Understanding Panic Attacks

By Luna Fejza, RN, Certified Nurse Psychotherapist, Auren Wellness

A panic attack can make you feel as though something is seriously wrong, even when you are not in obvious danger.

Your heart may suddenly race. Your chest may tighten. You might feel dizzy, shaky, short of breath, nauseated, overheated, or disconnected from your surroundings. Then the frightening thoughts begin: What if I faint? What if I lose control? What if this is a heart attack?

The first panic attack often seems to come out of nowhere, making it difficult to trust your body afterward. You may begin monitoring every sensation, avoiding places where escape feels difficult, or planning your day around preventing another attack.

In my work, I often see the fear of another attack become as disruptive as the panic itself. The good news is that panic attacks are treatable. Therapy can help you understand what your body is doing, respond differently to the sensations, and gradually stop organizing your life around fear.

Quick answer: A panic attack is a sudden surge of fear accompanied by symptoms such as a racing heart, shortness of breath, dizziness, trembling, or feeling disconnected. Although panic attacks can feel dangerous, the sensations themselves are usually part of the body's alarm response. CBT can help reduce fear of these sensations, interrupt the panic cycle, and rebuild confidence in avoided situations.

What does a panic attack feel like?

Panic attacks can look different from person to person, but common experiences include:

• A racing or pounding heart
• Shortness of breath
• Dizziness or weakness
• Sweating, trembling or chills
• Tingling or numbness
• Feeling detached from yourself or your surroundings

Panic often peaks within minutes, although anxiety and exhaustion may last longer.

Having a panic attack does not necessarily mean you have panic disorder, which involves recurrent attacks followed by ongoing fear or behavioural changes. New, severe, or unexplained symptoms should be medically assessed, but repeatedly treating familiar panic sensations as emergencies can reinforce the cycle.

Why panic attacks feel so dangerous

Panic attacks involve the body's alarm system activating strongly, sometimes without a clear external threat.

When the alarm system turns on, your heart beats faster, breathing changes, muscles tense, and attention narrows toward possible danger. The problem is that the alarm may interpret harmless sensations as immediate danger.

For example, you notice your heart beating quickly. You think, Something is wrong with my heart. That thought increases fear, which makes your heart beat even faster. The stronger sensation seems to confirm the fear.

This creates a feedback loop:

Body sensation → frightening interpretation → increased anxiety → stronger body sensation

The fear of panic can make life smaller

After an attack, avoidance can feel protective. You may stop exercising because a faster heartbeat reminds you of panic. You might avoid crowded places, exercise, or being far from home.

You may sit near exits, check your pulse, carry supplies, travel only with someone you trust, or leave at the first sign of discomfort.

These strategies bring short-term relief but can teach your brain that the situation was dangerous, gradually making your world smaller.

If fear of another panic attack is shaping where you go, what you do, or whether you feel safe alone, panic attack therapy can help you understand the cycle and begin approaching life with more confidence.

What to do during a panic attack

Trying to force panic to stop can add another layer of fear. A more helpful response is to recognize what is happening without treating it as proof of catastrophe:

This feels intense. My alarm system is activated. I do not have to solve every sensation right now.

Let your breathing settle naturally and shift attention outward by noticing the room, your feet on the floor, or what you can see and hear.

The goal is learning that the sensations can rise, peak, and pass without requiring escape.

How therapy helps with panic attacks

Cognitive behavioural therapy (CBT) is one of the best supported psychological treatments for panic disorder. A large review of 136 randomized trials found CBT to be among the most effective and acceptable psychotherapies studied for panic disorder.

Therapy may involve:

• Understanding your individual panic cycle
• Identifying catastrophic interpretations of physical sensations
• Reducing checking, escape, and reassurance-seeking

Interoceptive exposure involves safely recreating feared sensations, such as a faster heartbeat or mild dizziness, so the brain can learn that discomfort does not automatically mean danger.

This work should be planned collaboratively and adapted to the individual. Therapy is not about pushing someone into overwhelming situations or telling them to "just calm down." It is about helping the nervous system learn through experience that panic sensations can be tolerated without escape.

When should you consider professional support?

Consider therapy when panic recurs, fear of another attack consumes your attention, or avoidance begins restricting your life.

Panic may feel unpredictable, but the cycle that keeps it going can be understood and treated. You do not have to wait until your world has become very small before asking for help.

If panic attacks are interfering with your work, relationships, travel, or daily routines, I offer therapy across Ontario. Book a free 15-minute consultation with me to discuss what has been happening and whether working together feels like the right fit.

This article is educational and is not a substitute for medical advice, diagnosis, or individualized treatment. New, severe, worsening, or unexplained symptoms, particularly chest pain, breathing difficulty, fainting, or neurological changes, should be assessed by an appropriate healthcare professional. If you are experiencing an emergency or immediate danger, call 9-1-1 or go to your nearest emergency department.