Guide
Panic attacks: what is happening in your body, and what helps.
A panic attack can feel like an emergency: a pounding heart, short breath, dizziness, and a wave of dread that seems to come from nowhere. It is common to wonder, the first time, whether something is badly wrong medically. Understanding what panic is, and what keeps it coming back, is often the first step toward feeling less afraid of it and more able to ride it out.
01Panic attacks
What a panic attack is
A panic attack is a sudden surge of intense fear that comes with strong physical sensations. These can include a racing or pounding heart, tightness in the chest, shortness of breath, dizziness, trembling, tingling hands, nausea, feeling detached from your surroundings, and a powerful sense that something terrible is about to happen. A wave usually builds quickly and peaks within minutes before it begins to ease. Afterward, many people feel drained and shaken, and unsure what just happened to them.
02Panic attacks
Why your body does this
Your body has an alarm system designed to keep you alive. When it senses danger, it floods you with adrenaline so you can fight or run: your heart speeds up, your breathing quickens and your muscles tense. In a panic attack, that alarm fires without a real threat in front of you, sometimes after a long stretch of stress and sometimes out of the blue. The sensations are intense and frightening, but they come from the same protective system that would help you in a genuine emergency.
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The fear of the next one
For many people, the panic attack itself is only half the problem. The other half is the fear of having another one. You start watching your body for the first flutter of symptoms, and that watching can itself trigger a wave. Then avoidance creeps in: the store where it happened, the highway, crowded rooms, exercise that raises your heart rate. Avoiding these brings quick relief, but over time your world can get smaller and smaller around the fear.
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What can help in the moment
When a wave starts, try slowing your breathing so that each exhale is longer than the inhale. Bring your attention to your senses: name what you can see, hear and touch around you. Remind yourself that this is a surge that will crest and pass, even though it feels endless. Fighting the sensations tends to feed them, so it can help to let them be there while you keep breathing slowly. These skills take practice, and they work best when you rehearse them on calm days too.
05Panic attacks
How therapy works on the cycle
Cognitive Behavioral Therapy helps you catch the interpretations that turn a sensation into a catastrophe, such as a fast heartbeat meaning something is badly wrong, and test them against what actually happens. Gradually and at a pace you agree to, you can begin returning to places you have been avoiding. Mindfulness-based practice and DBT distress tolerance skills help you stay with uncomfortable sensations without being swept away. Erin explains what she is using and why, and asks what is helping.
06Panic attacks
When to get checked first
Panic and medical problems can feel similar, so new, changing or unexplained physical symptoms deserve a visit to your doctor. If you are ever unsure whether chest pain is panic or something medical, treat it as medical and call 911. Getting a clear medical picture is not a detour from therapy; it is often what lets you approach the work with more confidence.
You might notice
- A pounding heart out of nowhere
- Fear of having another attack
- Avoiding places where one happened
- Feeling detached during a wave
None of this is a diagnosis, and no outcome is guaranteed. It is a starting point for a conversation.
Questions
Common questions
- Can a panic attack hurt me?
- The sensations are intense, but the alarm response behind a panic attack is the body's own protective system. That said, symptoms that are new, different or unexplained deserve a medical check first, so you and your doctor can rule out other causes.
- Why do panic attacks happen when I am relaxed?
- Panic does not always arrive in the middle of stress. It can show up when you finally slow down after a long stretch of pressure, or when you notice a body sensation and start to worry about it. That unpredictability is part of what makes it so unsettling.
- How does therapy help with panic attacks?
- Therapy usually combines understanding the panic cycle, practicing skills for the moment, and gradually facing what you have been avoiding at a pace you agree to. Erin draws on CBT, mindfulness and DBT skills and checks in with you about what is helping.
In Erin's words
What she would say if you called today.
Panic is frightening, and I take it seriously. Together we will map what sets it off and what you do afterward, then practice skills you can use in the moment. We will move at a pace you agree to, and I will check in honestly about what is helping.
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