Understanding Anxiety and Panic
Suddenly your heart is racing, you can’t get enough air, your hands are shaking, and one thought takes over: “Something terrible is about to happen.” That is what a panic attack feels like. Around one in eight people have at least one in their lifetime – you are not alone.
Anxiety itself is not a sickness. It is your body’s alarm system and has always protected people from danger. Sometimes, though, this alarm is set very sensitively and goes off even though there is no fire – a false alarm. This article explains what happens and what can help.
What happens in your body
When there is danger, your body switches into fight-or-flight mode. Every reaction has a purpose:
- Racing heart:Your heart pumps more blood to your muscles.
- Fast breathing, feeling short of breath:Your body takes in more oxygen. Breathing too fast often causes tingling or dizziness.
- Trembling, tense muscles:Your muscles get ready to fight or run.
- Queasy stomach:Digestion is turned down – it doesn’t matter right now.
- Everything feels unreal:Feeling detached from yourself is also part of the alarm response, and it passes.
It feels threatening, but it is the alarm response of a healthy body. A panic attack usually peaks within a few minutes and then fades on its own.
The anxiety cycle
Panic often builds up in a loop where body and thoughts drive each other:
- 1
Body – Your heart beats faster – say, after climbing stairs or drinking coffee.
- 2
Thought – “Is something wrong with my heart?”
- 3
Fear – The thought makes you afraid.
- 4
Even more body – Fear makes your heart beat even faster.
- 5
Even more attention – You focus only on your heart – and the thought seems confirmed.
↺ … and round it goes again.
The loop can be interrupted at any point: in the body by breathing out slowly, in your thoughts by checking them calmly. The typical thinking trap here is catastrophizing – read more in the article Recognizing Thinking Traps.
Why avoidance makes anxiety grow
When you’re anxious, you want to leave the situation or not go in at all. That’s understandable – but it has a downside:
In the short term
Relief. The anxiety drops immediately.
In the long term
Your brain learns: “Lucky I got out.” It never finds out that nothing would have happened. Next time the anxiety comes sooner, and the list of places you avoid grows longer.
Small precautions – so-called safety behaviors – work the same way: only leaving the house with someone, always carrying a water bottle, constantly checking your pulse. They feel helpful, but they keep the anxiety alive.
What helps during a panic attack
1. Name it
Tell yourself: “This is a panic attack. It is very unpleasant, but it will pass.” Knowing what is happening makes it less frightening.
2. Breathe out longer
Breathe in calmly and take more time breathing out, for example 4 seconds in and 6 seconds out. Slow exhaling calms the body. Breathing into a paper bag is no longer recommended.
3. Ride the wave
Don’t try to push the anxiety away – fighting it often fuels it. Picture it as a wave: it rises, peaks and flattens out again. You don’t have to stop it, just get through it.
4. Come back to the here and now
Name 5 things you can see, 4 you can touch, 3 you can hear, 2 you can smell and 1 you can taste. This brings your attention out of your head and back into the room.
5. Stay if you can
If the situation is safe, stay until the anxiety noticeably eases. That way your brain experiences that the anxiety passed and nothing bad happened.
In the long run: step by step
- 1
Build an anxiety ladder – Write down situations that make you anxious and rank them from easy to hard – for example from a quick visit to the corner shop to a crowded mall on a Saturday.
- 2
Start at the bottom – Begin with the easiest step and stay until the anxiety clearly eases. Repeat it until it feels familiar. Only then move on to the next one.
- 3
Get to know your body again – If your doctor sees no reason against it: a pounding heart after exercise or climbing stairs shows you that a fast pulse on its own is not dangerous.
- 4
Keep track – Note when the anxiety comes, how strong it is (0–10) and what helped. That way you spot patterns – and your progress.
- Caffeine, alcohol and too little sleep can make anxiety worse.
- With strong anxiety, practicing is often easier with a professional – this is how cognitive behavioral therapy (CBT), for example, works.
Good to know
- Get it checked by a doctor the first time. A racing heart, chest pressure or shortness of breath can also have physical causes, for example in the heart, lungs or thyroid. Have this examined before assuming it is panic. With chest pain, severe shortness of breath or if you are unsure, call emergency services right away: emergency number in your country.
- Getting help is a good step. If anxiety or panic attacks come often, you avoid places or situations, or your everyday life is getting narrower, talk to your doctor or look for psychotherapy. Anxiety disorders are well researched, and effective treatments exist.
- An article is no substitute for therapy. If you are in an acute crisis or thinking about death: crisis lines in your country.
Getting to know your anxiety
These questions help you understand your own anxiety better. Take your time – there are no wrong answers.
1. My first signs
What do I notice first when anxiety rises? (e.g. a pounding heart, a tight throat, racing thoughts)
2. What I avoid
Which places or situations do I avoid because of anxiety – and what do I always carry “just in case”?
3. My first step
What would be the easiest step on my anxiety ladder that I could practice this week?
Breathing exercise
In the Emergency Kit: a circle shows you when to breathe in and out – to arrive in the moment.