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The question

I recently had a panic attack for the first time, after a period of severe stress. It's only happened once but now I'm worried that it could happen again. Do you have any tips on coping with panic attacks? How do I fight off stress so that it doesn't get to that point?

The answer

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A panic (or anxiety) attack can be one of the most terrifying events a person can experience. These attacks are associated with a number of emotional and behavioural symptoms that may include:

  • Overwhelming fear
  • Rapid heartbeat and increased breathing rate
  • Chest pain/discomfort
  • Sweating and shaking
  • Dizziness/lightheadness
  • A feeling that you can't get enough air
  • Feelings that you are losing control or "going crazy"

There are effective steps you can take to help shorten the length and intensity of a panic attack, and in some cases prevent it from happening at all.

First, make sure that what you are having is in fact a panic attack and not some other physical health issue, such as a thyroid or heart problem. Speak to your family doctor about your symptoms.

Once you know that what you're experiencing is a true panic attack, the most effective approach is to first reduce your general stress and then identify and challenge anxiety-provoking thoughts.

Start by listing all the things you feel some stress about right now. Organize these by common areas of your life:

  • Work stressors
  • Conflict in important relationships
  • Child-related stressors
  • Financial concerns
  • Health problems

Once you have this list, ask yourself what you can do about each of these problems. Think about all of the possible solutions (remember, you are just brainstorming, so list every possible solution). Write down the pros and cons of each solution, then choose (and take!) some action. Taking action will help reduce your stress.

When you are feeling anxious, it can be helpful to pay attention to your thoughts and ask yourself, "What specifically am I predicting will happen?" In the midst of a panic attack, people tend to have exaggerated, unrealistic thoughts. Challenging this faulty way of thinking can help tremendously.

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You may, for example, have the fear that you will pass out. Ask yourself how likely this is to happen, how often it has actually happened in the past year and if it were to actually happen, how would you deal with it. Asking yourself these questions when you start to feel a panic attack coming on can help reduce the intensity of that attack.

One of the most effective treatments for panic attacks is cognitive-behavioural therapy (CBT), typically delivered by a clinical psychologist. Most people experience significant improvement from eight to 12 sessions of CBT. Contact your provincial psychological association and ask for a list of registered psychologists with expertise in CBT.

Send psychologist Joti Samra your questions at She will answer select questions, which could appear in The Globe and Mail and/or on The Globe and Mail web site. Your name will not be published if your question is chosen.

Click here to see Q&As from all of our health experts.

The content provided in The Globe and Mail's Ask a Health Expert centre is for information purposes only and is neither intended to be relied upon nor to be a substitute for professional medical advice, diagnosis or treatment.

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