A panic attack does not feel like “just anxiety.”
Your heart may race. Breathing can become difficult. You might feel dizzy or suddenly overwhelmed by the sense that something is seriously wrong.
For many people, the physical sensations are so intense that they may be having a heart attack, losing control or about to pass out.
These symptoms are real. They come from the body’s alarm system becoming activated, even when there is no obvious danger.
What Is Happening in the Body?
The human body is designed to respond quickly when it senses a threat. Heart rate and breathing change as the body prepares to protect itself.
That response is useful when danger is real. During a panic attack, however, the alarm can go off when no immediate threat is present.
This is why reassurance may not make the anxiety disappear. A person can understand intellectually that they are probably safe while their body continues to signal that they are not.
How Panic Can Build on Itself
Sometimes a panic attack begins with a thought or a stressful situation. Other times, the first thing someone notices is a physical sensation.
Maybe it’s the heart that starts beating faster. The person wonders why and begins monitoring it closely. That concern increases the fear, which can make the heart beat even faster.
The sensation and the fear begin feeding each other.
After an episode, even an ordinary change in breathing or heart rate may feel threatening because it resembles the beginning of the previous attack. The fear of another panic attack can eventually become a source of anxiety on its own.
Is It a Panic Attack or Something Else?
Having a panic attack does not necessarily mean that someone has panic disorder.
Panic attacks can occur during periods of intense stress or alongside other mental health concerns. Physical symptoms may also have medical causes.
For that reason, chest discomfort, shortness of breath, faintness or a racing heart should not automatically be attributed to anxiety. New, severe or unfamiliar symptoms deserve appropriate medical attention.
It is understandable to want immediate certainty that an episode was “only panic.” That is not always a distinction someone can safely make alone.
Understanding What Happened
Learning why panic feels so physical can remove some of its mystery. It does not mean that a person should be able to think their way out of an attack.
The body’s alarm system is designed to react before there is time for careful reasoning. Having that response is not a sign of weakness or a failure to remain calm.
A thoughtful evaluation can help clarify what may be contributing to these episodes and whether additional support is needed.
Peter Zafirides, MD
Central Ohio Behavioral Medicine
