Panic Attacks: What They Are and How to Stop Them
The first time it happens, most people think they're dying.
Their heart is hammering. They can't breathe properly. There's a pressure in their chest, a tingling in their hands, a terrible sense that something catastrophic is about to happen. They might call an ambulance. Go to A&E. And when everything checks out medically, they're told it was a panic attack.
And then they're terrified it will happen again.
Key Takeaways
A panic attack feels frightening but cannot hurt you; it typically peaks within about ten minutes and then passes
The cycle of fearing the next attack and avoiding situations is what keeps panic going
CBT is one of the most well-evidenced treatments for panic attacks and panic disorder
Slowing your breathing and staying put can help in the moment, but addressing the pattern is what makes the lasting difference
What Actually Happens During a Panic Attack?
A panic attack is a sudden surge of intense fear that triggers a severe physical response. It's the body's threat system — the fight-or-flight response — firing when there's no actual physical danger.
Your nervous system reads something as threatening (even if you can't identify what), floods your body with adrenaline, and prepares you to run or fight. Your heart rate surges. Your breathing speeds up. Blood moves away from your extremities. You start to hyperventilate — which reduces carbon dioxide in the blood, causing tingling, dizziness, and a strange sense of unreality.
All of those sensations are real. And all of them feel terrifying in the moment.
But here's the crucial thing: a panic attack cannot hurt you. Your body is doing exactly what it evolved to do. It's just doing it at the wrong time.
Panic attacks typically peak within ten minutes and then subside. The physical sensations, frightening as they are, will pass.
Why Do Panic Attacks Happen?
Sometimes there's an obvious trigger. A stressful situation, a crowded place, a specific fear that escalates suddenly. But sometimes panic attacks seem to come out of nowhere — appearing while you're relaxing, asleep, or doing something completely ordinary.
That "out of nowhere" quality is one of the things people find most frightening. In reality, panic attacks that feel unexpected usually have a trigger — it's just not a conscious, obvious one. The nervous system picks up on something that connects, below conscious awareness, with an earlier experience of threat.
The Panic Cycle: How Anxiety Feeds Itself
One of the most important things to understand about panic attacks is the cycle that keeps them going.
You have a panic attack. It feels terrible. So you become hypervigilant about the physical sensations in your body — watching for signs that another one might be coming. You notice your heart beating a little faster. And those sensations — perfectly normal physical fluctuations — get interpreted as the start of another attack. Which triggers anxiety. Which produces more physical sensations. Which confirms the fear.
The anxiety about the anxiety keeps the anxiety alive.
And the avoidance — the train you no longer take, the supermarket you no longer visit, the meeting you call in sick to — reinforces the belief that those situations are genuinely dangerous. Which makes them harder to approach.
How Counselling Helps
CBT (Cognitive Behavioural Therapy) is one of the most well-evidenced treatments for panic attacks and panic disorder. It works directly on the cycle.
First, it helps you understand what's actually happening during a panic attack — not the frightening story your mind tells you ("I'm dying," "I'm losing control"), but the real physiological process. Understanding this removes some of the catastrophic interpretation that amplifies the fear.
Second, it helps you change your response to the early sensations. Instead of treating a slightly racing heart as a crisis, you learn to notice it without reacting — allowing it to pass rather than feeding it with more fear.
Third, gradually and carefully, it helps you re-engage with the situations you've been avoiding. This isn't about forcing yourself through terror. It's a structured, supported process of building new associations.
What You Can Do Right Now
There are things that can help in the moment when panic strikes.
Slow your breathing. Breathe in slowly for four counts, hold for two, out for six. Extended exhalations activate the body's calming system and start to counteract the hyperventilation.
Stay where you are if you can. Leaving the situation reinforces the belief that it was dangerous. If you can ride it out — even sitting down somewhere nearby — it helps.
Don't fight the sensations. Fighting intensifies them. Allowing them, knowing they'll pass, is counterintuitive but more effective.
Remind yourself that what you're feeling is uncomfortable but not dangerous. Your body is doing its job, just at the wrong time.
These strategies help in the moment. But they're not a substitute for addressing the pattern itself.
Getting Support
If panic attacks are affecting your life — if you're avoiding situations, dreading the next one, or finding that anxiety is narrowing what you're able to do — it's worth getting proper support.
You don't have to live like this. Panic attacks are one of the most treatable forms of anxiety, and most people who work with a therapist see significant improvement.
Wellbeing Practice has therapy rooms in Wimborne and Poundbury. Online and telephone sessions are available too. The initial assessment is £48. No GP referral needed.
Frequently Asked Questions
Can a panic attack actually kill you?
No. A panic attack cannot kill you or cause lasting physical harm. The sensations — racing heart, difficulty breathing, chest pressure — are the result of adrenaline and hyperventilation, both of which are harmless in themselves. This doesn't make the experience any less frightening, but it is important to know.
How do I know it's a panic attack and not a heart problem?
It's always worth ruling out a medical cause for chest pain or breathing difficulties, particularly if you've not experienced panic attacks before. If you're unsure, see your GP. That said, panic attacks produce distinct physical sensations that are well-recognised — if a doctor has confirmed there's no cardiac or physical cause, the physical sensations are almost certainly anxiety-related.
How many people experience panic attacks?
Panic attacks are common. Studies suggest between one in four and one in three people experience a panic attack at some point in their life. Panic disorder — where attacks are recurrent and begin to significantly affect daily life — is less common, but still affects around one in seventy-five people.
Can panic attacks go away on their own?
Some people have isolated panic attacks that don't recur. For others, particularly where avoidance develops, the pattern tends to persist or worsen without treatment. CBT has a strong success rate for people who engage with it fully — most see substantial improvement within eight to twelve sessions.
Will I have to talk about things from my past in counselling for panic attacks?
Not necessarily, and not from the start. Counselling for panic attacks often begins with the mechanics of panic itself — understanding the cycle and building tools to respond differently. Whether and when to explore underlying experiences depends on what seems to be driving the anxiety, and is always your choice.
Written by Ian Smith, BSc (Hons), BACP Accredited, founder of Wellbeing Practice — counselling and professional support across Poundbury, Wimborne, and Online.
