NHS Fife Department of Psychology

Panic
A Self Help Guide

Help Yourself @ [Link]

 Index

Introduction .............................................................. 3

1. Recognising panic
How do I know if I am having a panic attack? ...... 5

2. Understanding panic
What causes it and what keeps it going? ............. 8

3. Can panic attacks really harm me? .................. 14

4. What techniques can help me cope with and

reduce panic attacks? ...................................... 15

5. Further help ...................................................... 24

What is a panic attack?

Everyone knows what panic is, and it is common to feel panicky

from time to time:

You get the sense that you are being followed on your way home,
late at night.

You discover you have had your wallet stolen.

You are sitting an exam. You look at the paper and think you
don’t know the answers to any of the questions.

Someone runs in front of your car and you almost hit them.

It would be normal in any of these situations to feel a sense of

panic. The feeling would be understandable and would pass fairly
quickly.

A panic attack is a bit like 'normal' panic, but different in a number

of ways:

The feelings seem to come 'out of the blue' and are not usually
related to the sort of frightening situation described above.

The feelings are a lot stronger.

As the feelings are UNEXPECTED and STRONG they can feel

extremely frightening.

Panic attacks affect people in many different ways, but there is

usually a frightening feeling that something really awful is about to
happen.

THE TRUTH IS: NOTHING AWFUL IS GOING TO HAPPEN, AS

PANIC ATTACKS ARE NOT DANGEROUS.

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Lots of people have panic attacks, although they can affect people
in different ways. Some people have only one; others may have
them for many years. Some people have them every day, some
people only once in a while. If you were to ask all of your friends if
they had ever had a panic attack, it is very likely that at least one or
two will have had the same experience. They are quite common
and NOT a sign of serious mental or physical illness.

Some non-serious physical conditions can cause symptoms similar

to panic attacks.

For example: certain medicines taken together

thyroid problems
drinking too much caffeine
pregnancy
low blood sugar, etc

If, after reading this leaflet, you are concerned that your problem
may have a physical cause and you have not yet had a check-up
from your GP, then it may be a good idea to make an appointment.

SUMMARY:
Panic attacks are very common. They are NOT dangerous and are
NOT a sign of serious mental or physical illness.

This booklet aims to help you reduce your panic attacks by helping
you to:

 Recognise whether or not you are having panic attacks.

 Understand panic, what causes it and what keeps it going.

 Accept that panic cannot harm you.

 Learn techniques to reduce panic.

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1. Recognising panic
How do I know if I am having a panic attack?

This may sound obvious, but it isn’t. Sometimes panic feels so

awful, and comes so “out of the blue”, that people can’t quite
believe that it’s only a panic attack, and think it must be something
more serious. The feeling of a panic attack can be so unusual that
you may not even realise this is what is happening.

One of the most important first steps in overcoming panic attacks is

recognising whether or not your symptoms are caused by a panic
attack.

Panic affects your body, your mind and the way you behave. The
following are some of the most common symptoms experienced by
people having a panic attack. Some people have all of the
symptoms, others just a few. Think about when you feel panicky –
what happens?

Your body (please tick those that apply)

Heart pounding, beating fast or skipping a beat

Heart seems to stop, followed by a big thud, chest pains
Changes in your breathing, either gulping air, breathing fast or
feeling short of breath
Pounding in your head
Numbness or tingling in fingers, toes or lips
Feeling as though you can’t swallow, feeling sick
Feeling as though you’re going to faint, wobbly legs

Write down any other symptoms .........................................................

...............................................................................................................
...............................................................................................................
...............................................................................................................

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Your mind (please tick any thoughts or feelings that apply)

Feelings of utter terror

Feelings of unreality, as though you’re not really there
You feel anxious in situations where you had a panic attack
before.

Frightening thoughts such as: (please tick any thoughts that

apply)

“I’m going to have a heart attack”

“I will collapse or faint”
“I’m running out of air”
“I’m going mad”
“I’m choking”
“I’m going to be sick”
“I’m losing control”
“I’m going to make a complete fool of myself”
“I’ve got to get out of here”

Write down any other frightening thoughts or feelings: ........................

...............................................................................................................
...............................................................................................................
...............................................................................................................
Remember these thoughts and fears never come true in a panic
attack, but people sometimes think they will.

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Your behaviour (please tick any of these that apply to you)

YOU AVOID situations that have caused panic or that

you fear might cause panic, for example going shopping.

