Panic Attacks & Panic Disorder
Panic attacks involve sudden, intense waves of fear or physical distress that can feel overwhelming, frightening, and out of control — even when there is no immediate danger. Panic disorder refers to a pattern where these attacks, or the fear of having them, begin to shape daily choices, behaviour, or sense of safety.
If you’ve experienced a panic attack, you already know how real it feels.
Your body may surge with fear, your heart may race, your breathing may feel restricted, and your thoughts may spiral — often without a clear or logical reason.
For many people, panic doesn’t start as a constant problem. It often appears suddenly, during stress, transition, or periods of pressure. Over time, the fear of having another panic attack can become just as disruptive as the attack itself. People may begin avoiding certain places, situations, or sensations, not because they are dangerous, but because they feel unpredictable.
Panic attacks are one of the most misunderstood experiences in mental health.
They can feel sudden, intense, and physically overwhelming — often creating a powerful sense that something is dangerously wrong, even when no clear threat is present.
For many people, the first panic attack seems to come “out of nowhere.” Others notice panic emerging during periods of pressure, transition, or emotional overload. Over time, the fear of having another attack can begin to influence daily decisions — where to go, what to do, or how closely to monitor the body.
At ShiftGrit, we understand panic as a learned threat response, not a personal failure or a sign that something is permanently broken. When the nervous system begins to interpret certain internal sensations as dangerous, it can react with intense fear very quickly — even if the logical mind knows there is no real threat.
This page offers an overview of how panic often shows up, what may be happening beneath the surface, and how therapy commonly works with these patterns. It is meant to provide clarity and orientation, not diagnosis.
Panic feels physical — not “just in your head”
Panic attacks often involve strong physical sensations such as a racing heart, shortness of breath, dizziness, or chest tightness. These reactions can feel urgent and alarming, even when medical tests show nothing dangerous is happening.
Fear of panic can become the real driver
After one or more panic attacks, many people become highly alert to bodily sensations. The anticipation of another attack can lead to avoidance, hyper-monitoring, or changes in behaviour that unintentionally keep the cycle going.
Panic often follows a pattern
Panic attacks are rarely random. They tend to develop through repeatable loops involving stress, interpretation of sensations, emotional reactions, and protective behaviours — even if the pattern isn’t obvious at first.
Panic does not mean you are unsafe
Although panic feels intense, it is typically the result of a nervous system responding to perceived threat rather than real danger. Understanding this distinction is an important step in working with panic patterns.
Inner statements
“Something is wrong with my body.”
People whose panic centres around physical sensations, health concerns, or fear of medical emergencies.
“I’m about to lose control.”
People who fear fainting, panicking in public, or being unable to escape a situation once panic starts.
“This isn’t going to stop.”
People who have experienced repeated panic attacks and feel trapped in an ongoing cycle of fear and anticipation.
“I can’t trust my body.”
People who feel disconnected from or constantly on guard against their own physical sensations.
Common questions
Are panic attacks dangerous?
Panic attacks can feel frightening and intense, but they are not typically dangerous in themselves. The sensations are real and uncomfortable, but they are usually the result of the nervous system reacting to perceived threat rather than actual harm.
Why do panic attacks seem to come out of nowhere?
Panic often develops beneath conscious awareness. The body may be responding to stress, internal sensations, or learned associations that the mind hasn’t yet connected into a clear pattern.
Does having panic attacks mean I have panic disorder?
Not necessarily. Many people experience panic attacks without meeting criteria for panic disorder. Panic disorder generally refers to a pattern where panic and fear of panic significantly shape behaviour or sense of safety over time.
Can panic happen even when life is going well?
Yes. Panic can emerge during periods of success, transition, or emotional strain. It is not always tied to obvious external stressors and does not mean something is “wrong” with your life.
Living with panic often means navigating daily life with an added layer of unpredictability. Even on “good” days, there may be an underlying awareness of the body — scanning for sensations, changes in breathing, heart rate, or tension.
Panic doesn’t always look dramatic from the outside. Many people appear calm, capable, and functional while internally managing waves of fear, physical discomfort, or constant vigilance. Over time, this effort to stay ahead of panic can be exhausting and can quietly shape routines, decisions, and confidence.
The experiences below reflect some of the most common ways panic shows up in day-to-day life. Not everyone will relate to all of them, but many people recognize parts of their own experience in several areas at once.
