Panic Attacks
If you have had a panic attack, you will know about it. As someone who has had a few over her lifetime, I can tell you: subtle they are not.
What is actually happening.
A panic attack is what occurs when the body becomes suddenly and completely flooded with adrenaline. The heart races. The breath tightens. The chest contracts. The mind — with perfect, terrible efficiency — begins generating explanations: heart attack, collapse, going crazy, something catastrophically wrong.
Almost always, the catastrophe is the panic itself.
What follows the flood is equally important: once the body has exhausted its adrenaline response, the parasympathetic nervous system steps in — producing a wave of calm, and often significant tiredness, as the system temporarily resets. This is not a sign that something went wrong. It is the body doing exactly what it was designed to do.
Why it usually isn't about where you were
People consistently get caught up in the location of their first panic attack — the supermarket, the highway, the meeting room. But nine times out of ten, the location wasn't the cause. It was simply where the bucket finally overflowed.
Panic attacks most commonly occur after a period of cumulative, heightened stress — when the nervous system has been operating near its threshold for weeks or months, and something tips it over. The bucket was already three-quarters full. The supermarket just added one cup too many. Less commonly, a single intensely frightening or overwhelming event can trigger the first panic attack — but the underlying mechanism is the same.
Why they keep happening
The first panic attack is frightening. But what often sustains panic attacks over time is not the original trigger — it is the fear of having another one. The nervous system, already primed, begins scanning for signs of danger. And because the body's own sensations — a slightly elevated heart rate, a moment of breathlessness — now register as potential threat, the alarm can be triggered by the alarm itself.
This is the panic cycle. And understanding it is the first step to breaking it.
What treatment looks like.
Panic attacks are treatable and, once you understand what is driving them, genuinely understandable. That combination — understanding plus the right approach — is what changes the experience.
Psychoeducation
One of the most powerful things that can happen early in treatment is simply learning what a panic attack actually is. When you understand that what you are experiencing is an adrenaline response — not a heart attack, not a mental breakdown, not evidence that something is fundamentally wrong with you — the fear of the panic itself begins to lose some of its grip. Not all of it. But some. And that matters.
Working with the body
Because panic is a physiological event, the body is where a significant part of the work happens. There are specific tools and techniques that work directly with the nervous system as it activates — ways of interrupting the adrenaline cycle, regulating the breath, and bringing the body back to a state where the thinking mind can re-engage. These are learnable skills, not just coping strategies. With practice, they become available to you in the moment.
Working with the cycle
Beyond the immediate physiological response, treatment addresses the panic cycle itself — the hypervigilance, the avoidance of situations associated with previous attacks, and the fear of fear that keeps the system primed. CBT is particularly effective here, working with the interpretations and predictions that sustain the cycle. Gradually, the nervous system gets new information. The threat assessment begins to update.
The bigger picture
For many people, panic attacks are a signal — not just of an overloaded nervous system, but of something worth examining underneath. Sustained stress, unprocessed anxiety, accumulated pressure that has had nowhere to go. Part of the work is addressing what is present right now. Part of it is looking at what created the conditions in the first place.
If panic attacks are affecting your daily life, a Mental Health Care Plan from your GP provides access to Medicare-rebated sessions with a clinical psychologist.
Panic attacks are understandable.
And they are workable.
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