Panic attacks can feel terrifying, overwhelming, and unpredictable. Many people describe them as a sudden surge of fear that comes out of nowhere, accompanied by physical symptoms like a racing heart, shortness of breath, chest pain, dizziness, or a sense of losing control. If you experience panic attacks, you’re not alone—and there is hope. Dialectical Behaviour Therapy (DBT) offers powerful tools to help manage panic and regain a sense of stability.
In this blog, we’ll explore how DBT can support people living with panic attacks, focusing on practical skills that help reduce distress, regulate emotions, and build long-term resilience.
What is a panic attack?
A panic attack is an intense episode of fear or anxiety that typically peaks within 10 minutes, although symptoms may last longer. While panic attacks are not life-threatening, they can be deeply distressing and may lead people to avoid certain situations or develop fears around having another one.
Some people experience panic attacks as part of an anxiety disorder, while for others they may be linked to past trauma, ongoing stress, or overwhelming emotions. Regardless of the cause, DBT offers an approach that addresses both the emotional intensity and the behavioural responses that can maintain the cycle of panic.
How DBT helps with panic attacks
DBT was originally developed to support people with intense emotions and self-destructive behaviours, particularly those diagnosed with borderline personality disorder (BPD). However, over the years, it has been adapted for a range of mental health concerns, including anxiety and panic.
The foundation of DBT is the dialectic—balancing acceptance with change. This means that we learn to accept the reality of our distressing experiences while also building the skills needed to respond differently.
Here are three key DBT skill areas that are especially helpful for managing panic attacks:
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Distress Tolerance: Surviving the wave
When a panic attack strikes, it’s not always possible to stop it immediately—but you can ride it out with skills that reduce the intensity and help you stay grounded.
- TIP skills (Temperature, Intense exercise, Paced breathing, Paired muscle relaxation) are designed to calm your body quickly.
- Splashing your face with cold water or holding an ice cube can activate your dive reflex, helping to slow your heart rate and calm the nervous system.
- Paced breathing (e.g., breathing in for 4 counts, out for 6) can bring you back to the present and reduce physical symptoms of panic.
- Self-soothing with your senses—like listening to calming music or smelling a favourite scent—can ground you during distress.
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Mindfulness: Observing without judgement
Mindfulness is a core part of DBT, helping us to observe what’s happening in our mind and body without getting swept away by it.
During a panic attack, mindfulness skills can help you:
- Notice your thoughts and sensations without trying to fight or avoid them.
- Label the experience: “I’m noticing tightness in my chest” or “My mind is telling me something bad is happening.”
- Gently bring your attention to the present moment, using grounding techniques like noticing five things you can see or feeling your feet on the floor.
Practising mindfulness regularly can reduce the frequency and intensity of panic attacks over time, helping you to respond with more awareness and less fear.
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Emotion Regulation: Understanding the bigger picture
Emotion regulation skills in DBT focus on identifying your emotions, reducing vulnerability to emotional extremes, and increasing positive experiences.
This might include:
- Checking the facts: Are you in real danger, or is your mind reacting to a perceived threat?
- Opposite action: If the urge is to flee or avoid, try staying in the situation while using calming strategies.
- Building mastery: Engage in activities that give you a sense of competence, which can help reduce anxiety over time.
Learning how your emotions work and how they interact with your thoughts and behaviours is a powerful part of breaking the panic cycle.
A Compassionate Approach
Many people feel ashamed or frustrated about their panic attacks. At DBT-UK, we emphasise self-compassion—recognising that your response is not a personal failure, but a survival strategy your body has developed. DBT invites you to work with your nervous system, not against it.
In group and individual DBT sessions, you’ll learn to apply these skills in a supportive environment, with the help of trained therapists who understand the challenges of living with intense emotional experiences.
Final thoughts
Panic attacks can feel frightening and isolating—but they are treatable. With DBT, you can learn practical skills to reduce your distress, calm your body, and respond with awareness rather than fear. Over time, you can begin to feel more in control and less overwhelmed.
If you or someone you know is struggling with panic attacks, DBT-UK is here to help.
For more information on
Dialectical Behaviour Therapy
Contact DBT-UK
info@dbt-uk.co.uk | +44 (0) 7541 458 851
