A panic attack is an intense surge of fear that peaks within minutes. It is profoundly unpleasant, but it is not medically dangerous and it responds well to treatment.

Coping with panic attacks
A panic attack is not dangerous. What makes it feel dangerous is the catastrophic interpretation of bodily sensations.

What happens during an attack?

Symptoms usually peak within ten minutes and subside within twenty to thirty. In the moment, the sense of having a heart attack or losing control is extremely convincing.

Typical symptoms

  • Palpitations, racing heartbeat
  • Shortness of breath or a sense of choking
  • Tightness or pain in the chest
  • Trembling, sweating, chills or hot flushes
  • Dizziness, light-headedness
  • Numbness or tingling
  • A sense of unreality (derealisation)
  • Fear of losing control, going mad or dying

How the panic cycle is built

At the core of panic disorder is a misinterpretation. The body produces an ordinary sensation — the heart speeds up slightly. That sensation is read as catastrophe: I am having a heart attack. The interpretation raises anxiety, the anxiety intensifies the sensation, and the loop closes.

An important distinction: a panic attack and panic disorder are not the same thing. Having a panic attack once in your life is common. The disorder is defined by the fear of having another one beginning to narrow your life.

What to do after a first attack

  • Medical assessment first: chest pain and palpitations occurring for the first time should always be seen by a doctor, and cardiac causes ruled out.
  • Psychological assessment second: if there is no medical cause and attacks recur, a psychological assessment is needed.
  • Do not let avoidance set in: staying away from the place where you had an attack is the single most important step in panic disorder becoming established.

What actually helps?

  • Cognitive behavioural therapy: first-line in panic disorder; it targets the catastrophic interpretations directly
  • Interoceptive exposure: deliberately inducing the feared bodily sensations in a safe setting
  • Breathing regulation: reduces hyperventilation, but must not become a safety behaviour
  • Medication: for frequent and severe attacks, following psychiatric assessment

What you can do during an attack

  1. Remember it will passA panic attack is self-limiting. It typically subsides within twenty to thirty minutes.
  2. Slow the breath downRather than trying to breathe deeply, breathe out slowly. Rapid breathing intensifies the symptoms.
  3. Stay rather than fleeLeaving the situation brings immediate relief but feeds the next attack.
  4. Write it down afterwardsWhat was the trigger, what did you think, what did you do? That record is the most valuable material in therapy.
Note: This article is for general information. It does not diagnose and is not a substitute for professional assessment. If your symptoms are making daily life difficult, consult a mental health professional. If you are having thoughts of harming yourself, call your local emergency number — 112 in Türkiye — or go to the nearest emergency department.

Individual Counselling

Work on panic disorder is structured and time-limited; the aim is to break the cycle.

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References

  1. Clark, D. M. (1986). A cognitive approach to panic. Behaviour Research and Therapy, 24(4), 461–470.
  2. American Psychiatric Association. (2022). Diagnostic and Statistical Manual of Mental Disorders (5th ed., text rev.). American Psychiatric Publishing.