ESCAPE as soon as you can when panicking, for

example, rushing round the supermarket to get out as
soon as possible.
PREVENT what you think is going to happen, by doing
something to make yourself safe, for example, gulping
air if you think you are going to suffocate or sitting down
if you think you are going to faint, or lying down if you
think you are having a heart attack or scanning your
body for evidence of something being wrong.

SEEK HELP In one study a quarter of all people having

their first panic attack called an ambulance or went to
accident and emergency, they were so convinced
something dangerous was happening to them. Perhaps
you have done this, or called out the doctor?

COPE People often try to cope with a panic attack by

doing things they have found or have been told are
helpful, for example, distracting themselves or trying to
relax.

Write down anything else you do or don’t do as a result of having a

panic attack:
...............................................................................................................
...............................................................................................................
...............................................................................................................
Whilst all of these things can help to stop a panic attack, as we shall
see later, they can also become part of the problem.

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If you have ticked quite a few of these symptoms, thoughts and
behaviours, then it is likely that you are suffering from panic attacks.

SUMMARY: Recognising a panic attack.

A panic attack is a strong feeling of terror that comes on very
suddenly. Physical symptoms include: pounding hearts, fast
breathing, shaking, wobbly legs. People often have lots of
frightening thoughts and think something awful is happening. They
often try to avoid or escape the panic.
But panic is not dangerous or harmful.

2. Understanding Panic
What causes it and what keeps it going?
All of the panic symptoms described above are nothing more than
an extreme form of fear. Fear is our body’s natural response to a
situation perceived as threatening. Fear can range from mild
anxiety (which can be helpful when there is a goal, like passing an
exam) through to full blown panic.

But why have fear at all when it’s such an unpleasant feeling? In a
way, it is a bit like pain. If you were to break your ankle, it would
feel very painful, which would be a warning to you not to walk on it.
If you heard a noise downstairs at night, you might feel frightened,
which is a warning that you might have to deal with a dangerous
situation. Fear is very useful. It prepares your body for action. This
has been called the “fight or flight” response. So that when you
feel fear, what is happening is that your body is preparing to fight or
run away from the thing it feels threatened by, or possibly to stay
completely still and wait for the threat to pass.

If we take the example of the noise downstairs. Let us suppose it is

a burglar, as you fear. You may wish to stay absolutely still, so as

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to prevent the burglar from attacking you. You might want to go and
challenge him or you might need to run away should he come after
you. Your fear response would help with any of these. When you
are frightened you breathe more quickly so that you can get lots of
oxygen to your muscles. Your heart beats faster to pump the blood
faster round your body. Your digestive system closes down to allow
your body to concentrate on the more immediate threat. This is
your body’s normal healthy reaction to situations where your body
feels under threat. It is your body’s alarm system.

The problem with panic attacks is that usually they occur when
there is no obvious physical threat there at all. Your body is
reacting as though it was about to be attacked when in reality it is
not. In other words it is a false alarm. It is a bit like the annoying
smoke detector, which goes off at all the wrong times, because it is
sensitive to small amounts of smoke. Or the burglar alarm that
goes off because of the cat. Or even more annoying, the car alarm
that is triggered by the wind. These are all alarms that can be
triggered when there is in fact no danger. The same can be the
case with your body’s “alarm” system. Sometimes it can be set off
when there is no real danger.

The problem is that our body’s “alarm system” was designed many,
many years ago, when people had to cope with dangers in order to
survive. Nowadays, we are rarely faced with the sort of life or death
threats our ancestors faced. We have very different threats, mainly
related to stress. Financial worries, overworking, moving house,
divorce for example, can all be stressful, and can raise our anxiety
levels to the point where our “alarm system” is triggered. It is a bit
like a “stress” thermometer - which when it reaches a certain level
results in panic. Whilst a panic attack may be unpleasant, it is not
dangerous. Quite the opposite. It is a system designed to protect
us, not harm us.

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SUMMARY: Understanding Panic.

Panic is a form of fear. It is our body’s alarm system signalling

threat. It prepares our body to fight or run away from danger. But
as there is no physical danger it is a false alarm.

A panic attack may be unpleasant but it is not dangerous.

What causes panic attacks to begin?

Panic attacks can start for a number of reasons.

