Understanding Panic Attacks: A Science-Based Guide to Support and Response

 

Panic attacks are sudden episodes of intense fear or discomfort that peak within minutes and are often accompanied by physical symptoms such as chest pain, shortness of breath, dizziness, and a sense of impending doom. Though they can feel life-threatening, panic attacks are not inherently dangerous. They are a physiological misfire of the body’s fight-or-flight system, triggered without a real threat (Feinstein, 2021).

🔬 What Happens During a Panic Attack?

At the core of a panic attack is the brain’s alarm system, particularly the amygdala, sending signals that flood the body with adrenaline. This cascade activates the sympathetic nervous system, preparing the body to respond to danger. However, in the case of a panic attack, there is no actual threat, which leads to a mismatch between perception and reality (Science News Today, 2025).

Common symptoms include:

• Rapid heartbeat
• Sweating or chills
• Trembling
• Shortness of breath
• Nausea
• Tingling sensations
• Feelings of unreality or detachment

These symptoms can mimic serious medical conditions, which is why many people experiencing a panic attack believe they are having a heart attack or losing control (Perkins, 2021).

🧠 Who Is Affected?

Panic attacks can occur in anyone, but they are more common in individuals with anxiety disorders, depression, PTSD, or a family history of panic disorder. According to Harvard Health Publishing, nearly 5% of the U.S. population experiences panic disorder, which involves recurrent attacks and persistent worry about future episodes (Fisher, 2024).

🤝 How to Help a Friend Having a Panic Attack

Supporting someone during a panic attack requires calm, informed action. Here’s what you can do:

1. Stay Calm and Present

Your demeanor sets the tone. Speak in a steady, reassuring voice. Avoid saying things like “calm down” or “you’re overreacting,” which can invalidate their experience.

2. Validate Their Experience

Say something like: “You’re safe. I’m here with you. This will pass.” Acknowledge their fear without amplifying it.

3. Guide Their Breathing

Encourage slow, diaphragmatic breathing:

• Inhale through the nose for 4 seconds
• Hold briefly
• Exhale through the mouth for 6 seconds

This activates the parasympathetic nervous system, helping the body exit fight-or-flight mode (Science News Today, 2025).

4. Ground Them in the Present

Use grounding techniques:

• Ask them to name five things they can see, four they can touch, three they can hear, two they can smell, and one they can taste.
• Offer a cold object to hold or suggest they focus on the texture of something nearby.

5. Avoid Overstimulating

Don’t crowd them or offer too many solutions. Give space if needed, but remain nearby and attentive.

6. Stay Until It Passes

Panic attacks typically peak within 10 minutes and subside within 30. Stay with your friend until they feel more stable.

7. Encourage Professional Help

If attacks are frequent or debilitating, gently suggest they speak with a mental health professional. Cognitive Behavioral Therapy (CBT) and medication are effective treatments for panic disorder (Fisher, 2024).

🧭 Final Thoughts

Panic attacks are not signs of weakness or instability—they are misfires in a finely tuned survival system. Understanding the science behind them empowers us to respond with empathy and precision. Whether you're the one experiencing panic or supporting someone who is, knowledge is the first step toward calm.

📚 References

• Feinstein, J. (2021). The science behind panic attacks — and what you can do to manage them. TED Ideas. https://ideas.ted.com/the-science-behind-panic-attacks-and-what-can-you-do-to-manage-them/
• Fisher, J. (2024). Panic attacks: Recognizing and managing panic attacks and preventing future attacks. Harvard Health Publishing. https://www.health.harvard.edu/mind-and-mood/panic-attacks-recognizing-and-managing-panic-attacks-and-preventing-future-attacks
• Science Desk. (2025). How to manage panic attacks fast: Evidence-based techniques. Science News Today. https://www.sciencenewstoday.org/how-to-manage-panic-attacks-fast-evidence-based-techniques

 

 

What Not to Do During a Panic Attack

 

Understanding Panic Attacks

A panic attack is a sudden, intense surge of fear or discomfort that typically peaks within minutes. Symptoms may include:

• Racing heart
• Shortness of breath
• Dizziness or faintness
• Chest pain
• Sweating or shaking
• A feeling of losing control or impending doom

While panic attacks feel terrifying, they’re generally not physically dangerous. They're often caused by a misfiring of the body’s fight-or-flight response, with no actual threat present.

What Not to Do When You’re Having a Panic Attack

1. ❌ Don’t Fight the Sensation

• Trying to "stop" the attack often intensifies it.
• Instead: Acknowledge what’s happening—“This is a panic attack. It will pass.”
• Why it works: Acceptance calms your threat system.

2. ❌ Don’t Hyperventilate or Try to "Get More Air"

• Breathing rapidly worsens dizziness and chest tightness.
• Instead: Breathe in through your nose for 4 seconds, hold for 4, exhale slowly for 6.
• Why it works: Regulates CO₂ and calms the autonomic nervous system.

3. ❌ Don’t Leave the Situation Immediately (Unless Unsafe)

• Escaping reinforces the idea that the situation was dangerous.
• Instead: Stay put if safe, and let the wave pass.
• Why it works: Builds confidence and reduces future triggers.

4. ❌ Don’t Google Symptoms in the Moment

• You’ll spiral into worst-case scenarios and misdiagnosis.
• Instead: Use a trusted grounding tool (like 5-4-3-2-1 sensory technique).
• Why it works: Keeps your mind in the present, not catastrophizing.

5. ❌ Don’t Self-Medicate With Alcohol, Caffeine, or Drugs

• These substances may intensify anxiety symptoms or cause dependence.
• Instead: Hydrate with water and rest post-attack.
• Why it works: Supports nervous system recovery without adverse effects.

6. ❌ Don’t Judge Yourself Harshly

• Thinking “I’m weak” or “This shouldn’t be happening” adds mental strain.
• Instead: Validate your experience—panic is common and treatable.
• Why it works: Reduces shame and fosters resilience.

7. ❌ Don’t Try to Rationalize or “Think Your Way Out”

• Panic hijacks the brain’s logic center—reasoning won’t always land.
• Instead: Use sensory distraction (hold ice, repeat calming phrases).
• Why it works: Activates different brain areas, short-circuiting panic.

✅ Recovery & Prevention Tips

• Work with a licensed therapist trained in CBT or exposure therapy.
• Practice breathing or grounding daily—not just during attacks.
• Track triggers gently, with curiosity not judgment.
• Consider joining support groups to normalize the experience.