In your body
- Sudden surges of fear accompanied by a racing heart, shortness of breath, dizziness, or chest tightness
- Feeling “flooded” by physical sensations that seem intense or unfamiliar
- Tingling, numbness, or lightheadedness that creates fear something serious is happening
- A strong urge to escape, sit down, or get to a “safe” place
- Feeling disconnected from the body or surroundings during or after panic episodes
In your thoughts
- Interpreting physical sensations as signs of danger (e.g., heart attack, fainting, losing control)
- Rapid, catastrophic thinking once panic starts (“What if this doesn’t stop?”)
- Difficulty trusting reassurance, logic, or medical explanations during panic
- Constant mental monitoring of the body for early warning signs
- Fear of panic itself becoming a dominant concern
In your behaviour
- Avoiding places, activities, or situations associated with past panic attacks
- Planning routes, exits, or contingencies “just in case”
- Relying on safety behaviours (carrying medications, sitting near exits, staying close to home)
- Cancelling plans or limiting commitments due to fear of panic occurring
- Needing frequent reassurance from others
In relationships and daily life
- Feeling embarrassed or frustrated about panic, especially when others don’t understand it
- Worrying about being a burden or drawing attention if panic occurs
- Feeling misunderstood when panic doesn’t have a clear cause
- Tension between wanting independence and needing support
- Feeling disconnected from previously enjoyable activities
When it tends to show up
Panic can appear in a wide range of situations, and it is not always tied to obvious stress. Some people notice panic during periods of pressure, transition, or emotional overload. Others experience panic when things seem calm or stable, which can make it even more confusing.
Common contexts where panic may show up include:
- Times of high responsibility or performance demand
- Moments of physical vulnerability, such as fatigue, illness, or caffeine use
- Situations where escape feels limited (meetings, public spaces, driving, travel)
- Periods of emotional suppression or prolonged stress
- After an initial panic attack, simply noticing bodily sensations can be enough to trigger fear
Over time, panic can shift from reacting to external situations to reacting to internal sensations themselves.
Common impact areas
- Work
- Relationships
- Sleep
- Health
- Self Esteem
Panic attacks are not random malfunctions of the body. They are the result of a threat-detection system doing its job too well, in the wrong context.
At the centre of panic is a rapid interpretation process. The nervous system notices a sensation — such as a change in heart rate, breathing, dizziness, or tension — and quickly labels it as dangerous. Once that interpretation is made, the body responds as if there is an immediate threat, even if there is no external danger present.
This reaction happens before conscious reasoning has time to intervene. While the logical mind may recognize that nothing is actually wrong, the threat system has already been activated, creating intense physical fear and urgency.
Over time, the system can become sensitized. The body learns to associate certain internal sensations with danger, and the fear response begins to trigger itself. Panic then becomes less about what is happening externally and more about how internal sensations are interpreted.
From a pattern-based perspective, panic is maintained not by weakness or lack of control, but by a learned loop that repeatedly reinforces the idea that certain sensations are unsafe. Understanding this loop is key to understanding why panic feels so automatic and difficult to stop once it begins.
A common loop
Trigger
A physical sensation, emotional state, or situation is noticed — such as a racing heart, shortness of breath, dizziness, fatigue, or feeling trapped.
Interpretation
The sensation is quickly interpreted as dangerous or threatening (e.g., “Something is wrong,” “I’m not safe,” “I’m about to lose control”).
Emotional Response
Fear surges as the nervous system activates a threat response, preparing the body to escape or protect itself.
Behaviour
Protective actions occur, such as escaping the situation, avoiding certain places, monitoring the body closely, or seeking reassurance.
Consequence
Short-term relief reinforces the idea that the sensation was dangerous, making the nervous system more likely to react the same way in the future.
Panic is driven primarily by the threat-focused part of the nervous system, sometimes described as the survival or “alarm” system. This system is designed to react quickly and decisively when danger is detected.
The challenge with panic is not that this system is broken, but that it is misclassifying internal sensations as threats. Once activated, the body produces real physical changes — increased heart rate, altered breathing, muscle tension — which can then be interpreted as further evidence that something is wrong.
This creates a feedback loop: sensations trigger fear, fear intensifies sensations, and intensified sensations reinforce fear.
