Panic attacks are terrible. I suffered from them for years and they are something I do not wish on even my worst enemy (I think until you have experienced one it is difficult to understand how they feel). I also went years suffering from them, not realizing it was due to PTSD. That said, I do think we have to be very careful here about shaping the world or our entertainment around potential triggers. They are not easy to anticipate and they are rarely concrete (not everyone is triggered by the presence of a clear sign or topic for example, it could be the product of a chain of thoughts that are impossible to anticipate and begin with something fairly benign). I think this is something that really needs to be taken case by case. When I was suffering through this, it would have been impossible for me to expect my group to have to work around what was going on with me, so I stopped gaming for a bit, or when I did feel I could game, I played and if I started to feel a problem come on, I would politely leave (in one instance I actually left to go to the emergency room). One thing that can happen when you are experiencing this is you start imposing what is going on with you, on others.
For instance, when this first started happening to me, I couldn't deal with any dark topics on television, in movies, etc. Now I grew up loving dark and violent shows, and horror was my favorite genre, so this was pretty discomforting. I was recuperating staying with family and there was one TV. It would have been discourteous of me to expect everyone to change their viewing habits around myself. So I would leave the room if people wanted to watch something more intense. One thing I know would not have helped me though was people working too much around what triggered me because that would have made it all too easy not to address the issues and start learning to be comfortable with the things that were causing the feeling of panic. There is no one size fits all, but I think on this topic, especially in the gaming community, we think there is one clear answer to this issue and there just isn't. For me the experience has made me very wary of things like trigger warnings and safety tools in RPGs (I do think if something comes up or you have a problem in your group it needs to be handled compassionately, but I am very skeptical of the effect these tools will have-----at the very least I think they would have done more harm to me).
This is why the X-card, specifically, is so beneficial, though.
You don't have to "shape" stuff beforehand and try and anticipate every possible situation. And it's less disruptive to the game than you having to leave. It also makes people feel less bad.
I think a lot of people "skeptical" of it just don't really understand it, or are put off by what they misperceive as "woke" language or the like. I mean, you can get more detailed descriptions, but the principle is simple.
1. There's a card with an X on it on the table.
2. If you're upset by what's going on, you tap the card.
3. At this point, you can explain if you want, and most people do, but you're not required - it's usually best to indicate the topic/incident causing it at least though, if it's anything but obvious.
4. The DM works out what to do - usually with some discussion with the player who tapped it - if it's a situation, that in-fiction is occurring, maybe you skip to past it. If it's a description of something, you stop the description, and so on.
That's basically all. It's very simple and easy to use.
Safety Tools for Simulations and Role-Playing Games by John Stavropoulos Want to use the X-Card in your published work? You can! The X-Card is published under a Creative Commons Attribution-ShareAlike 3.0 Unported (CC BY-SA 3.0) License. Your work may be published under any license. Simply cr...
Goes into more detail (but is still short). Read the FAQ before objecting I'd suggest. I see there's also an O-card some people use, which means the opposite - i.e. "This rocks/more of this".
In your example, D&D I think normally isn't particularly "dark", but sometimes bits of adventures are randomly super-dark, and you could tap the card to sort of fast-forward through those bits or whatever. It's not likely to harm the experience for others (indeed most people feel good about it, they're helping a bud), and it prevents anyone having to leave or whatever. It's also got a much lower load on everyone involved than more complicated tools like Lines and Veils and stuff (which also can be embarrassing to the person involved in a way this typically isn't).