Stress

As mentioned, stressful events can cause anxiety to go up, which

may lead to the alarm system being triggered. Are you aware of
any stress in your life over the last few years? For example, work
stress or being out of work, relationship problems, loss of a loved
one, financial difficulties. Please list any stresses that you are
aware of:

...............................................................................................................
...............................................................................................................
...............................................................................................................

Health worries

Panic attacks often begin when a person becomes over-concerned

about their health. This can happen for various reasons.

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Sometimes people with panic attacks have recently experienced the
sudden death of someone they know or are close to. They then
become very worried about their own health, and look for signs that
they may be developing the same illness. They are often aware of
medical ‘mistakes’ where serious illness has not been picked up,
and so become worried that there is something seriously wrong.
This leads to raised anxiety. They then think the anxiety symptoms
are evidence of a serious illness, which can result in panic. Think
back to when your panic attacks began. Was anything happening
that might have caused you to think more about your physical
health?

Other health-related reasons

Sometimes panic attacks occur for the first time during a period of
ill-health. For example some viruses can cause dizziness.
Pregnancy or the menopause can cause changes in the way our
body works that can lead to a first experience of panic. Consuming
large amounts of caffeine, or low blood sugar can also lead to
feelings of faintness. Can you think of any 'health-related' reasons
for your panic attacks?

Difficult emotions

Panic attacks often begin when there are feelings from the past or
present that are being “swept under the carpet”. Maybe you have
relationship problems, or something from the past that you are
thinking about a lot.

Out of the blue

Sometimes we just don’t know why panic attacks begin. Some

people even have their first panic attack when they are asleep! It
may just be that certain people, in certain circumstances respond
like the over-sensitive car alarm. Their alarm system is triggered
when there is in fact no danger.

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It is less important to know what causes panic attacks to begin and
more important to know what keeps them going.

What keeps panic attacks going?

As you will remember, panic affects your body, your thoughts and
your behaviour. All three work together to keep panic going.

Physical

Firstly, the physical symptoms can be part of the problem. For

example, for people whose breathing is affected by anxiety,
something called hyperventilation (see leaflet) can occur. This
just means someone is taking in too much air and not breathing out
enough. This is not dangerous but can lead to feelings of dizziness,
and is often taken as further evidence that there is something
seriously wrong.

Thoughts

Secondly, the physical symptoms and anxious thoughts form a

vicious circle that keeps panic attacks coming back again and
again. Also, focusing your mind on your body can lead to noticing
small changes and seeing this as a threat.

People often find it hard to believe that our thoughts can produce
such strong feelings as fear. But if we believe something 100%
then we will feel exactly the same way as if it were true.

Another way thoughts can affect panic, is when someone starts to

worry that they are going to panic in situations where they have
panicked before. This, unfortunately, makes it more likely to
happen again, and often leads to avoidance.

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Behaviour

Thirdly, how a person behaves before, during and following a panic

attack has a big part to play in whether panic attacks keep
happening. The avoidance, escape, and safety behaviour
described earlier are all part of the vicious circle.

'THREAT'
Alarm bell
Safety behaviour Thinks, "Something bad
is going to happen.
Sits down – "If I hadn't
sat down I would have Thinks, "I'm sure my
had a heart attack" heart missed a beat"

Physical symptoms of
Thinks, "Now I really am anxiety, for example
having a heart attack" heart thumping

Physical symptoms Thinks "Oh no,

get worse something is wrong"

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SUMMARY:
Fear is our body's way of coping with threat - preparing us to fight
or run.

Panic attacks can begin for a number of reasons:

stress
health worries
during a mild illness
because of difficult emotions
out of the blue

Panic attacks are kept going because of the vicious circle of

physical symptoms
thoughts
behaviour

By avoiding, escaping or preventing panic attacks, you may

never find out that nothing terrible was going to happen
dread going back into the situation, because you fear another
attack
lose confidence in your ability to cope alone

3. Can panic attacks really harm me?

We have spent a lot of time looking at recognising and

understanding panic, because this should give you all the
information you need to be able to accept that panic attacks are not
harmful. If you can do this then you have come a long way to being
able to end your panic attacks.

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To what extent, sitting here now, do you believe that your panic
attacks mean that something awful is going to happen (0-100%), for
example, heart attack, stroke, fainting, choking, suffocating?

................................%

Next time you have a panic attack, can you rate at the time how
much you believe something awful is going to happen?

................................%

SUMMARY: Panic attacks are not harmful

4. What techniques can help me cope with and reduce

panic attacks?