Importantly, the part of the brain responsible for logic and reasoning often remains aware that there is no real danger. However, awareness alone is usually not enough to shut down a threat response once it has been activated. This is why panic can feel uncontrollable, even for people who understand it intellectually.
From this perspective, working with panic involves addressing how the nervous system has learned to interpret certain experiences, rather than trying to simply suppress symptoms or “think differently” in the moment.
Panic is rarely sustained by fear alone. Beneath the physical sensations and anxious thoughts, there are often deeper beliefs about safety, control, and the body that shape how panic is interpreted and responded to.
Limiting beliefs are not conscious choices or rational conclusions. They are internal rules formed over time, often early in life, that help the nervous system decide what is safe and what is not. When these beliefs are activated, the body can react automatically — even when the present situation does not call for alarm.
In the context of panic, certain beliefs can make normal bodily sensations feel dangerous, unpredictable, or intolerable. These beliefs do not mean something is wrong with you. They reflect how your system learned to protect itself.
Below are some of the most common limiting beliefs that tend to show up beneath panic patterns. You may recognize one, several, or none of them. This section is meant to support understanding, not labelling.
Limiting Beliefs Commonly Linked with Panic disorder Therapy
These identity-level patterns frequently show up for clients seeking panic disorder therapy. Explore the beliefs to learn the “why” and how therapy can help you recondition them.
“I Am In Danger”
Even when everything’s quiet, your body stays braced. The belief “I Am In Danger” forms in environments where trauma, chaos, or emotional instability made safety feel impossible. It…
Explore this belief
“I Am Not in Control”
When “I Am Not In Control” is running the show, everything feels like too much. You either grip harder—rigid routines, hypervigilance—or give up entirely. Underneath it all is…
Explore this belief
“I Am Weak”
When the belief “I Am Weak” takes hold, it can drive avoidance of vulnerability, overcompensation through perfectionism, and deep fear of failure. Learn how this identity-level pattern is…
Explore this beliefWant to see how these fit into the bigger pattern map? Explore our full Limiting Belief Library to browse all core beliefs by schema domain and Lifetrap.
Panic patterns do not usually emerge from a single moment or cause. They tend to develop gradually, shaped by how the nervous system learned to respond to stress, uncertainty, and internal sensations over time.
For many people, panic reflects a system that learned to stay alert in environments where safety, predictability, or emotional regulation felt inconsistent. This learning can occur in subtle ways — through repeated stress, pressure to perform, lack of emotional guidance, or early experiences where internal distress felt overwhelming or unsupported.
These patterns are not signs of weakness or damage. They represent adaptive responses that once served a protective purpose. Over time, however, the same strategies that helped a person cope can become overactive, leading the body to react as if danger is present even when it is not.
Understanding where panic patterns come from is not about finding someone or something to blame. It is about recognizing how the nervous system learned its rules — and how those rules may no longer fit the present context.
“I Am Not in Control”
Schema Domain: Impaired Autonomy & Performance
Non-Nurturing Elements™ (Precursors)
This loop shows how beliefs keep themselves alive. The mind gathers what appears to be proof, emotional pressure builds, and relief is found through patterned responses. While the relief is real in the moment, it often strengthens the original belief—making it more likely to activate again. Over time, the belief functions as a self-fulfilling prophecy.
“I Am In Danger”
Evidence Pile
When this belief is active, the mind stays on alert for signs of threat, instability, or impending harm, interpreting uncertainty or intensity as evidence that danger is present or imminent.
Show common “proof” items
- Sudden changes in tone, mood, or environment that feel unpredictable
- Strong bodily reactions (racing heart, tension, startle) that signal alarm
- Past experiences where harm followed warning signs or was unexpected
- Conflict, raised voices, or emotional intensity—even when not directed at you
- Situations where safety, support, or control feels uncertain or out of reach
When the belief “I am in danger” is active, the nervous system stays on constant alert, scanning for threat and preparing for impact—even when no immediate danger is present.
Show common signals
- Persistent hypervigilance or difficulty relaxing, even in safe environments
- Racing thoughts focused on “what could go wrong”
- Heightened startle response or sensitivity to noise, tone, or movement
- Muscle tension, shallow breathing, or a sense of bracing internally
- Trouble sleeping or feeling “on edge” most of the day
To reduce the intensity of feeling unsafe, people often rely on behaviors that create short-term relief but reinforce the sense that danger is always near.
