Panic attacks are intense episodes of fear and physical distress that can appear suddenly and without warning. For those who experience them, the racing heart, shortness of breath, dizziness, or feeling of losing control can be terrifying. But there is hope.
Dialectical Behavior Therapy (DBT) offers effective tools that can help individuals relieve, reduce, and regain control during panic attacks. Originally developed by Dr. Marsha Linehan, DBT is a structured therapeutic approach that focuses on balancing acceptance and change. It’s particularly useful for those dealing with emotional dysregulation, anxiety, trauma, and other high-stress mental health conditions.
Let’s explore how key DBT skills can be applied when panic strikes.
1. TIPP Skills: Rapid Relief in the Moment
TIPP stands for Temperature, Intense Exercise, Paced Breathing, and Progressive Muscle Relaxation. These are fast-acting physical interventions that can bring immediate relief from overwhelming anxiety and panic.
Temperature: Splash cold water on your face, hold an ice pack to your cheeks, or dip your hands in cold water. This activates the dive reflex and lowers your heart rate. Intense Exercise: A burst of cardio (jumping jacks, running in place) can use up excess adrenaline and calm the nervous system. Paced Breathing: Try 4-7-8 breathing or box breathing to help reset your breath and reduce hyperventilation. Progressive Muscle Relaxation (PMR): Tense and then release different muscle groups to regain physical control and release stored tension.
🧠 Why It Works: TIPP skills target the physiological symptoms of panic, giving your body a chance to regulate itself and signal to the brain that the threat has passed.
2. Mindfulness: Anchor Yourself in the Present
Mindfulness helps you detach from racing thoughts and ground yourself in the current moment. DBT encourages the use of “What” and “How” skills:
Observe: Without judgment, notice what is happening around and inside you. Just notice. Describe: Label your emotions and sensations: “I’m feeling fear,” “My hands are tingling.” Participate: Fully engage in the present moment without self-consciousness.
🔹 Try This: The 5-4-3-2-1 Grounding Technique
Name 5 things you see, 4 things you can touch, 3 things you hear, 2 you can smell, and 1 you can taste.
🧠 Why It Works: Panic attacks often involve catastrophic thoughts about the future. Mindfulness helps you return to the safety of the present.
3. Distress Tolerance: Surviving the Storm
Distress Tolerance skills are designed for crisis moments when emotions feel too big to manage. Key DBT tools include:
Self-Soothing with the Five Senses: Light a calming candle, listen to music, sip warm tea, wrap yourself in a blanket, or look at comforting images. Distraction: Shift your focus by engaging in an activity (puzzle, reading, talking to a friend), or mentally imagine a peaceful scene. IMPROVE the Moment: Imagery: Visualize a calm place. Meaning: Remind yourself this will pass. Prayer: Lean into spiritual or grounding beliefs. Relaxation: Stretch, breathe deeply. One thing at a time: Focus only on now. Vacation: Give yourself a break, mentally or physically. Encouragement: Use affirmations or coping statements.
🧠 Why It Works: These techniques interrupt the emotional spiral and give your brain a structured path toward stability.
4. Emotion Regulation: Understand and Influence Your Feelings
Panic can feel like it’s hijacking your mind. Emotion regulation teaches you to name and respond to feelings, instead of being controlled by them.
Check the Facts: Ask yourself if the intensity of your fear matches the facts. Is your panic based on a real threat or an assumption? Opposite Action: If you feel the urge to flee or isolate, consider doing the opposite—call someone, take a walk, or stay grounded where you are. Build Mastery and Positive Experiences: Over time, practicing coping skills during non-panic moments builds resilience for the next time panic arises.
🧠 Why It Works: Regulating emotions isn’t about suppressing them—it’s about changing how you respond when they show up.
5. Radical Acceptance: Let Go of Resistance
Panic often worsens when we fight or fear it. DBT’s Radical Acceptance means fully acknowledging reality—even when it’s painful—without judgment or resistance.
You might say to yourself:
“I am having a panic attack. I don’t like this, but I accept it. It will pass.”
🧠 Why It Works: Accepting what is happening reduces added suffering caused by resistance, shame, or fear of the panic itself.
Final Thoughts: You Are Not Alone
DBT doesn’t just teach coping—it helps you transform how you relate to your emotions. Panic attacks may not disappear overnight, but with the right tools and support, they can become more manageable, less frightening, and shorter in duration.
If you or someone you love struggles with panic attacks, consider working with a therapist trained in DBT to build and practice these skills. And remember: you have the strength to survive the storm—and the power to bring yourself back to peace.
Interested in DBT-informed therapy or panic support in Michigan?
The Social Work Concierge, LLC provides virtual trauma-informed therapy rooted in cultural humility and compassion.
📞 Call/Text: (616) 345-0616
📧 Email: leonica@socialworkconcierge.com
Healing shouldn’t be a privilege. Let’s make it a priority.
The Social Work Concierge, LLC 
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