Coping With Severe Panic and Anxiety using "Just This" (DBT)

Whether you have Borderline Personality Disorder or are emotionally sensitive, from time to time, most of us have experienced the dreaded panic or anxiety attack.  In the midst of it, it feels as if it is going to last forever -- like there is no relief or end in sight.

The more we feed the fear by entertaining these kinds of thoughts, unfortunately, the worse the episode can get.  This is because our brains, specifically the amygdala, has sensed that we are in some type of danger. We may be perfectly safe on our couch in front of the television when we have this reaction.  This is because the amygdala reacts even to perceived danger. So, if you become frightened by thoughts and thoughts alone -- with no imminent or present danger, your brain can still go into red-alert and react accordingly.

This is the state I had been in since last night.  I'll spare you the gory details, but I ended up in the emergency room for intense pain.  I dreaded going to the ER.  I had been away from that place for 20 months -- a record.  I used to frequent it when having mental health crises and hoped I wouldn't see that it again for a very long time.

So, despite sharp pains, I was hesitant to follow through on the advice nurse's recommendation to go in. My Wise Mind kicked in, though, and I followed through. Six hours later, I found out it was probably just a combination of referred nerve and ovary pain.  It's all dissipated now.  

I did my best to stay grounded while at the hospital.  I counted how many green things I saw (not many!), self-soothed visually by looking at this photo of polar bears on the wall (thank goodness it was in the room!)

and the crack of light coming through this window...

and I even made it through an invasive exam in this room though deep breaths and self-talk.

Overall, I made it through a potentially triggering situation with flying colors. 

I didn't feel like myself at all when I got home last night, though. I hadn't been allowed to eat or drink at the hospital in case I needed to have an operation (they thought at one point that it was my appendix).  I needed to get an IV, which those of you who have been following me for a long time know that the combo of not eating and drinking and being made to have an IV have been quite triggering for me in the past due to past trauma. They also gave me Benadryl, which made me groggy. Last night and this morning, feeling disoriented and having become emotionally dysregulated, I ended up having 2 bad panic attacks with a relatively high level of anxiety in the interim.

It wasn't until I noticed my thoughts that I started to get a grip on my state of mind.  It was time to get skillful.

I did some guided meditations for about an hour and lots of self-talk.  I noticed the thoughts, and most of them were future, fear based: 

"What if this never ends? What if I don't feel better again?  What if I let my readers down after recently announcing my recovery from BPD -- is it okay to still have and show my moments of suffering?" 

That's when I got into mindfulness. I kept repeating and reassuring myself, "Just this..."

Just this...

  • moment
  • breath
  • thought
  • bite of food
  • step
  • rapid heart beat
  • transient feeling
  • episode
  • deep breath
....etc.  It's amazing how powerful it can be to ground yourself with the phrase "Just this..." followed by whatever you are feeling or experiencing.  It's a powerful reminder that, as intense as things feel, they will pass.  It's also a reminder that all we ever have to deal with (and in reality, all we CAN deal with) is in this very present moment. We can't know if we'll still feel anxious by dinner time (I just wolfed down a sandwich by the way, so the worry thoughts of the emotional mind that I would feel that way "forever" have been disproven), or even how we'll feel in the next hour.

I encourage you the next time you feel anxiety or panic, as incredibly difficult as I truly know it is, to get a hold of your Wise Mind in any way that you can. Start counting things around you. Notice anything that is comforting or soothing.  Lie down and try some guided meditation, even if it feels like you are going to crawl out of your skin.  Go for a walk.  Anything you can do to reassure your very well-meaning brain that you are not in any real danger will help to reduce the symptoms all the more faster.

I am the type of person where, even when I logically get that I'm okay and no longer feel anxious emotionally, my body is still metabolizing all of the chemical effects of the anxiety and panic, so the rapid heart rate, etc. may last beyond me beginning to feel better mentally. Knowing this can help me from getting hysterical. (For example: OMG -- why is my heart STILL racing even though I'm "over" the anxiety attack?)

I hope this helped or encouraged you in some way to know that you are not alone in  your experience of anxiety and panic and that there are ways to skillfully and effectively reduce your suffering.

Do you experience anxiety or panic attacks?  What do you find helpful during these difficult episodes?  Your comments are always encouraged.

Thanks for reading.
More Soon.

PS...I have permission from my psychiatrist to share her response email with me regarding my choice to go into the ER for the pain and the resulting panic attacks and thoughts...Here it is!

Dear Debbie- thanks for this email- I think you did the RIGHT thing going into the ER- think of it as "exposure" in terms of separating physical from psychological.

Also, re meeting the BPD criteria or not, I think you were very clear about the criteria you still meet-and those are real and create suffering-its okay to have what you have--think of all the work you have done and all the people you are also helping-
Perfect does not exist (for any of us!!!) Go back to your skills, write, relax and take the ativan 1 mg-that's fine--I look forward to our meeting.

Now that's what I call a caring and validating response.


  1. I think you're doing excellently, and an inspiration to all of us with BPD! I think your psychiatrist is right in that you're separating physical vs. psychological reasons for going to the ER. And that it's ok to go there for that reason, actually needed.

    1. Thank you so much for reading and taking the time to leave this kind comment, Joyce. ♥

  2. First of all, I'm so proud of you for handling a distressing situation so well. It reminds me of a situation early on in mine and Rowan's relationship when I had to take him to the ER for physical symptoms. The whole time it felt so surreal and a bit triggering being there again in the same hospital where I had been multiple times before. I was even recognizing staff and paranoia settled in even though we weren't there for me. After a while, I voiced my anxiety to Rowan, breathed deep breaths, and brought myself into the present. I realized that I was here with him, supporting him. I was not the one on the bed. It really ended up being a very bonding experience being able to serve him in that way, and it solidified our commitment to each other as partners through the thick and thin in an early stage in our relationship. :)

    Your experience *was* about you being in that bed, not someone else, and still... look at the wonderful insight and silver lining you have found. Simply amazing. :) I agree with your psychiatrist 100% on all accounts.

    1. Thank you so much for your thoughtful comment, Aeshe. I really appreciate that you shared your experience and your encouraging words. Huge hugs and love! ♥

  3. Well done for overcoming it. I'm terrible in anxiety attacks, I just can't seem to see past them at all. Hopefully now I've started DBT that will change though, but if we're hoping for stuff I just hope I don't have one again!

    1. Hi Livi -- thank you for your kind comments. I have lots of hope that as you learn the skills, you will feel more "skillful" in coping with the distressing emotions and more confident in your ability to regulate your emotions. Hugs! ♥



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