If you’ve ever had a panic attack, you’ll know how terrifying they can be. Your heart races, your chest tightens, you can’t catch your breath — and your brain is convinced that something is seriously, catastrophically wrong.
And yet panic attacks, despite feeling so dangerous, are not physically harmful. They are your body’s alarm system misfiring — triggering a full fight-or-flight response when there is no actual threat. Understanding this is the first step toward taking back control.
What is a panic attack?
A panic attack is a sudden surge of intense fear or discomfort that peaks within minutes and is accompanied by a range of physical and psychological symptoms, including:
- Racing or pounding heart
- Shortness of breath or feeling unable to breathe
- Chest pain or tightness
- Dizziness or lightheadedness
- Tingling or numbness in the hands or face
- Sweating or chills
- Nausea or stomach discomfort
- Feeling detached from yourself or your surroundings
- An overwhelming sense of dread or feeling that something terrible is about to happen
Panic attacks typically peak within ten minutes and subside within twenty to thirty minutes — though in the moment, they can feel like they will never end.
What causes panic attacks?
Panic attacks can be triggered by a specific situation — a crowded place, a social event, a stressful encounter — or they can seem to come completely out of nowhere, even waking you from sleep.
At the root of most panic attacks is a process called the panic cycle. It works like this:
- You notice a physical sensation — perhaps your heart beats slightly faster after climbing stairs
- Your anxious brain interprets this as dangerous — “something is wrong with my heart”
- This thought triggers more anxiety — which produces more physical symptoms
- The increased symptoms seem to confirm that something is wrong — which triggers even more anxiety
- The cycle escalates rapidly into a full panic attack
Understanding this cycle is enormously empowering — because it shows that panic attacks are driven by the meaning we give to physical sensations, not by actual danger.
Practical tips for managing panic attacks
1. Remind yourself it will pass In the middle of a panic attack, your brain is convinced something terrible is happening. Gently remind yourself — “This is a panic attack. It is not dangerous. It will pass.” You have survived every panic attack you have ever had. You will survive this one too.
2. Slow your breathing When we panic, we tend to breathe rapidly and shallowly — which actually increases feelings of dizziness and unreality. Slowing your breathing interrupts this process.
Try breathing in for four counts, holding for two, and breathing out slowly for six counts. The extended exhale activates your parasympathetic nervous system — your body’s natural calming response.
3. Ground yourself in the present moment Panic tends to pull you into catastrophic future thinking. Grounding techniques bring you back to the present moment and interrupt the panic cycle.
Try the 5-4-3-2-1 technique:
- Name 5 things you can see
- Name 4 things you can touch — and feel their texture
- Name 3 things you can hear
- Name 2 things you can smell
- Name 1 thing you can taste
This simple exercise engages your senses and anchors you in the here and now.
4. Don’t fight the panic Counterintuitively, trying to fight or suppress a panic attack often makes it worse. Resistance increases tension. Instead, try to allow the sensations to be there without adding fear on top of them. Think of it like a wave — if you try to fight a wave, it knocks you over. If you let it wash over you, it passes.
5. Move your body Gentle movement — walking, stretching, or simply standing up and changing your surroundings — can help discharge the adrenaline that fuels a panic attack and signal to your nervous system that you are safe.
This is one of the reasons Walk & Talk therapy can be particularly helpful for people who experience panic — combining movement with therapeutic support in a natural, open environment.
6. Cool down Splashing cold water on your face or holding something cold activates the dive reflex — a physiological response that slows the heart rate and can interrupt a panic attack quickly.
7. Talk to someone If you’re with someone you trust, tell them what’s happening. Being witnessed and supported during a panic attack can significantly reduce its intensity and duration. If you’re alone, even texting someone can help.
Longer term strategies
The tips above can help you manage panic attacks when they happen — but they don’t address the underlying anxiety that causes them. For longer term relief, the following approaches can make a significant difference:
Cognitive Behavioural Therapy (CBT) is one of the most effective treatments for panic disorder. It helps you identify and challenge the catastrophic thought patterns that fuel the panic cycle, and gradually face the situations you’ve been avoiding.
Psychodynamic therapy can help explore whether there are deeper emotional patterns or unresolved experiences contributing to your anxiety.
Integrative counselling combines a range of approaches tailored specifically to your needs — addressing both the practical management of panic and its deeper roots.
Lifestyle factors also play an important role. Regular exercise, reducing caffeine and alcohol, improving sleep, and building in regular relaxation can all significantly reduce the frequency and intensity of panic attacks.
When to seek help
If panic attacks are affecting your quality of life — causing you to avoid situations, withdraw from activities, or live in fear of the next one — please do reach out for support. Panic disorder is very treatable, and most people experience significant improvement with the right therapeutic approach.
You don’t have to keep managing this alone.
About my practice
I’m Klara Vantrubova, an integrative counsellor and psychotherapist based in West Hampstead, London (NW6), specialising in anxiety and panic. I offer a warm, practical and evidence-based approach to help you understand and overcome panic attacks for the long term.
I offer in-person sessions in West Hampstead NW6, Walk & Talk therapy in the Brondesbury area, and online sessions worldwide. I am currently accepting new clients.
👉 Book your free consultation here
Klara Vantrubova is an integrative counsellor and psychotherapist based in West Hampstead, London, offering in-person, Walk & Talk and online sessions. She specialises in anxiety, trauma, relationship issues and more.
Integrative Counselling & Psychotherapy 