How to Combat Anxiety, Panic Attacks, & Depersonalization

DenaFebruary 7, 2010

polar bear

It Happened to Me

I experienced depersonalization for the first time ten years ago. I was 15 years old, a sophomore in high school. I had just answered a question incorrectly in Spanish class. I was mortified. When you are shy (or suffering from anxiety) it takes a lot to raise your hand in class. The moment you even consider it, the “what ifs?” flood your mind. What if I get it wrong? What if everyone stares at me? What if the teacher embarrasses me? What if everyone thinks I am stupid? What if I blush? What if I sweat? What if I faint? What if I have a heart attack? It sounds crazy, that is, if you’ve never suffered from anxiety. On the other hand, if you have, then you know exactly what I’m talking about.

As the “whatifs” flooded my mind, something began to happen. I started to lose touch with reality. I drifted further and further into panic. In reality, I had raised my hand and gotten an answer wrong. In my head, it was much worse than that. The world was crumbling around me. I could feel every pair of eyes in the room searing through my skin. I knew that everyone was thinking about how stupid I was. My face turned red, I started to sweat, and my heart raced. I thought that I would faint. And then it happened, depersonalization.

I began to slowly drift away from my physical body. And then I was outside of my body looking in, as if in a dream. I was frozen and confused. I thought that I was having a mental break down. I would need to be carried away in a straight-jacket. My life was over. Eventually I came back to earth; but that was only the beginning of what would be a long, hard battle.

I would continue to suffer from depersonalization as a result of my anxiety for many years. It would not be until years later that I would discover the CBT that would save my life. Depersonalization can strike at any time. For me, it most often occurred in social situations. I would be in the middle of a conversation and the warning signs would appear:

  • Dark spots, or floaters, would appear in my line of vision
  • Voices (mine and others) would begin to carry an echo as if speaking into a deep cave
  • My heart would race
  • I believed that my words were no longer “making sense”
  • I would begin to float away from my body

What Causes Depersonalization?

All of the symptoms that I have discussed are caused by a panic attack. A panic attack is a distinct period of intense fear that develops abruptly and usually reaches a crescendo within a few minutes or less. Physical symptoms may include hyperventilation, palpitations, trembling, sweating, dizziness, hot flashes or chills, numbness or tingling, and the sensation or fear of nausea or choking. Psychologic symptoms may include depersonalization, fear of fainting, dying, doing something uncontrolled, or losing one’s mind. Panic attacks are caused by anxiety.

I did not know it, but I had been suffering from relatively intense anxiety my entire life. In retrospect, I suffered from anxiety from the time I was a toddler. Even as a two-year-old, I was constantly worried about my baby sister. As we grew older, I continued to worry over her and then over all aspects of my life. My worry was not normal or rational. It was intense and unnecessary; but no one could help me. I was a child and everyone just thought I was a “worrier.”

Taking Control

As I mentioned above, it would take years for me to overcome anxiety and lead a normal life. It would take years after that for me to lead an exceptional life, unaffected by anxiety — comfortable speaking in front of large crowds, being the center of attention, and becoming a healthy, confident woman. Overcoming anxiety (and depression) even led me to lose 70 pounds which I’ve talked about in more detail here.

All people suffer from varying degrees of anxiety and even depersonalization. Almost everyone has had some sort of outer-body experience. Whether it happens on a regular basis or on a rare occasion (think life flashing before your eyes before a car crash), it happens to all of us. We have developed these mental coping mechanisms as a result of thousands of years of evolution. In some cases, anxiety is healthy. You would certainly need some level of anxiety whilst scavenging for berries outside of a sleeping bear’s cave, for example.

However, too much of anything is not healthy. Too much anxiety is debilitating. It prevents you from living the life of your dreams. So what can you do to keep your anxiety in at a healthy level? There isn’t a really simple solution or a quick fix, so don’t let anybody fool you. It actually takes a lot of hard work (sometimes even years) because you have to completely re-train your mind. You have to change your thought processes. There are many ways to do this (therapy, hypnotism, etc.); however I used a process called CBT (Cognitive Behavior Therapy) to treat my anxiety and I had amazing results. You can read more about my experience with CBT here.

There are a couple of simple ways to decrease your anxiety before it begins to spiral out of control:

1. Control your thoughts. Panic attacks are almost always caused by negative irrational thoughts. If you stop those negative irrational thoughts as they occur, and turn them into positive rational thoughts immediately, you are far less likely to spiral into a panic attack.

Practice changing your thoughts by keeping a daily thought journal. Jot down your negative irrational thoughts on one side of the paper and turn them into positive rational thoughts on the other side. If you practice this habit enough, eventually you will be able to do it automatically and avoid panic attacks altogether.

2. Breathe. Panic attacks are almost always accompanied by a rapid heart beat. Rapid heart beat is a universal symptoms of fear — from a gazelle being stalked by a lion to a student giving a presentation to her class. As we exhibit symptoms of fear, we give in to it. First the rapid heart beat, then the sweat, and then the rest of the “fight or flight” response. By slowing down your heart rate, however, you can avoid the whole chain and stop it before it ever gets to the panic stage.

