Physical symptoms of a panic attack might include

  • shaking or trembling
  • choking or trouble breathing
  • chest pain or pressure
  • nausea
  • lightheadedness
  • hot flashes or chills
  • heart palpitations​

​A panic or anxiety attack can be a frightening experience, especially if it seems to come out of nowhere.  But panic attacks do come from somewhere, and it is possible to manage them, make them happen less often and less intensely, and, in many cases, get them to go away altogether.​


During a panic attack, you may feel helpless, as if there is nothing you can do.  But there are ways to regain your sense of control.

1. First, remind yourself that you don’t actually have to do anything.  The nature of a panic attack is that it is temporary and it will pass.  Worrying about how long the attack will last, or how soon the next one will happen, can actually prolong it.

Many people say a panic attack feels like going crazy or being out of control.   You might experience a sense of unreality, or detachment from your body or your surroundings.  Some people have had severe panic attacks that actually made them feel as if they were dying.  In fact, first time panic attacks are sometimes confused with heart attacks, because the symptoms are so similar.  If you experience anything that could possibly be a heart attack or medical problem, you should of course go to an emergency room and get medical attention immediately.  However, if your physician has told you that what you’re going through is not a medical problem but an emotional one, there are mental exercises and self-care habits that can give you relief.


It’s important to do what works best for you, whatever helps you feel calmer.  If you try a technique that you think should make you feel better, but it doesn’t, do something else instead.   That said, here are some simple suggestions to reduce anxiety and make panic attacks less likely to happen. 

1. Take care of your body.  Get plenty of rest, water, and nutritious food.

2. Take a break.  Leave your desk, get someone to watch the kids, turn off the electronics, even if it’s only for a few minutes.  Breathe, move, meditate, whatever helps you slow down.

3. Clear out the chemicals.  Cut down or stop using alcohol, tobacco, caffeine, or mood-altering drugs (other than prescriptions).  Addictive chemicals calm anxiety in the moment, but tend to have the opposite effect in the long run, making anxiety attacks more frequent and more intense.  Relying on alcohol or a drug to soothe anxiety will keep you from learning safer, more lasting and effective ways to feel calm.

4. Find an outlet.  Talk to a friend.  Write in a journal.  Punch a pillow.  Clean the house.  Roll up the car windows and yell (or sing).  Draw, sculpt, or just play around with crayons or clay.

5. Exercise.  If you get even a little more physical movement than you’re used to, you’ll probably notice that your muscles are looser, your breaths are deeper, and you feel more present.  Whether it’s a trip to the gym or a walk around the block, just the act of making time for your body can help to relax your mind.

LGBTQ-affirming psychotherapy for depression anxiety relationships body image - Feminist Psychotherapy Jeanne Courtney MFT - El Cerrito, CA

2. If you can, gently get control of your breathing.  If you can’t change the pace of your breathing, start by just observing it.  If that’s too difficult, try counting your breaths.

3. Get to a safe place, physically or mentally.  If you’re in a situation where you can step away and be alone for a few minutes, take a break.  If your panic attacks happen when you are alone (or because you are), move to a different room or find an easy, distracting activity such as listening to music.  If you’re in a place you can’t leave right away, use your mind to visualize a place where you always feel calm and safe.  If you have a photograph, a stuffed animal, or any other object that helps to quiet your fears, keep it handy.


There may be biochemical or genetic factors that make some people prone to anxiety.  Your physician or psychiatrist can prescribe medications to help you feel calmer.  With any medications, but with anti-anxiety drugs in particular, it’s important to ask if they can be habit-forming, especially if you are in recovery or have a history of abusing mood-altering drugs.

I'm focusing here on the causes of panic attacks that have to do with situations, emotions, behaviors, and relationships.  These are the factors that psychotherapy can address. Most of the clients who have come to me for help with this issue had panic attacks that started in one of three ways:

1. Phobias or fears, including social anxiety.  Using step by step visualization,  relaxation, and desensitization techniques, I help my clients let go of the strong feelings of fear that come up around people or in certain situations.  Sometimes it’s also necessary to talk about early life experiences that made those situations feel so frightening to begin with.

2. A recent trauma or reminder of a past trauma.  If you’ve had an injury, illness, or medical procedure, been threatened or assaulted, or found yourself in any situation where you felt unsafe, trapped, or out of control, panic attacks might happen at random times afterwards, even though your day-to-day life appears to be back to normal.  Therapy is a safe place to explore and confront the feelings the original situation brought up.  This is especially important if, during the crisis, you had to be strong and suppress your emotions.

3. Doing too much too well.  Strange as it seems, the majority of clients who come to me for help with panic attacks look fine.  They do a great job at work or school, and have lots of interests and goals.  What often happens, especially for women, I think, is that we can become so good at proving our worth and/or taking care of other peoples’ needs, we forget to notice our own emotions and vulnerabilities.  Worry, insecurity, and uncertainty don’t get much breathing room in a life that’s packed full with achievements and responsibilities.  Doing well on the outside is a good thing, of course.  But your insides need attention, too.  Sometimes it’s important to slow down, take breaks, and allow yourself to make mistakes.   In therapy, you can learn to give yourself permission to relax, ask for help, and find a healthy balance between doing and just being.


​Anxiety and Panic Attacks

CALL OR TEXT                        510.516.4662
EMAIL    JeanneCourtneyMFT@gmail.com
Feminist Psychotherapy with
Jeanne Courtney, MFT