Panic Attacks Part 1: What is Panic & Why We Need It

Businessman scared under table of Bear. frightened business man under work board. Wild Animal. Boss fear office desk. To hide from angry grizzly. Vector illustration

Panic is a normal, necessary physical response to the brain perceiving a significant threat.  It involves the release of a hormone that you are likely familiar with, adrenaline.  Adrenaline’s job is to tell the body to make chemical changes in the body so that the body is physically primed to either fight or flee/run away, from the threat.  These can be things such as:

  • Rapid heartbeat
  • Short, shallow breaths
  • Paling or flushing (can switch between both)
  • Digestion slows down or stops (becomes a low priority for your body)
  • Constriction of blood vessels in many parts of the body…including the BRAIN (which interferes with your ability to think logically)
  • Dilation of blood vessels for muscles (so they are ready for action)
  • Take energy from stored nutrients to fuel muscles
  • Dilation of pupils
  • Temporary loss of hearing
  • Tunnel vision (loss of peripheral vision)
  • Physical shaking

For an illustration of this, you can check here.

Back in the day of the caveman, the people who didn’t have a panic response were much less likely to survive because their bodies were not as prepared to deal with a physical threat.  Our body’s ability to quickly maximize all of our resources for survival is a critical aspect not only of humans but all animal species.  Yet, in our Western culture, many of us are fortunate that our safety is not regularly threatened in a physical way. Instead, because our brain does not recognize a difference between a physical threat and emotional threat, in a modern society a panic response can often be triggered by things such as fear of embarrassment or fear that a bridge might collapse.  Or, perhaps you do have experience with your physical safety being at risk and now, your body is in hyper-vigilant mode and looking for danger at every corner.

The problem here is that our body’s physical readiness to fight or run won’t help us to not be embarrassed. Nor will it help us cross a perfectly well-maintained bridge or walk around the corner in a typically safe neighborhood.  So instead, that physical response can feel scary itself and physically uncomfortable if we don’t do anything to burn off that energy and bring our body back to calm.  Additionally, increasing our breathing rate without making use of the extra oxygen we are taking in creates a chemical imbalance between the oxygen and carbon dioxide levels of our body that adds to our feelings of physical discomfort.  (Psychology Tools has a nice information sheet with some more details about this.)

So, what can we do if we start to physically panic about a possible emotional threat?  Check out the next article in this series!


Remaining articles in this series:


Panic Attacks Part 2: The Antidote to Panic - Relaxation Breathing


Previous article in this series:

Relaxation breathing is the antidote to panic.  Literally.  It is impossible to be truly breathing in a relaxed way and to be experiencing a full-blown panic attack at the same time.  This is because relaxation breathing helps to reset our body chemistry to a “normal” state and bring it out of panic.  If you haven’t read it yet, the previous article in this series, Panic Attacks Part 1: What is Panic & Why We Need It, you might want to check it out.

Some people may tell you that there is a “right way” to do relaxation breathing. In my opinion, if you try the “right way” and you find it to be really annoying and just plain won’t do it, then clearly that is not the right way for you. Generally, the recommendation is that you are breathing out for a longer count than you are breathing in and that you are taking in air by expanding your belly muscles, not your chest muscles.

My recommendation is that you find something that feels comfortable for you and go with that approach.  No matter which approach you choose, the most important thing is that you practice relaxation breathing every day when you are already calm. I cannot stress this point enough. When your body is in panic mode, learning a new skill is not something that your brain is going to be very good at. So if you’re heading into a panic attack and you haven’t been practicing your relaxation breathing, don’t be surprised if it doesn’t work to help you return to calm…yet.

Regardless of the breathing technique that you decide to use, I recommend that you practice your relaxation breathing during a time that you are already relatively calm and relaxed, for five minutes at a time, a minimum of 1-2 times every day, with one of those times being at night when you are lying down to fall asleep.  The main goal is to be able to clear your mind of all thought and just focus on the sensation of your breath going in and out of your body.  Or, you can add some sort of positive phrase that you can repeat to yourself if it helps.  (For example: “Breathe in calm.  Breathe out fear,” but it could be anything so long as you interpret it as positive and relaxing.)

Below is a video that describes square breathing and then, below that, a few other informational links.  The video is geared towards kids but you can use whatever imagery you like, and, who doesn’t enjoy the smell of fresh baked cookies??  (You’ll understand that last comment when you watch the video.)



Additional Breathing Information:

  • Another take on square breathing, including a printable that you can download and customize.
  • Diaphragmatic breathing, also known as “belly breathing,” which can be blended with square breathing if you’d like.

If you have a smart phone, there are also plenty of free apps that you can download to help coach you through relaxation breathing.  Here are two that I’ve had experience with:

  • Breathe2Relax – availabe on iPhone and Android (I recommend adjusting the default settings to what is comfortable for you.)
  • Centered – available on iPhone only 🙁

Remaining articles in this series:


Panic Attacks Part 3: Fear of the Fear - Don't Let Panic Attacks Take Over Your Life


Previous articles in this series:

Panic attacks feel very intense when you have them. At best, it’s not a comfortable feeling. At worst, it feels very scary because your body feels like it’s out of control. Some people even worry that they are having a heart attack. If you are experiencing these symptoms for the first time, definitely talk with a medical professional to rule out any medical causes before treating the symptoms as a panic attack. This is important for two reasons. The first is that you need to get a proper diagnosis.  The second is that if you are constantly worrying that you are having a heart attack…that’s going to increase your anxiety and make successfully treating panic very difficult.

dont-feed-the-fearsOnce you know that your body is healthy and ok, it’s time to dig in to the emotional aspects that come into play with panic and anxiety.  When you worry too much about the possibility that you might have a panic attack, then this worry itself can become the trigger for your next panic attack.  I call this having “fear of the fear (that it will happen again).” With the use of acceptance, information, “growth mindset,” and skill development, here are some guidelines that work against the negative spiral that can happen when people start to develop a “fear of the fear.” This article assumes that you already have started working on developing the skills for turning around a panic attack and is part 3 of a four-part series of articles I hope to complete.  Hopefully, I’ll get part 4 up soon!

