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When Fear of the Next Panic Attack Is Running the Show

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Panic can feel scary, intense, and overwhelming. Many people describe panic as coming “out of nowhere.” What often comes out of the blue are the physical sensations — a racing heart, dizziness, shortness of breath, chest tightness, or feeling unreal.

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Panic happens when the brain interprets those sensations as dangerous.

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A body sensation shows up, and the mind quickly jumps to thoughts like:

“Something is seriously wrong.”
“I’m going to pass out.”
“I’m having a heart attack.”
“I’m losing control.”
“I need to get out of here.”

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This is sometimes called fear of fear — becoming afraid of the physical sensations of anxiety themselves. The more dangerous the sensations feel, the more the body’s alarm system turns on, which can make the sensations even stronger.

Panic symptoms may include:

• Racing or pounding heart

• Shortness of breath

• Chest tightness

• Dizziness or feeling faint

• Nausea or stomach discomfort

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Over time, panic can lead people to avoid places or situations where symptoms might happen again, such as driving, stores, restaurants, exercise, being alone, or traveling. Avoidance can bring short-term relief, but over time it often makes panic feel more powerful.

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Evidence-based treatment for panic

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Panic is treatable. Evidence-based therapy helps people understand the panic cycle, reduce avoidance, and become less afraid of the physical sensations of anxiety.

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Treatment may include:

• Education about panic

• Learning how the body’s alarm system works can make panic feel less mysterious and less dangerous.

• Changing your relationship with panic symptoms

• Reducing avoidance and safety behaviors
  You can learn to experience uncomfortable body sensations without treating them as dangerous. Over time, this helps your brain learn that the sensations are uncomfortable, but not unsafe.

• Avoidance, checking, reassurance, escape, and other safety behaviors can keep panic going. Treatment helps you gradually face situations and sensations in a supported way.

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With the right treatment, people can build confidence, reduce the fear of anxiety sensations, and get back to the places and activities that matter.