expired medication that we haven’t taken in months 
  • Bringing “safe” people with us to feel more comfortable

Of course, these suggestions are much easier said than done!  They all involve taking a risk and doing something differently to learn what happens, and becoming more engaged in life and doing the things that we value, even while feeling anxious.

If you would like to work with a clinician on panic or anxiety, we encourage you to seek out a mental health provider who provides cognitive behavioral therapy (CBT) and/or acceptance and commitment therapy (ACT).  If you live in Massachusetts, our clinic has immediate openings, and we would love to help you out!  

Written by Beth Shikatani, PhD, a clinical psychologist who specializes in treating anxiety and OCD, and works at Cambridge Psychology Group.  Dr. Shikatani is also available to give presentations to mental health professionals and the community on anxiety, OCD, perfectionism, cognitive behavioral therapy, and mental health skills.