How to Prevent Panic Attacks -Challenging the Thoughts which Cause Panic

Prevent Panic Attacks - Challenging the Thoughts which Cause Panic

Prevent Panic Attacks - Challenging the Thoughts which Cause Panic


The underlying basis for panic attacks is your thoughts.  It is so hard to believe that your own thoughts are doing this.  At first I did not believe this; I thought I had some deadly disease.  But the truth is your own mind is doing this to you.  Once you have established this then you can begin to get well again. Sometimes our thoughts are so instinctive and well hidden that we do not even realize we have thought them.  The key to curing yourself of panic attack is removing those worrying thoughts which are causing the problem. 



unhelpful thinking

unhelpful thinking 1

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I have discussed in previous articles how distraction and relaxation can help a sufferer cope with a panic attack.  If you really want to bring about long term positive change and cure yourself of panic attacks then you have to challenge your thoughts.  For example

1. You have to identify what thoughts are triggering panic and anxiety  (What Triggers Panic Attacks).  Everyone is unique but most panic attack sufferers will tend to fear the same issues.

2.Once the thoughts have been identified, remember that thoughts can happen so fast so you may not even realize what they are.  Also the thoughts can be so engrained that you may not consciously be aware of the thoughts as they happen.  A top tip is to have a pen and write them down at the time when you are feeling panicky.

As you write these thoughts down I predict you will find that nearly all the thoughts are being exaggerated in your mind to be out of all proportion.  If you analyze them you will find they are unnecessarily frightening.  What you need to do is to think much more logical and realistic thoughts. 

Once the thoughts have been identified and targeted you can really begin to fight back and start turning the tables against the fear.  What you need to do is stack the cards in your favour.  I would ask that you answer the following questions when you have to undertake a task which causes anxiety. 


FOR EXAMPLE Going To The Supermarket (I have included example answers.)

Write down if there was any anticipation anxiety?

For example entering a busy supermarket the person thinks I may have a panic attack there.  It will be busy and there will be long queues at the check out.  What if I feel dizzy?

Write down what were the initial thoughts when you started to feel anxious?  I’m inside through the doors.  I feel anxious.  I see people and look around to see how busy it is.  I look at the end of the shop and I have to venture to the back to get what I want.

Write down what thoughts moved the anxiety to panic?

I have a large basket full of food.  Its heavy and I feel my breathing is very shallow.  My heart is beating fast.  I feel people are looking at me.  I scared to go to checkout.  I can’t seem to focus or concentrate on anything.  I may have to leave the basket on the floor and run out.

Write down how you dealt with the panic attack?
Got to the check out and want to the smallest queue.  I  leant against the counter to steady myself.  Paid as quickly as I could.

Finally write down what meaning you took from the attack?

I seem to be scared of the symptoms of panic (internal feelings) and of situations where there are people and places where I cannot easily escape (external places).  

challenging anxious thoughtsMost people start dreading the worse when the sensations start.  This is where the panic gets its power from.  Often people think something awful is about to happen to them.  It’s often helpful to write down the worst things you think might happen to you. When doing this try to be open with yourself.  Don’t write down that you told yourself that you were calm and relaxed because that’s clearly not the case.  Its impossible to have a panic attack if your relaxed and calm.  The more honest you are with yourself and the deeper you get in your inner most darkest and negative thoughts the quicker the recovery will be.   


After you have written down your panicky thoughts you need to evaluate them.  In order to do this we need to make this as simple and effective as possible.  Look at each thought which is making you anxious or panicky.  On one side make notes for the thought being true, in other words in support of the thought.  Then make some notes against the thought not being true and having some alternative explanation.  For example-

When I’m in a queue my legs go wobbly there must be something wrong with me?


Not being true

I have real physical symptoms

I don’t feel very well and I’ve felt it before

This is a symptom of anxiety

My symptoms only happen in certain places

My symptoms stop once I leave the queue

I never have collapsed

I usually feel anxious and get other symptoms as well such as dizziness.