Show Opt-Out patterns
- Avoiding situations, people, or places that feel unpredictable
- Avoiding situations, people, or places that feel unpredictable
- Over-planning, controlling routines, or needing certainty before acting
- Staying constantly busy or distracted to avoid internal sensations
- Emotional numbing, dissociation, or “shutting down”
“I Am Not in Control”
Evidence Pile
When this belief is active, the mind looks for signs that outcomes are unpredictable or externally driven, treating uncertainty as proof that control is slipping or already lost.
Show common “proof” items
- Plans change unexpectedly or don’t unfold as imagined
- Other people’s decisions affect the outcome more than anticipated
- Effort doesn’t reliably lead to the desired result
- Situations feel dependent on timing, luck, or external approval
- Even small variables feel capable of derailing progress
When control feels uncertain, tension builds as the system stays hyper-focused on managing outcomes, decisions, and risks—leaving little room for ease or flexibility.
Show common signals
- Mental over-planning or rehearsing every possible outcome
- Difficulty delegating or trusting others to handle things
- Strong discomfort with uncertainty, ambiguity, or waiting
- Feeling tense when plans change or things feel unpredictable
- A sense of responsibility for preventing things from going wrong
When the strain becomes too much, the system releases pressure by either tightening control further—or disengaging entirely to escape the overwhelm.
Show Opt-Out patterns
- Micromanaging, correcting, or taking over tasks
- Reassurance-seeking or repeatedly checking decisions
- Avoiding decisions altogether to escape responsibility
- Procrastination or "freezing" when choices feel loaded
- Emotional shutdown or withdrawal when things feel unmanageable
“I Am Weak”
Evidence Pile
When this belief is active, the mind tracks signs of struggle, sensitivity, or limitation and interprets them as evidence of personal weakness rather than context, load, or adaptation.
Show common “proof” items
- Feeling overwhelmed, emotional, or exhausted more easily than others
- Needing support, rest, reassurance, or extra time to cope
- Avoiding conflict, pressure, or high-demand situations
- Not pushing through difficulty in the way you believe you "should"
- Comparing your capacity to others who appear more resilient or unaffected
When weakness feels dangerous, pressure builds as the system works to suppress vulnerability, push through limits, and prove strength at all costs.
Show common signals
- Pushing through exhaustion, pain, or emotional strain
- Difficulty asking for help or admitting struggle
- Harsh self-talk around rest, sensitivity, or limits
- Feeling tense when emotions arise or when support is offered
- A constant sense of needing to "handle it" alone
When maintaining strength becomes unsustainable, the system releases pressure either by collapsing into helplessness—or by disconnecting from feeling altogether.
Show Opt-Out patterns
- Emotional numbness or shutting down
- Avoiding situations that might expose vulnerability
- Sudden burnout, illness, or withdrawal after long pushing
- Self-criticism or shame spirals after moments of struggle
- Letting things fall apart to confirm "I can’t handle this anyway"
When panic is involved, therapy is not about forcing symptoms to stop or convincing yourself that nothing is wrong. Instead, therapy often focuses on understanding how panic patterns formed, how they are maintained, and how the nervous system can learn to respond differently over time.
Because panic reactions happen quickly and automatically, effective therapeutic work usually involves more than insight alone. It often includes a structured process that helps identify threat patterns, explore the beliefs driving them, and work directly with the body’s learned responses in a gradual and supported way.
The goal of therapy is not to eliminate fear entirely, but to help the system become more flexible and accurate in how it responds to internal sensations and perceived danger.
What therapy often focuses on
Making the panic pattern visible
Therapy often begins by mapping how panic shows up for you specifically — including triggers, interpretations, physical reactions, and protective behaviours. This helps transform panic from something that feels random into a pattern that can be understood and worked with.
Understanding the role of beliefs and interpretations
Many panic responses are reinforced by beliefs about safety, control, or the body. Therapy may explore how these beliefs developed and how they influence the way physical sensations are interpreted as threatening.
Working with the nervous system, not against it
Because panic is driven by automatic threat responses, therapy often includes approaches that help the nervous system experience sensations differently — rather than relying only on logic or reassurance in the moment.
Reducing reliance on avoidance and safety behaviours
Avoidance and safety strategies can provide short-term relief but often strengthen panic patterns over time. Therapy may gently explore these behaviours and support more flexible responses as safety increases internally.