The good news is that panic attacks are very treatable. You may
find that your panic attacks have already started to reduce because
you have begun to recognise and understand, and accept that they
are not harmful.

As we have seen, panic affects your body, your mind and your
behaviour. It makes sense to try to deal with each of these. You
may find some techniques more helpful than others. Not everyone
finds the same things helpful. Also, if you have been having panic
attacks for a while, it may take some time for these techniques to
work. Don’t expect miracles straight away, but keep at it and you
should see the benefits soon, when you’ve found the techniques
that work best for you.

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Your Body

There are at least two things you can do to help with the physical
symptoms of anxiety:

1. Relaxation
2. Controlled breathing

These techniques are helpful for a number of reasons:

 Panic attacks often start in periods of stress. These

techniques can help you to deal with stressful situations
better, and reduce overall levels of anxiety.

 They can “nip anxiety in the bud” stopping the cycle

that leads to full blown panic, by reducing anxiety
symptoms and preventing hyperventilation.

 They can be used when avoidance is being cut down, to

help you cope with situations you fear.

 Being relaxed and breathing calmly is the opposite of

panic.

To begin with it is best to practise regularly when you are not

anxious. Look on it as getting into training. You would not enter the
Great North Run without training for a while first!

Relaxation

People relax in many different ways. It might be that looking at your

lifestyle would be helpful. What do you do to relax? Write down six
things you do, or could do to relax. For example, swimming,
reading, walking. As well as finding everyday ways of relaxing,
there are special relaxation techniques which can help with the

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specific symptoms of panic. We have already seen that one of the
things that happens when you panic is that your muscles tense up.
To help yourself you should try to relax your muscles whenever you
start to feel anxious. Relaxing in this sense is different from the
everyday ways of relaxing like putting your feet up and having a cup
of tea (although that is just as important!). It is a skill, to be learnt
and practised. There are relaxation tapes, and sometimes classes,
which can help. Yoga classes can also be helpful. Your therapist
will be able to give you a relaxation tape, so please ask.
Relaxation tapes teach you to go through the main muscle groups
in your body, tensing and relaxing your muscles. The tape will
come with a leaflet on relaxation and some people find these very
helpful.

Remember – Relaxation can help to reduce symptoms of panic, but

it is not preventing something terrible happening - because nothing
terrible is going to happen, whether you relax or not.

Controlled Breathing

As we saw earlier, when someone becomes frightened they start to

breathe more quickly, so that oxygen is pumped more quickly round
the body. However, breathing too fast, deeply or irregularly can
lead to more symptoms of panic, such as faintness, tingling and
dizziness. If breathing can be controlled during panic, these
symptoms may be reduced and so the vicious circle described
earlier can be broken. You must breathe more slowly.

If you breathe calmly and slowly for at least 3 minutes, the alarm
bell should stop ringing. This is not as easy as it sounds.
Sometimes in the middle of a panic attack, focusing on breathing
can be difficult. One of the effects of over-breathing is that you feel
you need more air, so it is difficult to do something which makes
you feel as though you are getting less!

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Again, practise while you are not panicking to begin with. This
technique will only work if you have practised and if it is used for at
least three minutes. It works much better in the very early stages of
panic. Practise the following as often as you can:

STEP 1: breathe out

STEP 2: breathe in slowly to the count of four, 'one elephant, 2
elephant, 3 elephant, 4 elephant'
STEP 3: hold your breath for the count of four
STEP 4: breathe out slowly to the count of four

Keep doing this until you feel calm. Sometimes looking at a second
hand on a watch can help to slow breathing down.

Remember – Even if you didn’t control your breathing, nothing

awful is going to happen.

Your Mind

There are at least four things you can do to help with the way your
mind fuels a panic attack:

1. Stop focusing on your body

2. Distract yourself from frightening thoughts
3. Question and test your frightening thoughts
4. Try to work out whether something else is making you tense

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Stop Focusing

Try to notice whether you are focusing on your symptoms, or

scanning your body for something wrong. There really is no need to
do this and it makes the problem far worse. It may be helpful to use
the next technique to help you stop the habit. In particular, focus on
what is going on outside rather than inside you.

