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The body becomes its own corset.

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Past, present, and future 
exist as a single force.

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A swing without gravity soars 
to a terrifying height.

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The outlines of people and things 
dissolve.

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Countless poets and writers 
have tried to put words

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to the experience of a panic attack—

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a sensation so overwhelming, many people 
mistake it for a heart attack, stroke,

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or other life-threatening crisis.

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Though panic attacks don’t cause 
long-term physical harm,

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afterwards, the fear of another attack 
can limit someone’s daily life—

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and cause more panic attacks.

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Studies suggest that almost a third of us

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will experience at least one 
panic attack in our lives.

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And whether it’s your first, 
your hundredth,

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or you’re witnessing someone else 
go through one,

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no one wants to repeat the experience.

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Even learning about them can 
be uncomfortable, but it’s necessary—

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because the first step to preventing 
panic attacks is understanding them.

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At its core, a panic attack 
is an overreaction to the body’s

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normal physiological response 
to the perception of danger.

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This response starts with the amygdala,

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the brain region involved 
in processing fear.

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When the amygdala perceives danger,

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it stimulates 
the sympathetic nervous system,

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which triggers the release of adrenaline.

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Adrenaline prompts an increase 
in the heart and breathing rate

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to get blood and oxygen 
to the muscles of the arms and legs.

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This also sends oxygen to the brain, 
making it more alert and responsive.

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During a panic attack,

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this response is exaggerated 
well past what would be useful

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in a dangerous situation,

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causing a racing heart, heavy breathing, 
or hyperventilation.

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The changes to blood flow 
cause lightheadedness

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and numbness in the hands and feet.

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A panic attack usually peaks 
within 10 minutes.

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Then, the prefrontal cortex 
takes over from the amygdala

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and stimulates 
the parasympathetic nervous system.

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This triggers the release of a hormone 
called acetylcholine

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that decreases the heart rate 
and gradually winds down the panic attack.

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In a panic attack, the body’s 
perception of danger

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is enough to trigger the response we would
have to a real threat— and then some.

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We don't know for sure 
why this happens,

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but sometimes cues in the environment 
that remind us

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of traumatic past experience 
can trigger a panic attack.

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Panic attacks can be part 
of anxiety disorders

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like PTSD, social anxiety disorder, OCD, 
and generalized anxiety disorder.

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Recurring panic attacks, 
frequent worry about new attacks,

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and behavioral changes 
to avoid panic attacks

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can lead to a diagnosis 
of a panic disorder.

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The two main treatments 
for panic disorder

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are antidepressant medication 
and cognitive behavioral therapy, or CBT.

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Both have about a 40% response rate—

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though someone who responds to one 
may not respond to the other.

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However, antidepressant medications 
carry some side effects,

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and 50% of people relapse 
when they stop taking them.

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CBT, meanwhile, is more lasting, 
with only a 20% relapse rate.

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The goal of CBT treatment for panic 
disorder is to help people learn

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and practice concrete tools 
to exert physical, and in turn mental,

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control over the sensations and thoughts 
associated with a panic attack.

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CBT begins with an explanation of the 
physiological causes of a panic attack,

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followed by breath and muscle exercises 
designed to help people

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consciously control breathing patterns.

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Next comes cognitive restructuring,

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which involves identifying 
and changing the thoughts

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that are common during attacks—

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such as believing you’ll stop breathing, 
have a heart attack, or die—

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and replacing them 
with more accurate thoughts.

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The next stage of treatment is exposure 
to the bodily sensations and situations

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that typically trigger a panic attack.

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The goal is to change the belief, 
through experience,

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that these sensations and situations 
are dangerous.

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Even after CBT, taking these steps 
isn’t easy in the grip of an attack.

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But with practice, these tools 
can both prevent and de-escalate attacks,

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and ultimately reduce the hold of panic 
on a person’s life.

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Outside formal therapy,

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many panickers find relief from the same 
beliefs CBT aims to instill:

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that fear can’t hurt you, 
but holding on to it will escalate panic.

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Even if you’ve never had a panic attack,

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understanding them will help you identify 
one in yourself or someone else—

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and recognizing them is the first step 
in preventing them.