When you actually study the thought I bet you will find that you are not faced with any some sort of imminent catastrophe but you actually fear the thought of the catastrophe.  Have you actually ever had a heart attack, gone crazy or collapsed.  My guess is that you have not.

Once you have eliminated any physical things that could be causing your symptom and seen a doctor, then its really best to think objectively.  Read about all the physical symptoms anxiety can cause and see if they generally match yours (remember everyone is different).  Then you need to come to a firm, logical, sensible conclusion that in your own mind you are sure you have panic attacks.

Remember the best conclusion to come to are hard, factual truths rather than just a gut feeling or intuition.  If you feel like you may have some deadly disease or you have read some medical information on the internet and it loosely fits what you have, then you are not really looking at the facts.

Its also worth pointing out I do not know your medical history, so you may have had some physical ailment that’s causes anxiety like sensations.  Nor can I say you will never collapse, have a heart attack, feel anxious.  These things are facts of life and everyone has to deal with this.  The crux of the matter is if you believe you have panic disorder and you understand it cannot harm, then every sensation can be systematically taken apart and challenged.  You can then start to desensitize yourself and feel better.  Slowly but surely the panic attacks will be less severe and further apart.  The background anxiety will totally switch off for longer periods, and situations which you once enjoyed will start to feel good again.

One of the key questions which seems to help most people is


Say this to your self again.  In your world you have built panic attacks to be the most important all consuming thing in your life.  But the reality of situation is people with epilepsy collapse every day but they still get up and walk around again.  Heart attacks victims still recover and lead a perfectively full life.  People who sweat, feel awful, tremble, have difficulty swallowing because of legitimate physical ailments still function and have a happy life on this planet.   They choose to be positive and make the best of the situation.  You can as well.  You just have to believe you can get well and take action and live in the moment and enjoy yourself.  You are lucky eventually your symptoms will start to diminish as you get better.

Spontaneous Panic Attack

Once you lift yourself out of the gloom with the knowledge you have learnt here, you will realize if you had a health problem you would not be able to feel better when the fear subsides.  Most people have safe places (i.e. home) where they tend to feel like their normal selves again.  Other physical causes would not follow this pattern. 

Generally with a panic attack something will trigger the attack which you will probably be aware of. If nothing is obvious it will normally be obvious if you think about it.  For example if you are having several panic attacks a day, then in my experience, you are so sensitized your body may trigger one anytime.  Not looking after yourself and not eating regularly can also set off panic attacks for no reason.  Also a sugary diet and drinking fizzy drinks can trigger panic attacks.  Situations which are similar to what causes your panic attacks can trigger an attack. So if social interaction is a trigger and you were to meet a relative, even though your comfortable with this person, the brain can interpret this as social contact and anxiety can be triggered.    

As I have stated in previous articles its amazing how distraction can short circuit the panic.  Sometimes when your concentration is transfixed by something you were not expecting the brain can switch off from panicking.  From this we can deduce that the more you worry the more powerful your anxiety will be.  The less power you give your negative thoughts the more you can enjoy life again.  Give your energy to positive healing and think positive thoughts.

bob marley “The greatness of a man is not in how much wealth he acquires, but in his integrity and his ability to affect those around him positively”   Bob Marley



Distraction is one of the key tools which can help reduce the strength of a panic attack.  However the distraction has to be of a strength to totally take the persons attention somewhere else.  From this we know that when worrying thoughts are stopped, and our thoughts are concentrating on more positive things, we stop the panic in its tracks and start to change our mental patterns and behaviour. 

Therefore if we think we are having a stroke or heart attack, would our symptoms start the minute we entered a shop?  Would our symptoms end the minute we sat down in our lounge and relaxed?  By logically thinking things through we start to reprogram our mind to believe the truth.  Thoughts are extremely powerful but not powerful enough to start a heart attack and then turn off a heart attack. 

We know form research what sensations arise from anxiety.  So would you say your symptoms fit much more closely to anxiety and panic disorder?