Distraction

This is a very simple but effective technique. Again, you need to

keep distracting yourself for at least three minutes for the symptoms
to reduce. There are lots of ways you can distract yourself. For
example, look at other people, and try to think what they do for a
job. Count the number of red doors you see on the way home.
Listen very carefully to someone talking. You can also try thinking
of a pleasant scene in your mind, or an object, like a flower or your
favourite car. Really concentrate on it. You can try doing sums in
your mind, or singing a song. The important thing is that your
attention is taken off your body and on to something else. Use what
works best for you.

Distraction really does work. Have you ever been in the middle of a
panic attack when something happened that totally took over your
attention, for example the phone ringing, or a child falling over?

Remember – Distraction breaks the vicious circle, but it is important

to remember that distraction is not preventing something terrible
from happening. In fact, as distraction works, this is evidence that
nothing awful was going to happen after all. For example, could the
fact that the phone rang really have prevented a heart attack?

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Question your thoughts

Sometimes, rather than distracting yourself from your anxious

thoughts it is more helpful to challenge them. In the long run, it is
most helpful to challenge your worrying thoughts, so that you no
longer believe them.

For thought challenging you need to do two things:

1. Work out what your anxious thoughts and worst fears are.
Everyone’s are different, you should already have a good idea
from the work done so far.
2. Start to challenge these thoughts and come up with more
realistic and helpful thoughts.

Once you are aware of your thoughts and pictures in your mind, ask
yourself:

What is the evidence for and against them?

How many times have you had these thoughts and has
your worst fear ever happened?
Do your experiences fit more with panic or with something
more serious? For example, if thinking about panic brings
a panic attack on, is it likely that a stroke or heart attack
could be caused in this way?

If you can come up with more realistic helpful thoughts, write them
down and keep them with you. It is often much more difficult to
come up with these thoughts when you are actually panicking.

Some examples of unrealistic and unhelpful thoughts, with more

realistic alternatives are given below.

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Unhelpful or unrealistic More realistic thoughts
thoughts
I am having a heart attack I have had this feeling many times
and am still here
I am going to faint People having panic attacks are
unlikely to faint. I have not fainted
before

I am going mad The feelings I am experiencing are

panic - they are nothing like going
mad
I will make a fool of myself I have panicked before and no-one
has even noticed. People are busy
getting on with their own thing

Whilst it is really useful to challenge thoughts in this way, probably

the best way is to challenge the thoughts through the things we do,
which is the next section. Before looking at how we can alter our
behaviour to help reduce panic, it is useful to look at one other way
in which your mind may be contributing to panic. Not through
unhelpful anxious thoughts, but because there may be other things
bothering you, as mentioned earlier. Remember that panic can
arise as a result of difficult feelings not being dealt with. It may be
helpful to work out whether anything like that is bothering you. Is
there anything from your past that you haven’t sorted out that is
preying on your mind? Are there difficulties in your relationship?
Do you feel angry or sad? Has someone or something upset you or
is something troubling you? Panic is less likely to happen if you
face up to emotional difficulties, either through talking to a friend or
a professional counsellor (for example your doctor, nurse, practice
counsellor or psychologist).

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Behaviour

Finally, challenging what you do is probably the most helpful way of

overcoming panic. We have already talked about how avoidance,
escape and safety behaviours keep panic going. It makes sense
then that to reduce panic you need to reduce these behaviours.

Put simply, what you need to do now is test out the situations you
fear most to prove to yourself that what is written here is true: a
panic attack cannot harm you.

This is best done, not all at once, but in a planned way. It’s
probably best to start off with a small experiment. It’s difficult to
believe something just by reading it, what you really need to do little
by little is to prove to yourself what is really going on.

It is important to remember that whatever you do or don’t do, the

panic attack will stop. Just like any other alarm would.

First of all, work out what behaviours you need to tackle:

Avoidance

For example, if you are frightened of being alone, or visiting a

supermarket, try gradually spending a little bit more time on your
own, or going to a small shop. Does your feared disaster actually
happen? Now you have some evidence that you didn’t die/go
mad/faint. The next step is to spend a bit longer, more often. You
will probably feel anxious to begin with, as you have learnt to be
anxious in certain situations, and you may have been avoiding them
for some time.

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Escape

Note which situations you are escaping from. Do you stop eating a
meal half way through in case you are sick? Or leave the
supermarket without your shopping? Try staying in the situation
until your panic starts to go down. What will you have learnt?

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Safety behaviours

Try to notice all the things you do to keep yourself safe, big and
small, and gradually cut them out.

Do you stand absolutely still to stop yourself having a heart attack?

