--- title: "Panic attack: what happens in the body and what to do" description: "What happens in the body during a panic attack, why it is not in itself a threat to life and what to do while it lasts. With links to WHO and NICE." url: https://manasiway.com/en/articles/panic-attack-what-to-do/ lang: en updated: 2026-09-28 tokens: 1664 --- # Panic attack: what happens in the body and what to do while it lasts Your heart is pounding, you cannot get enough air, your head is spinning, a wave of terror rolls in — “I'm dying” or “I'm losing my mind” — and 10–20 minutes later it all recedes, leaving you wrung out and afraid it will happen again. That is what a panic attack looks like. Few things are as frightening — and yet, once a doctor has ruled out other causes, it is not in itself a threat to life[1]. - Lyudmila Chernysheva, psychologist and hypnotherapist - Updated: September 28, 2026 ## What is really happening The body mistakenly switches on the “fight or flight” response at full power when there is no real threat: a surge of adrenaline speeds up the heart, breathing becomes fast and shallow; breathing fast lowers the level of carbon dioxide in the blood — hence the dizziness, the numbness, the sense that what is happening is not real[2]. Most often what lies behind this is a properly working alarm system that has gone off at the wrong time. But there is no way to tell it apart from other conditions on your own, just from how it feels. Have your heart and thyroid checked by a doctor — especially if the attack is your first, unusual or unlike the ones before[1]. It is for a doctor to say what it was. ## What to do during an attack Lengthen the out-breath: in for a count of four, out for a count of six to eight; a few minutes of breathing like this usually help to slow things down. Come back to the “here and now”: silently name five things you can see, four sounds you can hear and three sensations in your body. If you are somewhere safe, try not to leave straight away: in my experience, running away reinforces the fear. But that is a skill you build up gradually, ideally with a specialist — not a rule for every attack. And keep repeating a phrase that has served many people well: “this is panic, it peaks and then subsides, I know how to wait it out”. Breathing is first aid, not a safeguard for the future: in the long run, what matters is to stop fighting the sensations (more on this in the article “[Why panic comes back](https://manasiway.com/en/articles/why-panic-comes-back/)”). If someone close to you is having an attack, stay with them and speak calmly and briefly: “I’m here, this will pass.” Offer to breathe together — a slow in-breath, a long out-breath — and don’t rush them. If it is their first attack with chest pain, if they have fainted or find it hard to breathe at rest, call an ambulance (103 in Kazakhstan, or your local emergency number). ## What the research says The NICE guideline recommends CBT as the main psychological method[1]; a Cochrane network meta-analysis confirms that it is among the most extensively studied psychotherapies for panic disorder[3]. CBT is aimed precisely at breaking the loop of “fear of bodily sensations → stronger sensations”[2]. WHO lists panic disorder among the anxiety disorders, for which highly effective help is available[4]. ## When it has to be a doctor A first-ever attack with chest pain is a reason to call an ambulance (103 in Kazakhstan, or your local emergency number). The same applies to fainting, pain on exertion or breathlessness at rest. Do not diagnose yourself with “panic”. And if the attacks keep coming back, or you have started avoiding public transport, shops or being on your own, that is a reason to see a doctor: the earlier the work begins, the less your life has had time to shrink around the fear. ## Sources 1. National Institute for Health and Care Excellence (NICE) (2011). Generalised anxiety disorder and panic disorder in adults: management. Clinical guideline CG113 (published 26 January 2011, last updated 15 June 2020). *NICE*, [URL www.nice.org.uk/guidance/cg113](https://www.nice.org.uk/guidance/cg113) 2. Clark D.M. (1986). A cognitive approach to panic. *Behaviour Research and Therapy, 24(4), 461–470*, [DOI 10.1016/0005-7967(86)90011-2](https://doi.org/10.1016/0005-7967(86)90011-2) 3. Pompoli A., Furukawa T.A., Imai H., et al. (2016). Psychological therapies for panic disorder with or without agoraphobia in adults: a network meta-analysis. *Cochrane Database of Systematic Reviews, 2016(4): CD011004*, [DOI 10.1002/14651858.CD011004.pub2](https://doi.org/10.1002/14651858.CD011004.pub2) 4. World Health Organization (2026). Anxiety disorders (fact sheet). *World Health Organization*, [URL www.who.int/news-room/fact-sheets/detail/anxiety-disorders](https://www.who.int/news-room/fact-sheets/detail/anxiety-disorders) ## The limits of this article This article is for information only: it does not replace a consultation or a doctor's help. If you feel very bad right now — in Kazakhstan call 112 or 103; free round-the-clock psychological help — 1303 (Almaty). If anxiety is already getting in the way of sleep, daily tasks or decisions — in a consultation we can go through your own cycle of anxiety and find a first step that gives back a little control. - [Book a consultation](https://manasiway.com/en/booking/#consultation-60) - [Message on WhatsApp](https://wa.me/77025360139) ## See also - [Individual therapy](https://manasiway.com/en/consultations/) — how one-to-one work goes - [Booking](https://manasiway.com/en/booking/) — choose a format and book - [Why panic comes back](https://manasiway.com/en/articles/why-panic-comes-back/) — Why a single episode turns into a way of life — and where the loop can be broken. - [Bedtime anxiety](https://manasiway.com/en/articles/bedtime-anxiety/) — Why your mind switches on when the light goes out, and what you can change this week. --- HTML version: https://manasiway.com/en/articles/panic-attack-what-to-do/ · Booking: https://manasiway.com/en/booking/ · WhatsApp: https://wa.me/77025360139 · Telegram: https://t.me/Lyudmila_manasiway