For me there were certain places that I would know I would suffer from anxiety.  I would have worrying thoughts beforehand and anticipatory anxiety.  My brain was wired to trigger at this point.  Out of the blue panic attacks which was a bit more baffling.  Once I learnt that if your body is in such a high state of tension, panic attacks can trigger any time, the ‘out of the blue’ panic attacks lost a lot of their power.  It was comforting to know that once I learnt to relax, along with the other tools, these would subside.

I believe you will find that if you look through the thoughts you have written down you will find that your thought patterns and triggers suit much more closely with fear and panic than real physical and mental illness.

One of my many thought patterns which was negative was, if I started to feel anxiety my thoughts would go in a downward spiral which would make things worse.  When I thought through something, I made something which was trivial into a disaster waiting to happen, and if it did happen it would be much worse than it should be.

For example if I was driving on motorways (where I use to panic) I would think if I have a panic attack here, I going to slump at the wheel or go crazy and crash into other drivers on the road.  This was totally over exaggerating the reality of the situation.   The reality was I had experienced severe anxiety on motorways before but I had never driven dangerously.  The once or twice I felt really bad I just pulled over on the hard shoulder, or to the nearest service station until I felt better.  When you can objectively think things through without the fear and emotion, and see that panic is not something to be afraid off, you will take the sting out of it.  (Do you suffer from phobia's?)

What are the chances of your fears actually coming true?

Try to think of the number of times you thought about a particular fear.  If you were anything like me I was in total fear of panic attacks for many years and probably thought of them thousands of times.  What ever your ultimate fear is (a heart attack, going mad, fainting, etc) how many times as it actually happened.  There answer is probably never.  You can deduce from this your thoughts are not very accurate.  You may have thought during this panic attack this was the time you were actually going to keel over and die.  The fact you are reading this and searching for answers means you didn’t die and your thoughts are unfounded.  Would you bet on a horse that had run hundreds of races and never won?  Why would you then believe something is wrong with you when nothing as actually ever really happened?

Marilyn Monroe “We should all start to live before we get too old. Fear is stupid. So are regrets.”

If your worst disaster happened, how bad would it actually be?

Nobody wants to have a heart attack or die, but even people without panic disorder have to deal with this.  It’s a fact of life and if you fully accept this then there is nothing to fear.  You can also stack the cards in your favour by eating healthy foods and taking regular exercise and this will not only give you the feel good factor but leave your body in good shape.

Panic attack sufferers have much more negative thoughts than normal people, and tend to loose a grip on the reality of certain situations.  The feared disaster is often not as bad as we first think.   When our thoughts are so frightening we don’t tend to see the reality of what would actually happen if our fears come true.  Quite often we see things as a catastrophe when they are merely unpleasant.  For example if we fainted at work it would not mean that the whole company was laughing at you.  Many people faint at work and although it’s an inconvenience its not a life changing event.  If you think of embarrassing things that may have happened to you in the past they may have been distressing, but looking back were they really that bad?  Most people would feel sympathy and try to help you. 

Many people also fear losing their jobs if somebody finds out they have panic disorder.  This is an understandable feeling, but more and more work is now being done to bring mental illness to the open.  Television programs are now being devoted to mental illness and companies are now much more aware of the welfare of their workforce.  About 1 in 4 people will suffer from some sort of mental illness with the most common being depression.  The chances are your boss will have experience with this and will be understanding.  As part of my recovery I preferred not to think of a panic attack as a mental illness but just a habit of faulty thinking.  Panic attacks are basically just this – a bad habit.

In order to make progress at the start to eliminate these thoughts I am a great advocator of writing them down.  When you get more practised you can just run them through in your mind.  But for know its much easier to write them on paper and then you can refer to them anytime.  When your feeling anxious its not a good time to challenge your thoughts because you will not be able to think clearly.  The more you practise coming back to the thoughts which are entering your mind and disempowering by sensibly thinking them through, the more progress you will make.  This can often take time as thought processes take time to change.  Eventually your subconscious mind will naturally be calm. 