Walk about instead. If you normally sit down to stop yourself
fainting, try staying upright. What happened? What did you learn?

Write down some experiments you could try, and afterwards what
you found out, following the example below.

Safety behaviour What you do What did you learn?

and purpose instead

Lie down when Run up and down I did not have a heart
panic comes on to stairs attack even though I
prevent heart attack ran up and down the
stairs

Lean on shopping Walk without trolley, I did not faint even

trolley to prevent use basket instead without the trolley
fainting

By testing out your fears in this way, and finding out that your worst
fear never happens you will gradually become more and more
confident. Your panic attacks should become fewer and fewer and
less strong when they do come.

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SUMMARY: Coping with Panic

Remember:
Panic is a form of fear. It is our body’s alarm system signalling
threat. It prepares our body to fight or run away from danger. But
as there is no physical danger it is a false alarm.

A panic attack may be unpleasant but it is not dangerous.

 Practise relaxation, slow breathing, distraction and thought

challenging when not anxious until you have learned the
techniques.

 Remind yourself during a panic that you have panicked many

times before and nothing awful is going to happen.

 Use distraction, relaxation and slow breathing to help you get

the panic to go away.

 Challenge your unrealistic thoughts during a panic, using some

more realistic thoughts you have written down.

 Try not to avoid, escape or use safety behaviours, instead test

out what really happens.

 Try to sort out any worries or troubles that you have. Talk about
them; don’t sweep them under the carpet.

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5. Further help
Whilst the techniques in this book should help you to get better by
yourself, sometimes you may need professional help too.

If you feel you may need professional help, talk to your GP, who
might be able to provide this or who may refer you on to someone
else who can.

Some useful helplines

No Panic
Free Helpline (daily 10am-10pm) 0808 808 0545

Breathing Space
Free Depression Helpline (daily 6pm-2am) 0800 83 85 87

Panic websites

[Link]
Information and advice on coping skills; introduction to cognitive therapy and
worksheets that can be downloaded and completed; explains importance of
good breathing and gives exercises to try; comprehensive links and resource
pages.

[Link]
A “panic attack course” that can be completed online or can be emailed to
complete in your own time; explains what panic is, why people have panic
attacks and how thoughts cause panic; explains how to change the way you
think and how to control panic through breathing and relaxation.

[Link]
Comprehensive help for panic and associated conditions. Includes telephone
and written recovery programmes.

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General websites

[Link]
Fife Clinical Psychology Department Website

[Link]
The Living in Fife Website has been designed specifically for people living in
Fife. It provides both local and national information about support services.

Books

Baker, R. Understanding Panic Attacks & Overcoming Fear Lion Publishing

IBSN: 0745951236

Bourne, E. J. (2001) The Anxiety and Phobia Workbook 3rd Edition New
Harbinger Publications IBSN: 157224223X

Butler, G and Hope, T (1995) Manage Your Mind. Oxford

ISBN: 0192623834 (An excellent self-help textbook with chapters on all
major problem areas and a good CBT & problem solving approach. For most
people only one or two chapters are highly relevant.)

Goldman, C & Babior, S. (1995) Overcoming Panic, Anxiety and Phobias:

New Strategies to Free Yourself from Worry and Fear Whole Person
Associates IBSN: 1570250723

Jeffers, Susan (1987) Feel the Fear and Do It Anyway Vermillion (reprinted
2004) ISBN: 0712671056 (Easy to read. Encourages coping strategies and
an overall change in attitude.) Also available in audio format

Silove, Derrick & Manicavasagar, Vijaya (1997) Overcoming Panic.

Constable & Robinson. ISBN: 1854877011

Trickett, S. (1992) Coping Successfully with Panic Attacks. Sheldon Press.

ISBN: 0859696464

Weekes, Claire (1995) Self Help for your Nerves. Thorsons

ISBN: 0722531559 (Emphasises coping with physical aspects of anxiety and
panic. A little old-fashioned in style, but clear.)

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 Notes

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 Cut out and keep:
-----------------------------------------------------------------------

Coping with Panic

THINGS TO REMEMBER
The feelings are normal bodily
reactions; they are not harmful
Do not add frightening thoughts,
describe what is happening
Wait for the feelings to pass
Plan what to do next, then start off
slowly

Fife Clinical Psychology Department 28

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Reviewed 2013

Fife Clinical Psychology Department 29