Shallow breathing causes rapid heart rare and conversely, deep breathing causes a slower heart rate. As soon as you begin to experience the fear, take a deep breath in through your nostrils. Let the air flow through your chest and deep into the pit of your stomach. Allow your stomach to expand, like a balloon, as it fills with air. Then slowly exhale through your nose and expel all of the air from your body. Breathe in deeply again, allowing the air to fill your stomach as before. Each time you inhale, take in the positive energy & light around you. Let it fill & calm your soul. Each time you exhale, push out your negative energy & fear. Continue to do this until you feel calm.

Practice this breathing exercise daily (perhaps as a meditation each morning or night). Then, the next time that you feel yourself beginning to panic you will be expertly prepared to calm yourself through breath.


I suffered from anxiety for my entire life. Some days, I still suffer from anxiety. The difference now is that I have the tools necessary to defeat the anxiety & live my best life. When I fall down, I get back up. Every. Single. Time. If you are suffering, know that you can and you will get through this! Anxiety is not the end. You can overcome it.

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Comments (29)

  • JC Hewitt

    February 7, 2010 at 3:18 pm

    Thanks for sharing your process.

    Another technique that I've learned about (and used) is stomping your foot, knocking on something, picking up an object and dropping it or any other process that re-establishes rational cause and effect.

    It sounds simplistic, but it can derail an irrational thought spiral.

  • Dena

    February 7, 2010 at 3:21 pm

    @JC – I have to admit that when I first read your comment, I thought it was a mean joke. But then when I read it over, it made perfect sense!

    It is amazing how simple things can really "bring us back" when we need it. That's a great suggestion and thank you so much for sharing it.

  • Ryan

    February 8, 2010 at 12:22 am


    Great advice. I breathe deeply throughout the day – either when meditating or simply following my breath – to combat anxiety.

    It's so easy to let negative thinking strangle you, figuratively and literally, if you allow it too. Anxiety is like a cascade of negative thoughts which feels like it's never going to end. Both sides of my fam have members who suffer from some mental disorder. I followed in their footsteps before I took control.

    Realizing that you have the power to control your thoughts and feelings is the turning point.

    Thanks for sharing your insight.

  • Dena

    February 8, 2010 at 8:47 am

    @Ryan – I am happy to hear that you have overcome your struggles with anxiety. Life is incredibly different once you get past the fear, isn't it? For me it was sort of a re-birth.

    Breathing throughout the day, as you mentioned, is an excellent way to "pro-actively" avoid the build up of anxiety/stress.

    Thank you so much for sharing!

  • Dave Doolin

    February 8, 2010 at 11:30 am

    Very nice move!

    JC is right about finding something real.

    I don’t comment much, but I do read along. It’s very cool to see you growing your work.

  • Dena

    February 8, 2010 at 12:08 pm

    @Dave Doolin – I really appreciate it, Dave! So glad to hear that you are reading along. I really appreciate your support.

    I loved JC’s advice, too.

  • Jenna

    February 8, 2010 at 12:27 pm

    The new website looks beautiful, D. I can’t wait to follow your journey in this new space. <3

    1. Dena

      February 8, 2010 at 12:35 pm

      Thank you, Jenna! I am so glad that you like it.


  • Isao

    February 8, 2010 at 5:53 pm

    A year ago I read a book on CBT to take care of someone close to me who had difficulty controlling her emotions. Did not know it worked for depersonalization (or flying experience?). Will share your story with a friend of mine who had that experience and see what she says.

    1. Dena

      February 8, 2010 at 7:58 pm

      I have not heard of flying experience though I am sure that it is the same thing. The sensation of flying (outside of the body in the air) can definitely be a symptom of depersonalization. I will be very interested to hear your friend’s response to CBT. It is life-changing! Wishing her the best of luck. 🙂

  • Mental Health

    February 19, 2010 at 6:36 pm

    There is a social network for those with depersonalization/derealization:

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  • helen

    April 9, 2010 at 3:18 am

    i am very happy to find your website. i just want to discuss something. actually i had anxiety from my childhood , i fear when i see any mad people, i feel that some instances that happened with me are unusual , and i get anxious. but every time in my child hood i was able to handle it myself. but this time after many years i am 22 now suddenly i got some sensations after seeing a movie where some kind of mental disease was shown, and i got a panic attack, and after that i am not feeling as the person i used to be i can see the reality but i am not feelng it, i am not feeling myself, strange thoughts come tomy mind when i see objects , i use to question myself about the existance of the objects , i use to check myself whether my mind is all right or not , but i get assured that i know the reality and i remember everything but i cannot feel it, i try hard to change my mind, but i am not successful, is this the symptom of depersonalization and derealizaton, my doctor assured e that i am not going mad and this is due to anxiety, but how can i returm to the person i was. please help me.