The subconscious mind   

"The subconscious mind as the storage room of everything that is currently not in your conscious mind.  It is what we have learnt and stored away for use when we need it."

If you to walk in the street and suddenly a tiger were to jump out in front you heart would probably feel like its going to jump out of your chest, and your eyes are going to lock onto the tiger.  Rather than you running away you may find yourself frozen with fear.  All this happens even before you have had time to think!  So what’s causing all these sensations – its your subconscious mind.  Its done this automatically and instantaneously.  In this case its perfectly warranted.  When you enter a busy shop and these symptoms happen its not.   So you have to access your subconscious mind and tell it exactly where and when it should be triggering panic symptoms.   You do this by challenging your thoughts when your calm, relaxed and meditating.  I strongly recommend you sit your down on your bed in a dark room and for 30 mins each day systematically go through the thoughts you have written down.  Take the fear out of each thought.  Disempower them, take them apart and strip them down to the reality that they are – feelings and sensations which will pass and eventually subside.  When your mind and thought patterns are reprogrammed with new behaviour you will no longer feel panic in these situations.  Of course if that tiger reappears in the street you will but that’s OK, you should panic!

I will give you an example of how fainting can be disempowered.  Sometimes people do faint it’s a fact of life.  People basically faint when the blood pressure drops and it reduces the blood supply to their brain.  You often hear about soldiers fainting on parade when they have been stood up a long time.  This is because they are hot and their blood supply is being directed around their skin to try and cool them down.   This means less blood supply for the rest of the body.  In these conditions the blood pressure may drop to the brain and the body takes over.  In ‘taking over’ it makes you faint so your lying down and your brain and heart are at the same level, so its less work for the heart to pump blood to your brain.  Its actually a safety mechanism and its there to help you.  It is not something to be feared.  In the case of panic when your heart beats faster and adrenaline is pumped around the body your blood pressure actually raises, this makes the likelihood of fainting extremely remote.  Panic and fear has the opposite effect on the body its priming you to run not to lie down.       

Why 'mental illness' is different from anxiety and panic attacks.

Mental illness is used to cover a multitude of illnesses.  It can be very confusing as different people will take the words ‘mental illness’ to mean many things.  In its basic sense it can mean an illness which is not primarily physical.  So if we apply this to panic disorder it could be classified a mental illness.  There are various stigmas and connotations associated to mental illness which is why lots of people keep there illnesses from their relatives work colleagues and friends. 

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I would like to put a positive spin on panic attacks and anxiety.  We were not born with panic disorder.  At some point under stress a switch has flicked in our brain and we have started to feel this way.  As I have stated before a HABIT has evolved in our way of thinking to produce panic attacks.  That’s all it is, a habit.  We all pick up worries, bad habits, stresses through our journey through life, but the key is to stay positive.  This will lead you on a much happier journey through life and most importantly you will enjoy it. 

I would recommend at least until you feel better that stay away from the news.  The news is always negative.  A bad event happening half away around the world is not going to affect you.  I would look at the little things in life and take note.  By admiring spring flowers, winter frosts, birds singing, you can get into the zone and find pleasure.  Take up a hobby, get a better work life balance, really enjoy being with your family, go away on more short breaks using bargains on .  The list is endless, just get into the groove of doing what ever rocks your boat!    

Going back to mental illness its helpful to know a little bit more.  Most people will associate true mental illness with conditions like manic-depressive disorder and schizophrenia.  These are the more severe mental illnesses, and these illnesses are what  people think of when the term 'going mad' is thought of.    Psychological conditions can be broadly split up in two categories the neuroses and the psychoses,  The first group are very common and include anxiety, panic and depression.  Anyone can suffer these conditions.

I have taken these statistics from

The facts and figures around Mental Health in the UK are alarming.

  • 1 in 4 people will experience some kind of mental health problem in the course of a year
  • Mixed anxiety and depression is the most common mental disorder in Britain
  • Women are more likely to have been treated for a mental health problem than men
  • About 10% of children have a mental health problem at any one time
  • Depression affects 1 in 5 older people
  • Suicides rates show that British men are three times as likely to die by suicide than British women
  • Self-harm statistics for the UK show one of the highest rates in Europe: 400 per 100,000 population
  • Only 1 in 10 prisoners has no mental disorder

 The statistics speak for themselves, you can see how common Mental Illness is. 

