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Panic attacks: what is really happening

An attack of fear is neither a heart condition nor “going mad”. Here is the mechanism, step by step.

Roman Budaev ·

A person walks into the metro. Within thirty seconds the heart is pounding as if after a kilometre run, hands go cold, there is not enough air, and one perfectly clear thought appears: “I am about to die.”

The ambulance arrives, the ECG is clean. A week later it all happens again.

Three minutes that feel like an hour

A panic attack is a normal reaction of the body to danger, triggered at the wrong moment. The adrenal glands release adrenaline, the heart speeds up, breathing becomes shallow, blood drains from the limbs. The body prepares to run. There is nobody to run from — and all that energy stays inside.

A panic attack does not kill. What kills is living in wait for the next one.

Why “just don’t think about it” fails

Because fear is triggered not by a thought but by the memory of the body. Consciousness learns about the attack last, when it has already begun. The command “calm down” arrives several minutes late.

The work is built differently: we do not fight the attack, we find out what exactly the body was trying to escape from the first time. Once that event is found and lived through, the attacks have nothing left to serve.