What's Actually Happening
A panic attack is your body's alarm system firing at full intensity when there's no actual threat. It's the same response you'd have if a tiger walked into the room, except there's no tiger. Just your body acting as though there is.
Heart pounding. Chest tight. Breathing shallow. Dizzy. Hands tingling. A sense of unreality. And underneath it all, a conviction that something is seriously wrong, you're losing control, or you're about to die.
The sensations are real. The danger isn't. But in the moment, your body doesn't know the difference.
Here's the cruel irony: panic attacks themselves are harmless. Your heart can race at 150 beats per minute and you're not having a heart attack. You can hyperventilate and you're not suffocating. The dizziness isn't a stroke. The tingling isn't neurological damage. Every symptom is explainable and none of them are dangerous.
But try telling your body that when you're in the middle of one.
What Panic Feels Like
Panic attacks can include any combination of these experiences:
Heart & Chest
Racing or pounding heart, chest pain or tightness, feeling like something is wrong with your heart.
Breathing
Shortness of breath, feeling like you can't get enough air, choking sensation, throat tightness.
Body Sensations
Tingling or numbness in hands and face, trembling, hot flashes or chills, sweating, nausea.
Head & Mind
Dizziness, lightheadedness, feeling unreal or detached, fear of losing control, fear of dying.
The whole experience typically peaks within 10 minutes and rarely lasts more than 30. But those minutes feel endless, and the aftermath, the exhaustion and residual fear, can linger for hours.
The Panic Cycle
Here's what keeps panic attacks coming back. It's not random. There's a predictable loop that maintains the pattern:
A Body Sensation
Something triggers awareness: a skipped heartbeat, slight dizziness, a twinge of breathlessness. Often normal variations in physiology.
Catastrophic Interpretation
"Something's wrong." "This is a heart attack." "I'm going to faint." "I'm losing my mind." The sensation gets flagged as dangerous.
Fear Response
The brain detects "danger" and triggers the fight-or-flight response. Adrenaline floods the system. Heart rate increases. Breathing changes.
More Sensations
The alarm response creates more physical symptoms. Racing heart. Dizziness. Tingling. Each symptom becomes more evidence that something is wrong.
Escalation
Fear feeds symptoms, symptoms feed fear. The loop accelerates into full panic. The body is in emergency mode, convinced a threat exists.
Aftermath & Anticipation
The attack passes, but now you're watching for signs of the next one. This hypervigilance itself triggers step 1 again.
The problem isn't the initial sensation. It's what your mind does with it. Break the interpretation, and you break the cycle.
The Fear of Fear
For many people, the real problem isn't the panic attack itself. It's the fear of having another one. You start avoiding situations where attacks have happened. You scan constantly for early warning signs. You carry "safety behaviours" wherever you go. Your world shrinks. This anticipatory anxiety often causes more suffering than the attacks themselves.
Why Your Body Does This
Panic isn't a malfunction. It's a misfiring of a system that's supposed to protect you. The fight-or-flight response evolved to help you survive genuine threats: predators, falling rocks, enemy attacks. When that response fires, blood flows to your muscles, your heart pumps faster, you breathe more rapidly. All useful if you need to run or fight.
The problem is that this system can get triggered by internal sensations rather than external threats. A funny heartbeat. A wave of dizziness. A thought about what those symptoms might mean. The alarm goes off, but there's nothing to run from and nothing to fight. So you're left standing there, flooded with adrenaline, while your body prepares for a battle that doesn't exist.
Understanding this is the first step. You're not going crazy. You're not having heart attacks. Your body is doing exactly what it's designed to do. It's just doing it at the wrong time.
What Treatment Looks Like
Panic disorder is one of the most treatable anxiety conditions. The evidence base is strong. The interventions are specific. Most people see significant improvement.
Understanding Your Pattern
We map exactly how your panic attacks work: what triggers them, what thoughts fuel them, what you do when they hit. Understanding the cycle is the foundation for changing it.
