If you have ever had a panic attack, you already know it is one of the most frightening experiences a person can have. Your heart races, your breath disappears, and your body is convinced something terrible is about to happen.
Most advice on managing panic attacks gives you ways to stop or distract yourself from the feeling. After 14 years and more than 3,000 clients in Abu Dhabi, I have come to a different view. Those strategies are short-term, not long-term. And very often they backfire.
Here's why, and what actually helps.
What Most People Believe About Panic Attacks
When someone sits down with me after a panic attack, they usually believe three things:
• Panic attacks are probably inevitable for them now
• They are unpredictable, so there is no way of knowing when the next one will arrive
• It is the worst feeling in the world
I always agree with the last one. A panic attack really is the worst feeling in the world.
But the first two beliefs are where I want to start, because they don't have to be true. You can learn to understand, manage and change how your brain copes with panicky feelings. It does take work, and that work needs to happen before anything changes. But it is entirely possible.
What's Really Happening in Your Brain
A panic attack is your brain in a severe fight or flight response. Your threat detection system has decided you are in danger, and it is throwing everything it has at keeping you alive.
That is why panic is so physical. It isn't just a frightening thought. It is a whole-body alarm. And in that moment, brains honestly believe they are going to die.
Why you can't reason with a panicking brain
When your brain is in fight or flight, it can't hear anything. It is so afraid that it is simply responding to the fear.
This is not the time to argue with your brain, reason with it or try to talk it out of being scared. Logic doesn't reach a brain that believes it is fighting for its life. This is also why being told to "just calm down" has never helped anyone mid-panic.
Why panic feels so unpredictable
One of the most frightening things about panic attacks is that they seem to come out of nowhere. You might be in a meeting, at the supermarket or lying in bed when it hits.
But panic rarely comes from nowhere.
In my experience, it is the end point of anxiety that has been building quietly in the background. When anxiety isn't managed, the brain becomes more and more afraid, until one day it tips into full alarm. The attack feels sudden. The build-up usually isn't.
The Fear of the Next Panic Attack
After a first panic attack, many people develop a second fear: the fear of having another one. They start watching their body for warning signs. They avoid places where panic happened before. They carry escape plans everywhere they go.
This is completely understandable. But it creates a cycle. The more you fear panic, the more alert your brain becomes. The more alert your brain becomes, the more likely it is to sound the alarm. Fear of fear becomes its own fuel.
Avoidance teaches your brain one lesson: that the feeling really was dangerous. Every time you escape, your brain files it away as proof. This is why the way out of panic isn't more protection from the feeling. It is a different relationship with it.
Why Most Panic Attack Advice Backfires
Most of what you will read online about managing panic attacks offers strategies to stop or distract yourself from the feeling. Breathe slowly. Distract yourself. Sing a song. Hold someone's hand.
These are all valid responses. I teach some of them myself. But there are two problems.
• They are very hard to use in the middle of a panic attack, when your brain can't hear instructions
• Even when you manage to use them, you are usually using them to get rid of the fear
The paradox of fighting fear
And here's the paradox: when you use a strategy to make the fear go away, you are still fighting the fear. The strategy is happening for the wrong reason.
What your brain actually needs is for you to be able to sit with that fear. Staying with the feeling is what helps your brain feel reassured. Running from it, or battling it, keeps the alarm ringing.
This asks for a completely different way of thinking about feelings. Not as something you have to get rid of or change, but as something you can be with.
Panic Attacks Shouldn't Be a Regular Part of Your Life
This is what I say to almost every client who comes to me with panic attacks: if we manage anxiety properly, panic attacks should not happen. And if they do, it means the anxiety isn't being managed yet.
This isn't a personal failing. It's brain behaviour. If you don't manage your brain, it can become so afraid that it panics. If you teach it to be calm and to be with the feeling rather than fearing it, panic attacks should not happen regularly.
You Are the Only One Who Can Calm Your Brain
Here's the truth: when your brain panics, there is nobody else who can bring it back down but you, the owner of that brain.
If your brain goes into fight or flight and you panic along with it, there is nothing left in there to bring anything back to base. Your brain needs something to hang on to. That something is you.
The skill is learning to see yourself as separate from your panicking brain. You are anchored in your own strength and sense of self, managing a brain that happens to be panicky right now. From that anchored place, you can step back a little and begin to calm it.
How to Manage Panic Attacks: What I Teach My Clients
Interestingly, people generally aren't having panic attacks when they are sitting with me. They have them at other times. So most of the real work happens in between.
Between panic attacks
This is where you build the skills your brain will lean on later. With my clients, that means learning to:
• Be separate from your brain, noticing what it is doing rather than becoming it
• Reassure your brain, so it learns it doesn't have to go into full alarm
• Calm your body, because panic is such a physiological response
• Sit with uncomfortable feelings rather than running away from them
Breathing and other body-calming skills belong here. The difference is that you practise them to settle and support your brain, not to escape the feeling.
When panic starts
In the moment, the same principle applies. Rather than fighting the feeling, you stay with it.
• Recognise what is happening: your brain is in fight or flight
• Don't argue with it or try to reason it out of being afraid
• Anchor yourself, and be with your brain rather than panicking alongside it
• Let the feeling be there, and let your brain know you are there too
The Longer Journey: Five Steps to a Calmer Brain
Managing panic well isn't about one technique. It is about changing how your brain responds to fear over time. In my practice, I guide clients through five stages, each building on the last:
• Awareness: noticing anxiety early, while your brain can still hear you
• Understanding your brain: seeing that your alarm system is trying to protect you, not malfunctioning
• Changing your brain: giving it new evidence every time you stay with a difficult feeling instead of escaping it
• A flexible brain: being able to feel fear without being taken over by it
• Creating your new life: saying yes to the big, scary and wonderful things panic once kept you from
The goal isn't just fewer panic attacks. It is becoming more fully and powerfully yourself.
When to Get Support
You don't have to wait until things are unbearable. It is worth getting support if:
• Panic attacks are happening regularly
• You are starting to avoid places, people or plans because of them
• The fear of the next attack is shaping your days
Understanding your brain sooner makes the work easier. And you don't have to work it out alone.
If You've Just Had Another Panic Attack
If you are reading this after another panic attack and feeling hopeless, here is what I most want you to hear.
When brains get scared and move into fight or flight, the number one way to manage it is to be with your brain. Stay in communication with it. Reassure it, bring it back to base and give it an anchor to hold on to.
Start small. The next time you notice anxiety beginning to rise, don't push it away. Stay with it for a moment and let your brain know you are there. That is the beginning of a completely different relationship with fear.
Sometimes brains do get panicky. And yes, you can manage it.
If you are experiencing panic-like symptoms for the first time, it is worth checking in with your doctor to rule out any physical causes.
Want to understand what's really happening in your brain?