    1. Dena

      April 9, 2010 at 9:57 am

      Your doctor is correct. You are not going mad – AT ALL – the symptoms you are experiencing are very common and are a direct results of panic attacks, anxiety, and depersonalization. Your condition is severe and I am certain that you will overcome it.

      I would highly suggest seeking a therapist and pursuing Cognitive Behavior Therapy — I did it and it saved my life.

      Best of luck to you & I am sending you love & positive energy.

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    June 22, 2010 at 1:57 pm

    How to Combat Anxiety, Panic Attacks, & Depersonalization

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  • John

    January 19, 2011 at 5:43 pm

    “Panic attacks are almost always caused by negative irrational thoughts” – Yes I completely agree…and there are plenty of methods to interrupt and change these thoughts like nlp, hypnosis, cbt…these are the best panic attack treatments because they deal direct with the cause of anxiety rather than just treating symptoms.

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  • Erica Lee

    May 13, 2011 at 1:50 pm

    Despite the evidence, I still always feel like I’m the only person on the planet who has ever suffered from anxiety (and especially depersonalization!) I don’t know if people just don’t talk about it – it’s not exactly fun dinner conversation – or if we really are a select few, but I do know that it helps me immensely every time I hear a story of recovery like yours. Not only do you say you can manage your anxiety, you’ve even gone on to become confident, comfortable in your own skin and able to speak in front of large crowds. That’s amazing! And I’m so inspired by you.

    I have always been told that I was talented, aware, an “old soul” etc. etc. – but I think that was because I worried and over analyzed a lot. Like you, anxiety’s been with me my whole life. I’ve tried a lot of things, including CBT, and it has seemed to be the only thing to help. I like that you mention it can sometimes take years. I always try to remind myself that it’s like any other disease you have to manage daily, like diabetes.

    It’s such a strange thing to experience, because when you try to articulate your worries, they sound SO NORMAL. But to actually FEEL them is so different. I know it might seem ridiculous to others that I am literally deathly afraid that I look awkward, or that I’m deathly afraid I am inherently different than other people, but those are my fears. And to me they’re very real….however irrational.

    Anyway, I’m writing you a book,but I just wanted to thank you for writing this.

  • Shabbafrk

    July 17, 2012 at 9:19 am

    Always, Say everything in the life Is Possible.
    Winners dont do different things,They do things differently.
    try, to realize that world is the place where u can explore ur talent.
    depersonalization, its the fact live in dream.
    come to the realty,Nature has given good things surrounding u,

  • Rheana

    September 6, 2013 at 2:55 pm

    Thanks so much for sharing. Your story truly made me feel better! I’ve been suffering from anxiety all my life, but just recently started experiencing depersonalization and severe panic attacks. I’ve been seen by a psychiatrist and a psychologist, who both say I’m not crazy – just that I have anxiety issues. I’ve been wanting to take medication because I’m so tired of feeling this way (especially the depersonalization – I hate it, it scares me so much). What do you think about medications? Or do you firmly believe that there is a natural way to fix the disorder? Thanks for your help!

    1. denabotbyl

      September 6, 2013 at 4:25 pm

      Hi Rheana– I firmly believe that there is a place for medicine. I was on medicine for 6 years. I believe that it assists in the process and it should be a PART of a holistic plan including therapy, a healthy (organic/whole foods) diet, and exercise. The end goal should be to treat the underlying issue, never to use medicine as a band-aid. But everyone is different some people need medicine temporarily, some forever, some not at all. Still, the main priority should be treating the root and not just the symptoms. Best of luck to you.

  • Matthew

    May 29, 2015 at 1:36 pm

    Hi all I’ve been experiencing anxiety for the last 3-4 months as as well as depersonalisation, I’m 34 with a beautiful fiancé and 2 wonderful children, I have had it before when I was about 22 and I’ve gotta say it’s hands down the hardest most debilitating ailment someone could ever have, it ruins my confidence and my ability to have a relationship with my famil.
    I’ve recently started to see a therapist who’s trying me with CBT and Hypnotherapy and I’ve just been put on a course of meds from my GP for anxiety & depression, so watch this space and fingers crossed I suppose. Keep soldiering on people

  • John A

    January 28, 2016 at 11:42 am

    Hey guys, I’ve been suffering from panick attacks, anxiety, depersonalisation etc etc, for 25 years, I don’t know what caused it, but it went away after I learned to control it, and I had 10 years of peace, until recently, the past 10 days have been awful, much worse than before, constantly scared of dying, can’t get a breath etc, really bad depersonalisation, like I’m finding everything seems strange to me, even my own home, tried all the old techniques, breathing etc, no result, can’t even do simple things like eat.. Any advice? Thanks in advance

  • Kelly Carothers

    August 14, 2018 at 7:08 am

    Wow! Great article! I had a period in my life during which I suffered debilitating panic attacks – I would even wake up in the middle of the night with them. It’s important for us to share our stories with others so they know they are not alone.

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