A panic attack: what happens in the body, what you can do in the moment and when to ask for help
Your heart pounds, your breathing becomes short, your hands shake and an overwhelming fear appears that something serious is happening. For someone having a panic attack for the first time, the experience can be terrifying. Understanding what's going on in the body is often the first step towards making it less frightening.
In short
A panic attack is a sudden episode of intense fear or discomfort, with strong physical symptoms: palpitations, shortness of breath, sweating, trembling, dizziness, a feeling of losing control. It usually reaches its peak within a few minutes and then subsides. It isn't dangerous in itself, but the symptoms resemble those of other medical problems, so a first episode should be assessed by a doctor. In the moment, slow breathing, grounding yourself in the present and accepting the sensations without fighting them help. Repeated attacks respond well to treatment, especially cognitive behavioural therapy.
Important: when it's an emergency
If you have chest pain, severe difficulty breathing, weakness on one side of the body, speech problems or fainting, call 112. Especially with a first episode, the symptoms should be assessed medically. A panic attack is diagnosed after other causes have been ruled out.
What happens in the body
A panic attack is a strong activation of the body's alarm system, the "fight or flight" response, without any real danger at that moment.
- adrenaline rises, the heart beats faster and harder;
- breathing speeds up, and fast breathing can cause dizziness, tingling and the feeling that you can't get enough air;
- muscles tense up, trembling and sweating may appear;
- attention narrows towards the sensations in the body.
The mind interprets these sensations as a sign of danger ("I'm having a heart attack", "I'm going mad", "I'm going to faint"), and the interpretation amplifies the alarm. This is how the panic cycle forms.
The sensations are real and intense. But they're produced by an alarm system that's working too loudly, not by danger.
The usual symptoms
- palpitations or a fast heartbeat;
- shortness of breath or a feeling of choking;
- pressure or discomfort in the chest;
- dizziness, feeling faint;
- trembling, sweating, chills or hot flushes;
- nausea;
- tingling in the hands or around the mouth;
- a feeling of unreality or detachment;
- fear of losing control or of dying.
What you can do in the moment
1. Name what's happening
"This is a panic attack. It's unpleasant, but it will pass." Recognising it reduces some of the extra fear.
2. Slow your breathing
Breathe in through your nose for 4 seconds, breathe out slowly through your mouth for 6 seconds. A longer out-breath helps the nervous system come down from alert. Don't try to take in as much air as possible: hyperventilation makes the symptoms worse.
3. Ground yourself in the present
The 5–4–3–2–1 technique: name 5 things you can see, 4 you can touch, 3 you can hear, 2 smells and one taste. It moves your attention from inside to outside.
4. Don't fight the sensations
Paradoxically, trying to forcibly stop the sensations strengthens them. Let them rise and fall, like a wave.
5. Stay where you are, if it's safe
Escaping the situation brings relief in the moment, but can strengthen the fear of that place. If you can, stay until the wave passes.
6. Cold water, gentle movement
Cold water on your face or wrists and a few slow steps can help.
After the attack
Many people feel exhausted after a panic attack. Rest, a warm drink and a quiet activity are appropriate. It's useful to write down when it appeared, what was happening and how long it lasted. This information helps with any assessment.
When to ask for specialist help
- after the first attack, for a medical assessment;
- if the attacks keep happening;
- if you start avoiding places or situations for fear of another attack;
- if you live with a constant fear of "the next attack".
Repeated panic attacks and the fear of them can be part of panic disorder, one of the anxiety conditions that respond best to treatment. Cognitive behavioural therapy has the most evidence. Sometimes, a psychiatrist may also recommend medication.
At Emmanuel CliniX, the clinic behind NeuroFit, there are specialists in psychology, psychotherapy and psychiatry. Bookings: +40 790 099 070.
What you can do between episodes
- slow breathing practised daily, not just in a crisis;
- regular movement;
- consistent sleep;
- less caffeine, which can mimic the sensations of panic;
- cutting down on alcohol;
- a psychotherapist with whom you can work on the pattern of fear.
Where NeuroFit fits in
NeuroFit by Emmanuel CliniX, in Bucharest, is brain wellness, not treatment for panic disorder. For repeated panic attacks, the first step is an assessment by a specialist. The Relax experience (CES, taVNS, neurofeedback) can be used as part of a relaxation routine, after a safety screening and, where appropriate, in agreement with the specialist who follows you.
NeuroFit is brain wellness, not medical treatment.
Frequently asked questions
What is a panic attack?
It's a sudden episode of intense fear, accompanied by strong physical symptoms, such as palpitations, shortness of breath, dizziness and trembling. It usually reaches its peak within a few minutes, then subsides.
How long does a panic attack last?
Usually, the symptoms peak in about 10 minutes and gradually subside over the following minutes. The feeling of tiredness can last longer.
How do I stop a panic attack?
Name what's happening, slow your breathing with a longer out-breath, ground yourself in the present with the 5–4–3–2–1 technique and let the sensations pass without fighting them.
Is a panic attack dangerous?
A panic attack isn't dangerous in itself, but the symptoms resemble those of other medical problems. With a first episode or chest pain, call 112 or see a doctor.
Brain wellness information. It is not medical advice and does not replace specialist assessment, diagnosis or treatment.