When Your Body Cries Wolf: The Truth About Panic Attacks
By Ilana Pilcz, MHC, MA
The first time it happened, I thought I was having a heart attack. My hands went numb, my heart felt like it was racing a cheetah to escape my chest, my skin turned red-hot, and my thoughts turned to, "danger, danger, danger" escalating in speed and intensity with an internal image of red flashing lights and sirens. I went to the ER thinking that something this intense had to be serious. An EKG confirmed that it was, in fact, not a heart attack. It was my first panic attack.
What Is a Panic Attack?
A panic attack is a sudden surge of intense fear or discomfort that peaks within minutes. While extremely uncomfortable and frightening, panic attacks are not dangerous and typically last between 5-20 minutes.
What are the Common Symptoms of a Panic Attack?
Physical:
Racing/pounding heart
Shortness of breath
Dizziness or lightheadedness
Sweating, trembling, or shaking
Chest pain or tightness
Nausea or stomach discomfort
Numbness or tingling sensations
Mental/Emotional:
Fear of losing control
Fear of dying
Feeling detached from reality
Intense anxiety or sense of doom
What's Actually Happening in Your Body During a Panic Attack
Imagine your ancient ancestor suddenly spotting a saber-toothed tiger prowling in the tall grass. In an instant, their body launches into survival mode—heart pounding to pump blood to major muscles, breathing accelerating to take in more oxygen, pupils dilating to enhance vision, and a flood of adrenaline providing an instant energy surge, allowing them to have the best chance of survival. This primal "fight-or-flight" response evolved over millions of years as a life-saving mechanism.
During a panic attack, your body activates this exact same ancient survival circuit—but there's no actual saber-toothed tiger. Your brain's primitive alarm center (the amygdala) can't distinguish between a genuine physical threat and a modern stressor or even a random false alarm.
It triggers the full emergency response designed for running from predators: your heart races, breathing quickens, muscles tense, and stress hormones surge through your bloodstream. This biological response helped your ancestors survive in the wild, but in your living room or office, it just feels overwhelming and frightening.
The good news? Just as your ancient ancestor’s system returned to homeostasis once they escaped the saber-toothed tiger, so will your system. These intense physical sensations naturally subside within 10-20 minutes as your body's stress hormones are metabolized and your nervous system gradually returns to balance. The body simply cannot maintain such an intense state of emergency arousal for longer periods - this natural limitation is part of your built-in safety system. Your body isn't malfunctioning - it's actually working perfectly, it's just protecting you from a threat that exists only in your brain's ancient circuitry.
Tools That Can Help in the Moment
The most important thing to remember about a panic attack is that it will pass and although your system thinks you are in danger, you are safe. Often, tools like meditation or breathwork aren't accessible when our system is on red alert. However, there are some simple actions you can try that might help you ride the wave with a bit more ease:
1. Grounding (5-4-3-2-1): Notice 5 things you see, 4 things you feel, 3 things you hear, 2 things you smell, 1 thing you taste
2. Box Breathing: Inhale for 4, hold for 4, exhale for 4, hold for 4
3. Progressive Muscle Relaxation: Tense and release muscle groups slowly
4. Temperature Shift: Hold something cold, splash cool water on your face, suck on a peppermint, or step outside
5. Movement: Shake out your arms/legs or take a short walk to discharge energy
6. Mindful Acceptance: Observe sensations and name them without judgment (“my chest is hot, my hands are numb, etc.”; acknowledge "this is a panic attack, this will pass"
7. Repeat Calming Phrases:
○ "This is a panic attack. It will pass."
○ "My body is safe, even if my mind feels scared."
○ "I've felt this before, and I got through it."
○ "I can ride this wave; it always comes down."
○ "These sensations cannot harm me."
A Note on Medication
If prescribed by your healthcare provider, medications such as Xanax or Ativan (benzodiazepines) can be effective tools to reduce the intensity of panic attacks or prevent them from fully developing. These medications work quickly but are typically recommended for short-term or occasional use rather than as a primary long-term strategy. Always take these medications exactly as prescribed, and work with your provider to develop a comprehensive treatment plan that may include both medication and the coping strategies outlined above.
Self-Reflection: Identifying Your Triggers
Often, but not always, panic attacks are triggered by an emotion, belief, or experience. For some, that could be the fear of making a mistake, riding in an elevator, or losing connection with a loved one. It can be helpful to work with your unique sensitivities as a way to prevent, or at least understand, future panic attacks. Once the panic sensations have abated, ask yourself these self-reflective questions:
What was happening right before the panic attack?
What thoughts or sensations came up first?
Was there a trigger (stress, memory, environment, body sensation)?
What helped me cope this time?
Were there any warning signs I can recognize next time?
Was I experiencing unusual stress, fatigue, or caffeine intake?
Learning to Live with Panic: A Path Forward
Understanding panic attacks doesn't mean you'll never experience one again, but it does mean you can approach them differently. With time and practice, many people develop a new relationship with panic - one where these episodes become less frequent, less intense, and less disruptive to daily life.
Remember that panic attacks, while overwhelming, are not actually dangerous. They're simply your body crying wolf; a false alarm in your body's protection system. By recognizing them for what they are, using the tools that work best for you, and perhaps working with a mental health professional who specializes in anxiety, you can reclaim the sense of safety that panic tries to steal away.
The path to managing panic isn't about eliminating all anxiety from your life—it's about building resilience and confidence in your ability to ride the wave when it rises. And with each attack that you survive (and you will survive all of them), you gather evidence that you are stronger than your panic.