Adapted from Chapter 2, “The Anatomy of an Attack,” of The Anatomy of Panic: Stories, Science, and Healing from the Inside Out by Daniela Aneva.
It lasted eleven minutes. Carlos knew because afterwards he checked the timestamps on the messages he had been reading when it began. Eleven minutes. It had felt like an hour. At several points it had felt like the rest of his life.
Carlos is an architect who cycles sixty kilometres most weekends and had never given his heart much thought. Then one day at his desk, a flutter in his chest became a pound. His breathing sped up without his permission. Heat rushed up from his chest, his hands went numb and the tingling spread to his lips. The room tilted. He was certain he was about to collapse, and he called an ambulance.
By the time the paramedics arrived, it was passing. His heart tests were normal. A kind paramedic sat with him and asked whether anything had been very stressful lately. His father had been unwell. A big contract had fallen through. He hadn’t slept more than five hours a night in three weeks.
“What you just experienced,” she said, “was a panic attack. Your body ran a full emergency drill. Everything it did, it did correctly. It just didn’t need to.”
Why understanding the machinery helps
One of the most helpful things a person can do after a panic attack is to understand, in concrete detail, what was happening inside them. Not to dismiss the experience (it is real, and it is deeply uncomfortable) but because knowledge here isn’t just interesting. It is therapeutic. When you understand what your body is doing and why, panic becomes something you can interpret rather than something that simply happens to you.
An alarm built for lions
Your body’s emergency system was shaped over hundreds of thousands of years in a world of genuine physical danger. At its centre is the amygdala, a small almond-shaped cluster of neurons whose job is to scan for danger and hit the alarm immediately. It doesn’t reason or weigh evidence. It acts first and asks questions later. If something in the grass might be a lion, it is better to leap and discover it was the wind.
In panic, that alarm has become over-sensitive. It has learned to treat ordinary internal sensations, like a faster heartbeat or a moment of dizziness, as danger. It is a fire alarm that goes off at the smell of toast. And crucially, the amygdala doesn’t distinguish between a lion and a racing heartbeat. Both set off the same response.
What happens in your body, and why
- The jolt and the pounding heart. Adrenaline floods in and your heart speeds up to push blood to your legs and arms, ready to run or fight.
- Cold, tingling hands and feet. Blood is diverted away from the skin and extremities to the big muscles that need it.
- Dizziness, tingling around the mouth, feeling unreal. Faster breathing lowers carbon dioxide in the blood. It feels alarming, but it isn’t dangerous.
- Shaking and wobbly legs. Your muscles are braced for action. When you’re sitting in a meeting and there is nowhere for that energy to go, it comes out as trembling.
- Everything too loud and too bright. Your senses switch to high-gain threat-scanning mode.
- “I can’t think straight.” The thinking part of your brain is temporarily put in the background so survival can run without interference. That is why reassurance, even from yourself, is so hard to take in mid-attack.
The most important fact
A panic attack, however intense, always ends. The body can’t sustain full emergency mode for long, and your “rest and digest” system steadily works to bring you back down, even while the attack is happening. The symptoms are not signs that your body is failing. They are signs that your emergency system is working exactly as designed, triggered by a false signal.
Try this: write a short card to keep in your wallet or phone, in your own words: “This is my alarm system, not an emergency. My heart is pumping blood to my muscles. The dizziness is my breathing. This will pass.” Read it slowly when the first sensations start.
Carlos’s story is a composite; names and details have been changed. This article is for general information and isn’t a substitute for medical advice. If you have new or unexplained physical symptoms, see a doctor, and if you are ever unsure whether it’s an emergency, treat it as one. In the United States you can call or text 988 at any time.
The book follows twenty people through panic and recovery, with the science and the therapies that help. Get The Anatomy of Panic on Amazon, or learn about anxiety and panic coaching.