What to expect
Intake & Panic Pattern Mapping
Early sessions focus on understanding how panic actually shows up for you — including physical sensations, internal triggers, situational contexts, avoidance patterns, and the beliefs activated when panic begins. This helps make panic feel predictable and understandable, rather than sudden or random.
Threat Interpretation & Belief Work
As awareness grows, therapy may explore the interpretations and internal rules that intensify panic responses — such as beliefs about safety, control, or the body. This work helps reduce the fear of fear itself and loosens the reflexive escalation that often follows early sensations.
Reconditioning
Later sessions often focus on reconditioning the nervous system responses that keep panic repeating. Using structured, evidence-informed approaches, therapy may help reduce the emotional charge associated with familiar sensations and situations, supporting greater flexibility and earlier regulation as panic patterns arise.
When panic patterns begin to shift, the changes are often subtle at first. Rather than panic disappearing all at once, many people notice small differences in how their body reacts, how long panic lasts, or how much it influences their decisions.
Change does not usually mean never feeling anxious or uncomfortable again. Instead, it often looks like greater flexibility, earlier awareness, and a growing sense that panic is something happening within the system — not something that controls it.
The examples below reflect changes people commonly notice over time. Everyone’s experience is different, and progress does not always move in a straight line.
Common markers of change
Relationship with physical sensations
Before: Normal bodily sensations feel alarming or dangerous.
After: Physical sensations are noticed earlier and interpreted with less urgency, even if discomfort is still present.
Fear of panic itself
Before: A strong focus on preventing panic or avoiding situations where it might occur.
After: Less preoccupation with panic, and more confidence in the ability to respond if it shows up.
Behaviour and avoidance
Before: Decisions are shaped by escape routes, safety behaviours, or limiting plans.
After: More willingness to stay engaged in situations, even when some anxiety is present.
Internal response during panic
Before: Panic escalates quickly and feels overwhelming or uncontrollable.
After: Panic still arises at times, but peaks lower, passes more quickly, or feels less consuming.
Sense of trust in the body
Before: The body feels unpredictable or unsafe.
After: A growing sense that bodily reactions can be understood, tolerated, and worked with.
Skills therapy may support
Early pattern recognition
Noticing the early signals of panic — physical, emotional, or situational — before they fully escalate.
Tolerating internal sensations
Building the capacity to stay present with uncomfortable sensations without immediately reacting or escaping.
Flexible threat interpretation
Developing alternative ways of interpreting bodily sensations that reduce automatic fear responses.
Reduced reliance on safety behaviours
Gradually letting go of strategies that once felt necessary for control but reinforced panic over time.
Increased self-trust
Feeling more confidence in the ability to respond effectively if panic arises, rather than needing to prevent it entirely.
Next steps
Notice what resonates
If parts of this page reflected your experience, that recognition itself can be meaningful. You do not need to have everything figured out before reaching out. Therapy often begins by clarifying patterns together rather than arriving with a clear explanation.
Consider speaking with a therapist
Working with a therapist can provide space to explore panic patterns in a structured and supportive way. This may include understanding how panic shows up for you, what keeps it going, and how your system has learned to respond to perceived threat.
Choose support that fits your needs
Some people prefer in-person sessions, while others find virtual therapy more accessible. Finding a therapist who feels like a good fit — in approach, pacing, and style — is often an important part of the process.
Ways to get support
Find a therapist who works with panic patterns
If you’re considering therapy, you can explore therapists at ShiftGrit who work with panic, anxiety, and related patterns. This is an opportunity to find support that aligns with your needs and preferences, without pressure or obligation.<br />
Questions
Do I need a diagnosis to seek therapy for panic?
No. Many people seek therapy based on their experience rather than a formal diagnosis. Therapy can focus on patterns, reactions, and distress regardless of whether a diagnostic label is used.
What if I’m not sure panic fully explains what I’m experiencing?
That’s common. Early therapy sessions often involve exploring what fits and what doesn’t. Panic can overlap with anxiety, stress, health concerns, or other patterns, and clarity often develops over time.
What if panic feels too intense to talk about?
Therapy is typically paced carefully. You are not expected to push beyond what feels manageable. A therapist can help create enough safety to explore panic without overwhelming the system.
Is therapy the only option for panic?
People use many forms of support when dealing with panic, including medical care, self-education, and lifestyle changes. Therapy is one option that focuses on understanding and working with the patterns underlying panic responses.
