If you've ever had a panic attack, also known as an anxiety attack, you know how overwhelming and frightening it can be. It often feels like you're losing control, which makes the experience even more distressing. A panic attack often comes on suddenly, bringing with it a wave of intense physical symptoms that may include the following:

• Palpitations, pounding heart, or accelerated heart rate

• Sweating

• Trembling or shaking

• Sensations of shortness of breath or smothering

• Feelings of choking

• Chest pain or discomfort

• Nausea or abdominal distress

• Feeling dizzy, unsteady, light-headed, or faint

• Chills or heat sensations

• Paresthesia (numbness or tingling sensations)

• Fear of losing control or “going crazy”

• Fear of dying

Knowing the Difference: Anxiety Vs. Panic Attacks

Anxiety and panic attacks can both be very overwhelming, but they affect us in different ways.

Anxiety tends to build up slowly over time. It's like having a constant, low-level worry that keeps your brain on edge. This feeling usually stems from ongoing stress or concerns, and it can make you feel uneasy for a long time as your brain and body stay in a state of alert.  

Panic attacks, on the other hand, hit suddenly and with great intensity. They are like a quick, overwhelming surge of fear that feels like it comes out of nowhere. This sudden reaction is strong but short-lived, often peaking within 10 minutes and then gradually easing.  Recognizing this distinction helps explain why anxiety can feel like a continuous burden, while panic attacks strike with sudden, intense force.

Understanding What Happens in the Brain During a Panic Attack

When a panic attack strikes, it’s like your brain’s “fight or flight” system kicks into overdrive. This system is controlled by the amygdala, the part of your brain that’s always on the lookout for threats. When the amygdala senses danger, it triggers your body’s stress response, sending out distress signals to other parts of the brain, like the hypothalamus and the autonomic nervous system. This is what causes that sudden rush of adrenaline and the physical symptoms that follow.

At the same time, your prefrontal cortex—the part of your brain that usually helps you think clearly and make decisions—can get overwhelmed. This makes it harder to calm down and think rationally in the moment. It’s important to remember that this response is actually a normal way your body tries to protect you from harm. During a panic attack, though, this system becomes overly sensitive, reacting strongly even when there’s no real danger.  Knowing this can help reassure you that these intense feelings, while scary, are just your brain's natural alarm system at work.

Recognizing Panic Disorder and Its Impact on Your Life

If you frequently experience intense symptoms and start changing your behaviors to avoid future attacks, you may be dealing with panic disorder. The symptoms can be so severe that they often mimic those of serious conditions like heart disease, thyroid issues, or breathing disorders. This can lead to multiple visits to the emergency room or doctor’s office, as people with panic disorder might believe they have a life-threatening problem.

Panic attacks are extremely unsettling and can be very frightening. As a result, people who experience them often become anxious about the possibility of another attack. This fear can lead to major changes in their daily routines. For example, they might avoid exercise to keep their heart rate down or stay away from places where they’ve had previous attacks.

Riding the Wave

When I work with someone who experiences panic attacks, I encourage them to visualize the panic like a wave that has a beginning, a crest, and then eventually comes down and disappears. This imagery helps to see the attack as a temporary surge that will pass rather than a permanent state. Here are some steps to consider to ride the wave of a panic attack:

Notice, Name, Nourish: A Three-Step Approach to Managing Panic Attacks

Notice: If you are paying attention to the physical cues your body is sending, you can begin to recognize the signals that a panic attack is coming. Noticing those signals does not mean you can stop the wave. It does mean that you can be a bit more prepared, which will help make the process less scary and easier to ride out.

Name: When you recognize that a panic attack is underway, name it for what it is and what you can expect. For example, you may tell yourself, “My body is having a physical response of worry and trying to alert me. I will feel uncomfortable for about 10 minutes, but if I relax as best as I can, this wave will come back down, and I will feel better.” Later, you can take some time to consider if there was a trigger and problem to solve for the future. 

Nourish: Once the panic response has subsided, make sure to nourish your body and your mind. This means eating or drinking something healthy as a way to replenish the energy that was expended during the time of high anxiety. Also, remember to praise the process that you were able to tolerate with success. You didn’t make the panic attack go away, but you did let your body get out the negative energy and then moved on with your day. This is showing compassion and is nourishment to your soul. 

Seeking Professional Help

One of the best ways to get better at working through panic attacks is to work with a therapist. They can guide you through the process and help develop strategies to reduce the stress that may be contributing to the problem. With practice and support, you can become stronger and more self-aware. Consider exploring different types of therapy, such as Cognitive Behavioral Therapy (CBT), Exposure Therapy, or Mindfulness-Based Stress Reduction (MBSR). Each approach offers unique tools to help you manage panic attacks more effectively and regain control over your life.

Conclusion

Understanding what's happening in your mind and body can help ease the fear that comes with a panic attack. By paying attention to your body's signals, acknowledging your feelings, and caring for yourself afterward, you can start to face these moments with more confidence. Remember, you don’t have to navigate this alone—reaching out for support can be a powerful way to regain control. When you’re caught in a wave of panic, try to imagine it as just that—a wave that starts, peaks, and eventually washes away.

Resources:

Visit https://adaa.org/understanding-anxiety/panic-disorder-agoraphobia/symptoms for more information about anxiety and panic attacks.

Book Resources:

Overcoming Fear and Panic Attacks: A Guide to Understanding, Managing, and Thriving Beyond Anxiety and Panic by Dr. Mashal D. Al Nawab

Don't Believe Everything You Think: Why Your Thinking Is The Beginning & End Of Suffering (Beyond Suffering) by Joseph Nguyen

Retrain Your Brain: Cognitive Behavioral Therapy in 7 Weeks: A Workbook for Managing Depression and Anxiety by Seth J. Gillihan PhD