Panic disorder is a type of anxiety disorder characterized by a negative interpretation or appraisal of uncomfortable physical sensations such as heart beating fast, hyperventilation, hot flushes, shaky legs,  to name a few of them.”

People often feel as if they are losing control of that situation and may think that they’re going crazy, having a heart attack, or are going to die.

Physical symptoms may include: a fast heartbeat, chest or stomach pain, breathing difficulty, weakness or dizziness, sweating, feeling hot or a cold chill, tingly or numb hands.

When experiencing a panic attack, it is not uncommon for individuals to go to the Emergency Room to seek medical help, only to be told that there is no medical concern.

As a result, you may develop a fear of experiencing another panic attack in other situations, so you start avoiding places that are similar to the one in which you had an attack.

You may also change behaviors to avoid having a panic attack such as avoiding things that raise your heart race, or make you sweat.

Let’s think for a moment of Peter who avoids going to the grocery store near his house due to fear of experiencing another panic attack like he did 4 months ago.

He will drive across town to go to a different store to try and ensure he does not have another panic attack. When going to other places, Peter will take alternate routes to avoid driving past the grocery store where he once had a panic attack.

When having a panic attack, Peter becomes warm and sweaty, his heart races and his mind tells him things like: “It feels like I am going to die,” “I have to get away from here,” “am I going crazy?”

Panic Attacks Feel Terrifying: “It felt like I was dying.”

Samantha was standing in line at the grocery store when it started. Out of nowhere, her chest tightened. Her heart started racing. She felt dizzy, like the room was spinning. She thought: Am I having a heart attack? Am I going to faint in front of everyone?

She abandoned her cart and rushed to her car, shaking and gasping for air. After a few minutes, the symptoms eased—but the fear didn’t. For weeks, she avoided grocery stores entirely, afraid it would happen again.

If you’ve ever had an experience like Samantha’s, you are not alone. Panic attacks are surprisingly common — about one in four people will experience at least one in their lifetime — and around 4.7% of U.S. adults live with panic disorder (Kessler et al., 2006).

The good news? Panic attacks are treatable. Understanding what’s happening in your body and learning what truly helps can make all the difference.

What is a Panic Attack?

Panic attacks are sudden surges of intense fear or discomfort that peak within minutes. They often seem to come “out of the blue,” even if nothing dangerous is happening.

Common symptoms include:

• Racing heart
• Shortness of breath or hyperventilation
• Chest tightness or pain
• Sweating or chills
• Nausea or dizziness
• Numbness or tingling
• Fear of losing control, going crazy, or dying

These experiences can feel terrifying, especially the first time. But even though the sensations are intense, panic attacks are not harmful.

According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5; American Psychiatric Association, 2013), panic attacks are classified as a type of anxiety response — not a medical emergency.

What’s Happening in Your Brain and Body?

Your body is doing exactly what it’s designed to do when it thinks you’re in danger — it’s activating the fight-or-flight system.

This system is controlled by the amygdala, the brain’s alarm center. It tells your body to release adrenaline, speed up your heart rate, and prepare to run or fight. But during a panic attack, this alarm goes off when there’s no real threat — just a misinterpretation of physical sensations.

What happens next is called the “panic cycle:”

1. You feel a strange sensation (like a flutter in your chest)
2. You interpret it as dangerous (“What if I’m dying?”)
3. Your fear triggers more adrenaline
4. Your body reacts even more
5. The fear escalates

This cycle reinforces itself, creating the feeling of losing control.

Why Panic Attacks Seem to Come Out of Nowhere

Panic attacks can be triggered by stress, caffeine, sleep loss, or even subtle internal sensations like increased heart rate or shallow breathing. Over time, people may develop — anticipatory anxiety — the fear of having another panic attack — which actually increases the risk of future attacks.

Avoidance becomes a common coping strategy: avoiding driving, social events, or places where previous panic attacks happened. But unfortunately, avoidance reinforces the belief that those situations are dangerous.

What Actually Helps: Evidence-Based Tools for Panic Relief

Here’s what research shows can genuinely help:

1. Label It: “This Is a Panic Attack”
   Naming what’s happening reduces fear and helps re-engage the thinking brain. .
2. Slow Your Breathing — Gently
   Many people try to take deep breaths during a panic attack, but it’s more helpful to breathe slowly and evenly, preferably through the nose.
3. Stay Where You Are — And Let the Wave Pass
   Panic attacks feel like they’ll last forever, but they actually peak and subside within 5–10 minutes.
   Instead of escaping the situation, try staying present and observing the sensations like a wave that rises and falls. This approach is supported by exposure-based therapy, which helps retrain your brain to stop reacting to false alarms.
4. Try Interoceptive Exposure
   This technique involves gently exposing yourself to feared physical sensations (like spinning in a chair or running in place). Done in therapy, it helps reduce fear of bodily sensations.
5. Take Values-Based Action
   Instead of trying to control the panic, focus on doing something that matters. For example, if spending time with your child is important to you, go to their soccer game—even if your heart is pounding. This approach is rooted in Acceptance and Commitment Therapy (ACT), which emphasizes values and psychological flexibility.

When to Get Help

If panic attacks are interfering with your daily life, relationships, or sense of freedom, it’s time to reach out.

The gold standard treatments for panic disorder include:

• Cognitive Behavioral Therapy (CBT)
• Exposure Therapy
• Acceptance and Commitment Therapy (ACT)
• In some cases, medication may also be part of treatment

Most people experience significant improvement within a few months of starting therapy. According to a large meta-analysis, CBT has a strong effect size for treating panic and anxiety disorders.

One study found that regulating CO₂ levels through slow breathing helps reduce panic symptoms over time.

Reference

Barlow, D. H. (2002). Anxiety and Its Disorders: The Nature and Treatment of Anxiety and Panic. Guilford Press.

Clark, D. M. (1986). A cognitive approach to panic. Behaviour Research and Therapy, 24*(4), 461–470.

Craske, M. G., et al. (2007). Cognitive-behavioral therapy for panic disorder and agoraphobia. Psychiatric Clinics of North America, 30*(3), 671–688.

Hofmann, S. G., et al. (2012). The Efficacy of Cognitive Behavioral Therapy: A Review of Meta-analyses. Cognitive Therapy and Research, 36 (5), 427–440.

Meuret, A. E., Wilhelm, F. H., Ritz, T., & Roth, W. T. (2003). Feedback of end-tidal pCO₂ as a therapeutic approach for panic disorder. *Journal of Psychiatric Research, 37*(3), 237–245.