Using Dialectical Behavior Therapy To Manage Panic and Anxiety

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Dialectical Behavior Therapy (DBT) is an evidence-based, hands-on approach originally designed to help people with borderline personality disorder but can also be effective for other mental health challenges, including anxiety. With practical tools and techniques, DBT can equip you to manage intense emotions and take control of anxiety and panic attacks. Ready to learn how DBT can help you stop a panic attack? Let’s dive in!

1. Mindfulness

Mindfulness is at the heart of DBT, encouraging you to stay fully present and tune into your thoughts and feelings without judgment. By practicing mindfulness, you can ground yourself in the moment and dial down the intensity of your anxiety, helping you feel more centered and in control.

How to Practice Mindfulness:

  • Observe Your Breath: Focus on your breathing. Notice each inhale and exhale. If your mind wanders, gently bring your attention back to your breath.
  • Body Scan: Slowly bring your attention to different parts of your body, starting from your toes and working your way up to your head. Notice any sensations, tension, or relaxation.
  • Grounding Exercise: Engage your senses by noticing five things you can see, four things you can touch, three things you can hear, two things you can smell, and one thing you can taste.

2. Distress Tolerance

Distress tolerance skills are all about helping you navigate tough emotions and challenging situations. They’re especially handy during a panic attack, giving you tools to stay calm and grounded when everything feels overwhelming.

Distress Tolerance Techniques:

  • TIPP Skills:
    • Temperature: Splash cold water on your face or hold an ice pack to help bring your body temperature down.
    • Intense Exercise: Engage in short bursts of intense physical activity, like jumping jacks or running in place, to release tension and anxiety.
    • Paced Breathing: Slow down your breathing. Breathe in deeply for a count of four, hold for four, and then exhale for four.
    • Paired Muscle Relaxation: Tense and then slowly release each muscle group in your body, starting from your toes and moving up to your head.
  • Distract with ACCEPTS:
    • Activities: Engage in activities that require your attention and can distract you, like drawing, reading, or cleaning.
    • Contributing: Help someone else or contribute to a cause to shift your focus away from your anxiety.
    • Comparisons: Compare yourself to others who are less fortunate or think about past situations that were worse than the current one.
    • Emotions: Induce a different emotion by watching a funny video or listening to uplifting music.
    • Pushing Away: Mentally push away the distressing thoughts. Tell yourself you will deal with them later.
    • Thoughts: Distract your mind with thoughts like counting backward from 100 or reciting a poem.
    • Sensations: Focus on physical sensations, like holding an ice cube or frozen orange or taking a hot shower, to divert your mind from your anxiety. 

3. Emotion Regulation

Emotion regulation skills are like a guide to understanding and taking control of your emotions. By using these tools, you can not only manage your feelings more effectively but also reduce how often and how intensely anxiety shows up in your life.

Emotion Regulation Techniques:

  • Check the Facts: Analyze whether your anxiety is based on facts or assumptions. Ask yourself if there is concrete evidence for your fears.
  • Opposite Action: Engage in an activity that is opposite to your current emotion. If you feel like avoiding something, face it head-on instead. 
  • PLEASE Master:
    • Physical health: Take care of your physical health by eating well, sleeping adequately, and exercising regularly.
    • Listening to your body: Pay attention to signs of stress and fatigue and respond appropriately.
    • Eating: Maintain a balanced diet.
    • Avoid drugs and alcohol: These substances can exacerbate anxiety and panic.
    • Sleep: Ensure you get enough restful sleep.
    • Exercise: Incorporate regular physical activity into your routine.
    • Mastery is about engaging in activities or tasks that give you a sense of accomplishment, no matter how small they may seem. This can include developing new skills, pursuing hobbies, or simply completing daily responsibilities.
  • Build Positive Experiences: Engage in activities that bring you joy and fulfillment regularly to improve your overall emotional resilience.

4. Interpersonal Effectiveness

Although primarily focused on improving relationships, interpersonal effectiveness skills can also help better your anxiety by helping you to seek support and communicate your needs effectively.

Interpersonal Effectiveness Techniques:

  • DEAR MAN: Use this acronym to communicate effectively during distress:
    • Describe: Clearly describe the situation.
    • Express: Express how you feel about the situation.
    • Assert: Assert your needs or what you want.
    • Reinforce: Reinforce the positive outcomes of getting your needs met.
    • Mindful: Stay focused on your goals and the discussion.
    • Appear confident: Use a confident tone and body language.
    • Negotiate: Be willing to negotiate and find a middle ground.

DBT skills can be a game-changer when it comes to managing and dialing down the intensity of anxiety and panic. With skills like mindfulness, distress tolerance, emotion regulation, and interpersonal effectiveness, you’ll build a powerful toolkit to face anxiety head-on. The key is regular practice—making these skills second nature so they’re ready when you need them most. If anxiety or panic attacks are frequent or overwhelming, don’t hesitate to reach out to a therapist trained in DBT for personalized support and guidance tailored to your journey. At Birchwood Clinic in Chicago, our trusted team of counselors, therapists, clinical social workers, and psychologists are here to support you and help you better manage your anxiety.

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