  1. Recognize that this is a new situation for you and, because of that, it makes sense that it’s hard in the beginning to figure out what’s happening and how best to manage it. Also, know that you’re not alone. There are many people who have or are currently going through this too.You are having, what is called, a panic attack.  [Growth Mindset]
  2. Remember that fight or flight mode is a normal thing that our bodies do. The only problem is that it’s getting triggered when you don’t actually need to respond physically to an emotionally stressful situation. The most important thing to know here is, NO HARM WILL COME TO YOUR BODY AS YOU EXPERIENCE IT (your body physically revving up to fight or flee). It does feel yucky to be in physical panic mode.  This is especially true because your body, in that moment, is primed with an abundance of energy to physically react and that means that you experience temporary physical changes to your body (i.e. increased heart rate, quick & shallow breathing, increased blood circulation to muscles, decreased blood circulation to the “rational” part of your brain, and more), but your body naturally knows how to shift out of this mode when the perception of a physical threat is gone. [Information]
  3. Accept that this is not your last panic attack. What I’m saying here is find a way to be ok with knowing that it will happen again AND that should one happen and your growing relaxation and cognitive skills can’t turn it around, you can ride it out until it’s done and be still be ok. In general, the goal is for the panic attacks to start reducing in intensity as you get better at turning them around but this won’t happen if you avoid panic attacks, or things that might cause them, rather than face them. [Acceptance]
  4. Continue to experiment with and practice various relaxation techniques (relaxation breathing is the most important one for panic) and good self care habits so that you can hone your skills and have more “tools” in your “toolbox” when the need arises. [Skill Development]
  5. Work on developing cognitive strategies that can help prevent panic attacks from happening or intervene at the early signs of panic so that you can prevent a full blown physical response. [Skill Development]
  6. Keep a list of things that help turn your panic attacks around so that you can refer to the list the next time. [Skill Development]
  7. Remembering that low blood sugar, hypoglycemia, can mimic the beginning feelings of a panic attack, carry a healthy snack with you that has a nice combination of protein and complex carbs. [Information]
  8. Minimize or, ideally, eliminate caffeine. Drink water. Enjoy water.  Did I mention water? [Information]

Remaining article in this series:

  • Panic Attacks Part 4: Time To Tune Into Your Early Warning System (coming soon)


Panic & Time Magazine's "How to Increase Mental Toughness: 4 Secrets From Navy SEALs and Olympians" by Eric Barker

Fight or Flight Response Graphic

Click image to be linked to the full size version on it’s original website, Psychology Tools.

Panic. Our body’s ability to prime itself for a life-saving level of physical response, “fight or flight,” is a gift. It allows us to summon every possible physical resource we have to save ourselves from a physical threat. But, when the threat is imagined or emotional, it feels really yucky to be in physical panic mode.  This is especially true because our bodies, in that moment, experience temporary physical changes (i.e. increased heart rate, quick & shallow breathing, increased blood circulation to muscles, decreased blood circulation to the “rational” part of your brain, etc. Click image on the right for more details.) that can feel scary if we don’t understand why it’s happening. However, our body naturally knows how to shift out of this mode when the perception of the threat is gone. Of course, because being in that high alert mode has our body burning off a great deal of our energy in a short amount of time, we’re left feeling exhausted in the aftermath, even if we didn’t actually fight or flee.

The video displayed at the top of this page and accompanying article explains our body’s normal fight, flight, or freeze response and ways that the Navy SEALs and Olympic athletes train to have as much control as possible over preventing their bodies from triggering this response when they don’t want it.

Emphasis is on understanding the biology behind what is happening in our bodies when we experience fear and then using four basic skills to help our minds not be unnecessarily controlled by fear and panic:

  1. Positive Self-Talk
  2. Goal Setting
  3. Practice Visualization
  4. Use Simulations (practice)

All of these techniques are key components to CBT (Cognitive and Behavioral Therapy) and are used in therapy sessions with clients every day to treat both excessive anxiety as well as depression.  And, if you struggle with “panic attacks”, the fight, flight, or freeze response is technically what is happening in your body (this involves the amygdala, hypothalamus, and adrenaline).  It is a normal body function that is being triggered when there is the perception of a threat and prepares us to cope with life threatening situations.  However, when it comes to fear, our minds don’t differentiate between physical threats and mental/emotional threats.  But, the reality is that that the fight, flight, or freeze response isn’t very helpful when it comes to dealing with mental/emotional threats.  So, the better we can use coping skills to prevent ourselves from the panicking, the more success we will have in coping with the challenges we face.

The video also mentions using relaxation breathing as the primary method of quickly recovering from when our fight, flight, or freeze response has been triggered.  It talks about how particularly long exhales mimic our body’s normal relaxation mode (which is a new idea for me, I’ll have to find the time to look into the research on that point) and that the increase in oxygen in the bloodstream helps get the more logical, frontal cortex of the brain re-engaged so that you can think through your situation more rationally.

So, the next time you happen to be working on improving your CBT skills, just remember that if it works for the intense challenges that Navy SEALs and Olympic athletes face during actual physical threats, with practice, it will work for you when you’re working on not freaking out about having to do something in every day life like public speaking or taking a trip to the grocery store.