The second kind of metal illness psychoses includes the severe mental illnesses like schizophrenia, it is much less common.  You can rest assured  one psychological problem does not turn into the other. People with panic are no more likely than anyone else to develop a severe mental illness. You would not expect that having a cold means you will develop cancer. In just the same way, having panic attacks does not mean you will develop schizophrenia or any other severe mental illness.  Therefore panic attacks are very common along with depression and anxiety, and are perfectly treatable.  We can also take hope that mental health issues are becoming more mainstream.  For example politicians had an emotional debate in the commons on mental illnesses in June 2012. 

MP Dr Wollaston revealed that she had suffered panic attacks on the London Underground as she commuted to work after having a baby.

She Said: “For many people, an experience of depression will make you a stronger person and a more understanding person.

I am absolutely sure my own experiences of depression and recovery made me go on to be a much more sympathetic doctor and, I hope, a more sympathetic and understanding MP as well in recognising issues in others and responding to them.”

Also more and more TV documentaries are being on mental issues including  Ruby Wax's Mad confessions.

How to challenge your negative thoughts.     

I totally believe that if you continue to live your life the way you are doing, it will only lead to the same outcome you are experiencing now.  What is required is a life changing outlook; this means a lifestyle change.  Life style and behaviour are interlinked and both are a key element in overcoming panic. I have already shown how avoidance, scanning and anticipation anxiety must be eliminated or else the cycle of panic will continue. 

As part of a lifestyle change I also strongly advocate to have a basic common sense plan on how your going to (you may be already doing this) introduce an exercise regimeinto your life.  Personally I would recommend at least 3 times a week and whatever you do its must be rigorous exercise for panic attacksenough to make you sweat.  If you’re disabled or virtually house bound due to agoraphobia then you will have to think out of the box and perhaps buy some second hand gym equipment which suits your needs.  (  may be a good idea)

I often see exercise bikes in people’s garage which would be a great way to feel better.  The virtues of exercise have been described in many research experiments.  From my own experience exercise is like an antidote to panic.  It removes all the negative chemicals inside your body and makes you feel good about yourself.  However there are some common sense principles.  If you have not exercised before then build up slowly, you may even need some doctor’s advice.  Remember this is a life style change so what you do you to build it into you life which will sticks and fits into a routine.  You are much more likely to keep it going if its part of walking the dog, or going with your friends to aerobics.  I believe you need to do at least 30 mins per session and the more hard work you put into it the more benefits you will reap.  As a basic rule you need to feel sweaty by the end.  As I said before, build up slowly, and if for whatever reason you cannot push yourself just do what you can.  Apart from making you feel good it has the benefit of burning calories. 

Many sufferers complain that exercise brings on panic attacks, i.e. thumping heart, over breathing.  However if you have challenged you thoughts before hand and put into practice what I have shown (i.e. relaxation), there is no reason why your confidence will not build and you will actually start to you enjoy the experience.  I usually take an MP3 player (Relaxation MP3 Downloads )with me when I jog to listen to my favourite music.  This helps to distract me if I feel any unusual sensations in my body.   


This leads me onto a powerful way to really make a full recovery and to put all those fear to rest - take action.  Unless you put yourself into the situation that’s scares you, you will not see what the fear really is.

My panic attacks left me with all sorts of different situations which I would fear and worry about.  Just at the moment when I least wanted to have one, yes you guessed it, I would have a panic attack.  When you’re in fear of fear you can guarantee the panic will trigger at the point in which you are most fearful.  To overcome this -

1.  Think about an everyday situation which makes you panicky.  Run through the events in your mind and then right them down on paper so that the whole process is clear in your mind, from initially worrying about the situation to actually completing the task a head.  For example one of my phobias was walking around a busy shopping centre. I would think I was going to feel panicky and my legs would go weak and wobbly.  My breathing would often go shallow and I would suffer from palpitations.  Leading on from these sensations I would interpret these feelings as, I going to collapse and then make a fool of myself in front of other shoppers. 
The aim of doing this is to see if the thoughts are true, i.e. I will collapse or will I just feel very uncomfortable and nothing more will happen to me.