Changing the Interpretation
We work on the catastrophic thoughts that turn a normal sensation into a panic attack. Not positive thinking. Accurate thinking. Learning what these symptoms actually mean.
Interoceptive Exposure
Deliberately inducing panic-like sensations in safe conditions: spinning to create dizziness, breathing through a straw to feel breathless. Teaching your body that these sensations are uncomfortable but not dangerous.
Dropping Safety Behaviours
Identifying and gradually letting go of the things you do to feel safe: carrying medication "just in case," staying near exits, avoiding exercise. Each safety behaviour maintains the belief that you need it.
Reclaiming Your Life
Returning to places and situations you've been avoiding. Rebuilding confidence. Getting your territory back from panic.
This isn't about learning to endure panic attacks. It's about changing the mechanisms that create them. When treatment works, the attacks become less frequent, less intense, and eventually stop altogether for most people.
What Actually Changes
When treatment works, here's what shifts:
- You notice a racing heart and think "Oh, that's just adrenaline" instead of "Something's wrong with me."
- Physical sensations don't automatically spiral into full panic. The escalation stops before it starts.
- You stop scanning your body for danger signals. Hypervigilance drops.
- You go places you've been avoiding without needing to have an escape plan.
- You stop carrying "safety" items or performing rituals that you believed were keeping you safe.
- Panic attacks become rare, then stop. If one ever comes, you know exactly what to do.
Most people with panic disorder who complete evidence-based treatment experience significant improvement. This is one of the conditions where treatment really works.
Quick Self-Assessment
The PDSS (Panic Disorder Severity Scale) is a validated screening tool used by clinicians to assess panic severity. It covers the key dimensions: attack frequency, distress, anticipatory anxiety, avoidance, and life interference.
Panic Disorder Severity Scale
Think about the past week when answering these questions. This applies whether your panic attacks are cued (triggered by specific situations) or uncued (seem to come out of nowhere).
This screening tool is for informational purposes only and is not a clinical diagnosis. If you're experiencing panic attacks, please consult a qualified mental health professional for proper assessment and treatment.
Common Questions
If you're concerned, get checked out medically. Ruling out cardiac issues or other conditions is reasonable and often helps treatment. But if you've been cleared and the attacks keep coming, that's a strong indicator it's panic disorder.
No. Despite how terrifying they feel, panic attacks are not dangerous. Your heart can handle racing at 150 bpm. The dizziness won't make you faint (blood pressure rises during panic, not drops). You won't stop breathing. You won't go insane. The symptoms are intensely uncomfortable but medically harmless.
Psychological treatment alone is highly effective for panic disorder. Some people benefit from medication as well, especially in the early stages. That's a decision to make with your GP or psychiatrist. But medication isn't required for successful treatment.
Most people see significant improvement within 8-12 sessions of focused treatment. Some need longer, especially if panic has been present for years or is intertwined with other issues like agoraphobia or health anxiety.
Not necessarily. Panic attacks can be "cued" (triggered by specific situations, like crowded places or driving) or "uncued" (seemingly out of the blue). Both types are real and both respond to treatment. With uncued attacks, sometimes there are subtle internal triggers you're not aware of, sometimes there genuinely isn't an obvious cause. Either way, the treatment approach works.
Yes. With a Mental Health Care Plan from your GP, you can access Medicare rebates for up to 10 sessions per calendar year. Most private health funds also provide rebates depending on your cover.
Cammeray, on Sydney's Lower North Shore. Easy access from the North Shore, Northern Beaches, and CBD.
Ready to Break the Cycle?
Panic disorder is treatable. If you're tired of being controlled by attacks, let's talk about what effective treatment looks like for your situation.
Book a SessionIn crisis? If you're in immediate danger or at risk of harming yourself, please call 000. For urgent support, contact Lifeline on 13 11 14. If you're unsure whether you're having a panic attack or a medical emergency, call 000 or go to Emergency.