What Actually Happens During a Panic Attack

20 July

A racing heart. A tight chest. A wave of dread that seems to come from nowhere. That is how most people describe their first panic attack, and it is often mistaken for a medical emergency. Around 40 per cent of Australians will have a panic attack at some point in their lives (Beyond Blue, n.d.-a). Most of them will never have another one.

Understanding what is actually happening in the body during a panic attack takes away some of its power. It does not make the experience pleasant. But it does make it less frightening, and less likely to be mistaken for something more dangerous than it is.

What a panic attack actually is

A panic attack is a sudden surge of intense fear paired with physical symptoms that peak within about ten minutes (Beyond Blue, n.d.-a). It can happen while resting, during a stressful moment, or even wake someone from sleep. Anxiety disorders are the most commonly reported mental health condition in Australia, affecting 17.2 per cent of people aged 16 to 85 in any given year (Australian Bureau of Statistics, 2023). Panic attacks can occur as part of any anxiety condition, though not everyone with anxiety experiences them (headspace, n.d.).

Common signs of a panic attack include:

A pounding or racing heart
Shortness of breath or a feeling of choking
Chest tightness or pain
Dizziness or light-headedness
Sweating, trembling or chills
A sense of unreality or detachment from your surroundings
A fear of losing control, or a fear that something terrible is about to happen

(Beyond Blue, n.d.-a)

These symptoms are real. They come from the body's stress response switching on when there is no actual danger to respond to. That mismatch between what the body is doing and what is actually happening is part of what makes panic attacks so disorienting.

Panic attack or panic disorder

Having one panic attack does not mean someone has panic disorder. Panic disorder is diagnosed when attacks are recurrent and begin to shape daily decisions, such as avoiding exercise because a racing heart feels frightening, or avoiding certain places altogether in case an attack happens there (Beyond Blue, n.d.-a). Left unsupported, this pattern can quietly narrow a person's world.

Women report anxiety conditions at roughly double the rate of men, 21.1 per cent compared with 13.3 per cent (Australian Bureau of Statistics, 2023). Anxiety prevalence is also highest among people aged 16 to 24 (Australian Bureau of Statistics, 2023). None of this means panic is something to simply expect and manage alone. It means it is common enough that asking for support is a completely reasonable next step, not an overreaction.

What helps in the moment

There is no single technique that works for everyone, but a few strategies consistently help bring the body back to baseline.

Slow the exhale. Breathing out for longer than you breathe in signals safety to the nervous system.
Name five things you can see, four you can hear, and three you can feel. This grounding step pulls attention back to the present.
Find something solid to lean or sit against. Physical steadiness often helps mental steadiness follow.
Remind yourself it will pass. Most panic attacks peak within ten minutes, even though it rarely feels that short (Beyond Blue, n.d.-a).

None of these stop a panic attack from happening. What they do is shorten it, and make it feel less like an emergency and more like something that can be ridden out.

Why longer-term support matters

For people having panic attacks regularly, working with a psychologist tends to make the biggest difference. Cognitive behavioural therapy has strong evidence for treating panic disorder, largely because it helps people understand their triggers and unwind the avoidance patterns that build up around them (healthdirect, n.d.). At Valentia Health, our psychologists work with clients experiencing anxiety and panic to build practical, personalised strategies rather than generic advice, whether that is in person at our Taringa clinic or via telehealth from anywhere in Australia.

A Mental Health Care Plan from your GP can also make ongoing sessions more affordable through Medicare rebates. It is worth asking your GP about this before your first appointment.

Getting support

If panic attacks are becoming frequent, or if they are starting to change what you do or where you go, that is a good reason to talk to someone. Reaching out is not an admission that something is badly wrong. It is simply the next sensible step. Valentia Health offers individual therapy for anxiety and panic, both in person in Taringa and via telehealth across Australia. You can find out more or book an appointment at valentiahealth.com.au.

This post is for general informational purposes and is not a substitute for professional psychological advice. If you are in crisis, please contact Lifeline on 13 11 14 or call 000.