Understanding Panic Attacks and Panic Disorder

Panic attacks can be frightening, overwhelming experiences that often feel as though something is seriously wrong physically or mentally. Many people who experience panic attacks worry they are having a heart attack, losing control, “going crazy,” or dying.

A panic attack involves a sudden surge of intense fear or physical discomfort that reaches a peak within minutes. While panic attacks themselves are not dangerous, they can feel extremely alarming and may lead individuals to begin avoiding situations or activities out of fear another attack will occur.

When panic attacks become recurrent and are accompanied by persistent fear of future attacks or significant changes in behaviour to avoid them, this may be diagnosed as Panic Disorder.

What Does a Panic Attack Feel Like?

Panic attacks can involve intense physical sensations and catastrophic thoughts that escalate quickly.

Common symptoms may include:

Racing or pounding heart
Shortness of breath
Chest tightness or pain
Dizziness or lightheadedness
Sweating
Trembling or shaking
Nausea or stomach discomfort
Tingling or numbness
Feeling detached or unreal
Chills or hot flashes
Feeling like you may faint
Fear of losing control
Fear of dying

Panic attacks can occur unexpectedly or in response to specific situations, sensations, or stressors.

Because the symptoms are so physical, many people initially seek emergency medical care believing they are experiencing a serious medical event.

What Is Panic Disorder?

Panic Disorder involves more than having occasional panic attacks. It typically includes:

Recurrent panic attacks
Ongoing fear about having additional attacks
Hypervigilance to body sensations
Avoidance of situations where panic might occur
Significant changes in behaviour due to fear of panic

People with panic disorder often begin monitoring their body closely for signs of danger, such as changes in heart rate, breathing, dizziness, or physical discomfort. Over time, this fear of panic itself can become the main problem.

The Panic Cycle

Panic disorder is often maintained through a cycle of fear and avoidance:

A physical sensation occurs (e.g., dizziness, rapid heartbeat)
The sensation is interpreted as dangerous (“I’m going to faint” or “I’m having a heart attack”)
Anxiety increases rapidly
The body’s fight-or-flight response intensifies symptoms
Panic escalates
Avoidance, escape, or safety behaviours are used
Temporary relief occurs
The brain learns the sensations are dangerous

This cycle can cause individuals to become increasingly fearful of normal bodily sensations.

Common Safety Behaviours and Avoidance

People experiencing panic attacks often begin trying to prevent or escape panic in ways that unintentionally maintain anxiety. These may include:

Avoiding exercise or physical exertion
Avoiding driving, crowds, travel, or being alone
Carrying “just in case” items constantly
Sitting near exits
Excessively monitoring pulse or breathing
Reassurance-seeking
Avoiding caffeine or situations associated with panic
Leaving situations early
Constantly scanning for symptoms

Some individuals also develop agoraphobia, involving fear or avoidance of places where escape might feel difficult if panic symptoms occur.

Effective Treatment for Panic Disorder

Panic disorder is highly treatable. Evidence-based treatment typically includes Cognitive Behavioural Therapy (CBT) and Exposure Therapy.

Treatment often involves:

Understanding the body’s anxiety response
Learning how panic symptoms are maintained
Reducing avoidance and safety behaviours
Changing responses to physical sensations
Increasing tolerance for uncertainty and discomfort
Gradually re-engaging with avoided activities or situations

A key component of treatment may include interoceptive exposure, which involves intentionally practicing feared physical sensations in a safe and controlled way.

Over time, the brain learns that these sensations, while uncomfortable, are not dangerous.

Panic Attacks Are Not Dangerous

Although panic attacks can feel intense and overwhelming, they are not harmful to the body. Panic symptoms are caused by activation of the nervous system’s fight-or-flight response.

Many people become trapped not because panic attacks are dangerous, but because they begin fearing the sensations themselves.

Recovery often involves learning to respond differently to panic symptoms rather than trying to eliminate anxiety entirely.

Virtual Therapy for Panic Disorder

Virtual therapy can be highly effective for panic disorder and panic attacks. Treatment can often occur directly in the environments where anxiety and avoidance show up in daily life.

Many people living with panic disorder begin organizing their lives around avoiding anxiety, uncertainty, or physical sensations. Over time, this can shrink daily life and increase fear.

With evidence-based treatment and support, it is possible to reduce panic symptoms, regain confidence, and reconnect with activities and places that anxiety may have taken away.