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Elisa Goldstein, Ph.D.Elisha Goldstein, Ph.D.
A blog about mindfulness, stress-reduction, psychotherapy and mental health.

Panic Attacks: The 30-Minute Rule

Elisha Goldstein, Ph.D. Updated: Feb 23rd 2011

girl worryingI’ve seen hundreds of people who have suffered in their lives from panic attacks. Panic attacks are a triggered reaction that happens in the mind and body that usually leads to symptoms of rapid heartbeat, sweaty palms, tightening of chest, light headedness, narrowed vision or any combination of these. It may seem like there is a real physical problem happening and you need to go the hospital. Once someone rules out any physical problems and we know these are panic attacks, the treatment often revolves around getting a sense of their history with anxiety, relationships with family members, uncovering irrational beliefs, among other things. At the end of the day one of the best pieces of advice I’ve come across is the 30-Minute rule. What is that?

The 30-minute rule is a simple understanding that most panic attacks don’t last more than 20 minutes. It’s a psychophysical reaction that has already been set in place and there is no way to immediately cut it out. Like a cramp in the foot, have been revved up and need a process of cooling down. It’s not personal, the thoughts about all the upcoming catastrophes are not facts, and it’s just the mind trying to figure out how to get away from this awful feeling.

So if we can recognize this as a triggered reaction, as if someone pressed a button on you and away you went, then we can start to treat the thoughts as just mental events that are spiraling through the mind. We can treat the sensations as the body in its fight or flight mode.

Then comes the rule:

Wait 30-minutes and if the feeling is still there with this same intensity. Don’t take the thoughts seriously and just continue as best you can with your business.

Almost always what you’ll find is that the symptoms begin to slide away.


This rule takes away the energy you are giving the panic spiral. You are no longer feeding it with worrying or rapid body movements. As you take that out of the equation, the panic attack has nothing to maintain its momentum and it eventually comes and goes as all things in life do.

So the next time you feel a panic attack coming, see if you can apply the 30-minute rule. Treat it as an experiment, without expectations and let your experience be your teacher.

As always, please share your thoughts, stories and questions below. What has helped you with panic attacks? Your interaction creates a living wisdom for us all to benefit from.



Elisha Goldstein, Ph.D.

Elisha Goldstein, Ph.D. is a clinical psychologist in private practice in West Los Angeles and is author of the upcoming book The Now Effect, co-author of A Mindfulness-Based Stress Reduction Workbook, Foreword by Jon Kabat-Zinn, author of the Mindful Solutions audio series, and the Mindfulness at Work program currently being adopted in multiple multinational corporations.

Check out Dr. Goldstein's acclaimed CD's on Mindful Solutions for Stress, Anxiety, and Depression, Mindful Solutions for Addiction and RelapsePrevention, and Mindful Solutions for Success and Stress Reduction at Work. -- "They are so relevant, I have marked them as one of my favorites on a handout I give to all new clients" ~ Psychiatrist.

If you're wanting to integrate more mindfulness into your daily life, sign up for his Mindful Living Twitter Feed. Dr. Goldstein is also available for private psychotherapy.

Reader Comments
Discuss this issue below or in our forums.

Panic Attacks - Laurie - Feb 24th 2011

I have been taking zoloft and xanax since I was 14. I did go without the meds from the time I was 17 til 21. I had another episode after my house burned down and was put back on the meds. They increased my zoloft from 25 mg to 200 mg. I am now 29 years old. I feel broken and its like nothing helps. I have tried coping skills everything I can think of. I was once ambitious. Now I feel lost and broken like I am going through the motions of life with no direction. I once had short term goals, five year plan ten year plan, but I am no longer making progress. I have had alot of things that have went on in my life since my house burned down. I don't know what to do. I have been with the same man since I was 16; he doesnt seem to understand. I want me back. I just don't know where to start. Any advice??? Please.

check your meds - Robin - Feb 23rd 2011

I had horrible panic attacks about 15 years ago and we traced them to a side-effect of my xanax (zanax?). Ironically it was prescribed to treat anxiety. So I always recommend checking the side-effects from your meds as a possible cause. I haven't had one panic attack since we switched meds.

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