2.  Next go into a busy shopping area and stand and wait to see what happens.  When you actually want to have a panic attack usually it does not happen as your not fearing it.  If nothing happens expand your boundaries and going into a busier place.  If you fear lifts or escalators go on one, or join a long queue if your scared of that.  Just do whatever makes you fearful.  When the sensations appear stand your ground and observe them.  Just describe what is happening but don’t react to anything your thinking or feeling.  Just observe the panic from an unemotional bystander point of view looking inwards.

3.  Once you have felt the worse and sensations have started to subside you will probably feel extremely uncomfortable, but did you actually go mad, faint, collapse or go crazy in the shopping mall?   If you didn’t what does that say about your thoughts?  Did the disaster you were predicting actually happen or was it merely unpleasant.  Looking back I never once collapsed or made a fool of myself.  99% of the time other people did not even realize how intensely I was panicking inside.  Outwardly the physical sensations would cause me to shake, breathe awkwardly and tense up but that was the only real physical signs.  Most people have been in very fearful situations and would sympathize and help you if they could.  It’s one of the main misconceptions when you panic that you tend to feel the whole world is against you.  The reality is most people would help even if your worst fears did come true and you collapsed or fainted.

I would certainly recommend you build up your resilience and confidence slowly and do not push yourself too much at first.  Expose yourself to your fears slowly, and gradually build up to more fearful situations.   From LEARNING AFTER EACH ACTION IS TAKEN you will come to terms that your thoughts and feelings are bluffing you into believing things which are not true.  Just stay in the moment and learn to enjoy each experience as a positive step forward to achieving a goal.  After all being in a shopping queue is a chance to grab a bargain, being in a queue is there for you to purchase that bargain, etc.

step by step recoveryThis whole process of getting better is going to make you anxious.  You have learnt to be anxious in these situations and its going to take time to rehabilitate yourself.  The point you have to learn is does your fear actually happen?  By putting yourself out there in those fearful situations you retraining your mind, and this will gradually begin to build your confidence.   Identifying and challenging your catastrophic thoughts one step at a time is the best way to deal with panic attacks in the long run.


As a starting point I would certainly speak to your GP to see what help and support he/she will be able to offer.  In my experience it can be a battle to get any help on the NHS but you may have private medical through your work which can help.  I would certainly confide in your nearest and dearest as a problem shared is a problem halved.  I think you will be surprised how understanding they are.  Ultimately its only you that can cure yourself and put the effort to succeed and make a difference in your life.

I hope this article has helped you and given you some insight into the world of panic. Perhaps the main message is "Don't Despair !". Lots of people suffer from panic but lots of people also learnt to reduce and even eliminate their anxiety/panic. Panic does not have to rule your life, but to succeed in overcoming it you need to work hard at following the advice given here.  I can assure you there is no magic pill or advice that will cure you instantly, but stick to the advice given here and you should succeed.   

Please visit my resources page for further recommended reading.  I have also included programs which I have personally used during my recovery which can also help in your recovery.     




Other articles

Treatment for Panic Attacks
Panic Attack Breathing?
How to Stop a Panic Attack?
How to Cure & Recover From Panic Attacks
How to cure Panic Attack Disorder?

20 Strategies to Help You Cope with Panic Attacks

Books and other tools that I recommend


My Tools for Recovery

Ruby Wax's Mad confessions.


Overcoming Panic

Overcoming Panic and Agoraphobia

School Phobia, Panic Attacks and Anxiety in Children

Agoraphobia: Simple, Effective Treatment

The Anxiety Cure

The Panic Attack Recovery Book  ( A book I highly recommend)

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