A panic attack can be one of the most frightening experiences a person can have. The feeling of losing control, intense physical symptoms, and the conviction that something serious is happening can be overwhelming. However, understanding what’s happening in your body and learning specific techniques can transform how you experience and manage these episodes.
What Is a Panic Attack?
A panic attack is a sudden wave of intense fear or discomfort that reaches maximum intensity within a few minutes. During the episode, four or more of the following symptoms occur:
Physical Symptoms
- Heart palpitations or rapid heartbeat
- Sweating
- Trembling
- Sensation of choking or shortness of breath
- Chest pain or discomfort
- Nausea or abdominal discomfort
- Dizziness or feeling faint
- Chills or hot flashes
- Numbness or tingling
Psychological Symptoms
- Derealization (feeling that the world is not real)
- Depersonalization (feeling detached from oneself)
- Fear of losing control or “going crazy”
- Fear of death
Why Do Panic Attacks Happen?
The Physiological Mechanism
Panic attacks result from the activation of the body’s “fight or flight” response - a survival mechanism millions of years old.
- The amygdala (the fear center in the brain) detects a threat (real or perceived)
- The sympathetic nervous system activates rapidly
- Adrenaline is released into the body
- The body prepares for action:
- Heart rate increases (to pump more blood to muscles)
- Breathing accelerates (for more oxygen)
- Muscles tense (ready for fight or flight)
- Digestion stops (resources are redirected)
- Sweating increases (to cool the body in anticipation of effort)
Why These Sensations Feel So Frightening
The problem with panic attacks is that this response activates in the absence of real danger. The normal physical symptoms of the survival response are misinterpreted:
| Symptom | Catastrophic Interpretation | Reality |
|---|---|---|
| Rapid heartbeat | “I’m having a heart attack” | The heart is pumping more blood - it’s healthy |
| Difficulty breathing | “I’m suffocating” | Hyperventilation - too much oxygen, not too little |
| Dizziness | “I will faint” | Muscle tension and hyperventilation - rarely do people faint |
| Derealization | “I’m going crazy” | Normal response to intense stress |
The Panic Cycle
Once activated, a cycle is created that maintains and intensifies the panic:
Physical sensation (palpitations) → Catastrophic interpretation (“I’m having a heart attack!”) → Intensified anxiety → More physical symptoms → Confirmation of ‘danger’" → Maximum panic
Good news: This cycle can be interrupted at any point.
Immediate Techniques: What to Do During an Attack
The first and most important step is to tell yourself: “This is a panic attack. I’ve been through this before. It’s not dangerous. It will pass.”
Why it helps: Naming the experience activates the prefrontal cortex (the rational part of the brain), which can modulate the amygdala’s response.
2. Control Your Breathing - The 4-7-8 Technique
Hyperventilation maintains and intensifies panic symptoms. Controlled breathing can stop them.
- Exhale completely through your mouth
- Inhale through your nose, counting to 4
- Hold your breath, counting to 7
- Exhale through your mouth, counting to 8
- Repeat 4 times
Alternative - Paper Bag Breathing:
- Breathe into a paper bag (not plastic)
- This restores the CO2 balance disrupted by hyperventilation
- 6-12 breaths are usually sufficient
3. Grounding Technique 5-4-3-2-1
This technique anchors you in the present and interrupts the panic cycle.
Identify:
- 5 things you can see
- 4 things you can touch
- 3 things you can hear
- 2 things you can smell
- 1 thing you can taste
4. Rapid Muscle Relaxation
Muscle tension maintains the feeling of danger. Relaxation contradicts it.
Quick technique:
- Tense all muscles in your body intensely for 5 seconds
- Suddenly release the tension
- Notice the contrast and the sensation of relaxation
- Repeat 2-3 times
Instead of “I can’t take this, I’m going to die,” try:
- “This is unpleasant, but it’s not dangerous”
- “My body is trying to protect me, but there’s no real danger”
- “I’ve been through this before and it passed”
- “The sensations will reach a peak and then decrease”
Long-Term Strategies
1. Keep a Panic Diary
For each attack, record:
- Date and time
- What you were doing beforehand
- Symptoms you experienced
- Thoughts that appeared
- What you did to cope
- How long it lasted
Why it helps: You identify patterns and learn that attacks are limited in time.
This involves deliberately triggering physical sensations to learn that they’re not dangerous.
Example exercises (under the guidance of a therapist):
- Rapid breathing to trigger dizziness
- Running in place to accelerate heart rate
- Spinning on a chair to cause disorientation
- Breathing through a straw to simulate difficulty breathing
3. Identify and Modify Catastrophic Thoughts
Helpful questions:
- What evidence do I have that I’m suffocating/having a heart attack/going crazy?
- How many times have I believed this would happen and it didn’t?
- What would I tell a friend who had the same thoughts?
- What is the most likely thing actually happening?
Factors that can trigger attacks:
- Caffeine and stimulants
- Alcohol (especially during withdrawal)
- Lack of sleep
- Accumulated stress
- Hypoglycemia (skipping meals)
- Some medications or substances
Regular practice improves your capacity to activate the parasympathetic nervous system.
Recommendations:
- Diaphragmatic breathing daily (5-10 minutes)
- Mindfulness meditation
- Yoga or stretching
- Progressive muscle relaxation
When to Seek Professional Help
- Panic attacks are frequent (more than 2-3 per month)
- You avoid places or situations for fear of an attack
- You constantly worry about the next attack
- Attacks significantly affect your professional or personal life
- You experience depression or thoughts of self-harm
Effective Treatment Options
Final Message
Panic attacks, no matter how frightening, are not dangerous. Your body is functioning exactly as it should - responding to a perceived threat. The problem is that there is no real danger.
With practice and, if necessary, with professional help, you can learn to recognize attacks for what they are, reduce their frequency and intensity, and stop letting the fear of attacks control your life.
The first step is understanding. The second is practice. The third - if necessary - is to ask for help.
This article provides educational information and does not replace medical consultation. If you experience symptoms for the first time, please consult a doctor first to rule out medical causes.