Panic Attacks
Panic Attacks Therapy | Psychologist in Maastricht | English & Greek
When your body suddenly feels like it is in danger
A panic attack can be an intensely frightening experience.
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Your heart may suddenly start racing. You may feel short of breath, dizzy, shaky, hot, nauseous, or disconnected from your surroundings. Your chest may feel tight. You may feel as though something terrible is about to happen or even fear that you are going to die, lose control, faint, or “go crazy.”
Sometimes there is an obvious trigger. Sometimes there isn't.
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A panic attack can seem to come completely out of nowhere, which can make the experience even more frightening.
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And once you've experienced one, you may begin to worry about experiencing another.
You might start paying close attention to your heartbeat, avoiding certain places, carrying medication or water “just in case,” making sure someone is nearby, or planning how you would escape if another attack happened.
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Over time, the fear of having a panic attack can begin to become almost as limiting as the panic itself.
Therapy can provide a space to understand what is happening during a panic attack, explore the patterns that may be maintaining the fear, and gradually rebuild your confidence in your ability to experience uncomfortable sensations without feeling controlled by them.
Does this sound familiar?
Panic can feel very physical. You might experience:
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a sudden racing or pounding heart
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chest tightness or discomfort
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difficulty breathing or a feeling that you cannot get enough air
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dizziness, light-headedness, or feeling faint
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trembling or shaking
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sweating or feeling suddenly hot or cold
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nausea or stomach discomfort
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tingling or numbness
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a choking or tight sensation in your throat
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feeling detached from your body or surroundings
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a sudden sense of dread
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a fear that you are losing control
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a fear that something is seriously wrong with you
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a fear of dying
A panic attack can also involve thoughts such as:
“What is happening to me?”
“Am I having a heart attack?”
“I'm going to faint.”
“I can't breathe.”
“I'm going to lose control.”
“What if this never stops?”
These experiences can be extremely convincing in the moment. And when your body is sending you intense signals of danger, it makes sense that your mind tries to find an explanation.
Understanding panic attacks
A panic attack is a sudden period of intense fear or discomfort accompanied by physical and psychological symptoms.
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It can happen when you are already anxious, but it can also happen unexpectedly, sometimes without an obvious external trigger. Common symptoms include a racing heart, sweating, trembling, shortness of breath, dizziness, nausea, chest discomfort, tingling, and a sense of losing control or impending danger.
The experience can feel overwhelming because the body is producing a very strong alarm response.
One way of thinking about it is that your body's emergency system has become activated.
The sensations are real.
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The fear is real.
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But the presence of these sensations does not necessarily mean that the danger your mind is predicting is actually occurring.
A panic attack is not the same as panic disorder
Having a panic attack does not automatically mean that you have panic disorder.People can experience an isolated panic attack or occasional panic attacks without developing panic disorder. Panic disorder generally involves recurrent, unexpected panic attacks together with ongoing concern about having more attacks or significant changes in behaviour because of them. This distinction matters because sometimes the problem becomes less about the individual panic attack and more about what happens afterwards.
You may begin thinking: “What if it happens again?”
And then: “Where could it happen?”
And then: “What if I'm somewhere I can't escape?”
And eventually: “Maybe I shouldn't go there at all.”
This can gradually change the way you live.
Why does a panic attack feel so dangerous?
One of the most frightening aspects of panic is the physical sensations.
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Your heart races.
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Your breathing changes.
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You feel dizzy.
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Your chest feels strange.
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You become aware of every sensation in your body.
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And your mind tries to make sense of what is happening.
You might interpret the racing heart as: “Something is wrong with my heart.”
The dizziness as: “I'm going to faint.”
The difficulty breathing as: “I'm not getting enough oxygen.”
The feeling of unreality as: “I'm losing my mind.”
These interpretations can increase fear. And fear can increase the body's alarm response.
The sensations become stronger. Which makes the thoughts feel even more convincing.
This can create a rapidly escalating cycle.
When the fear becomes fear of fear
One of the most difficult parts of panic can be what happens between attacks. You may start monitoring your body for signs that another attack is coming. A slightly faster heartbeat becomes something to worry about.
Feeling warm makes you wonder whether you're becoming anxious.
A little dizziness makes you immediately think:
“Oh no. It's happening again.”
You may begin avoiding anything you associate with panic.
You might stop exercising because your heart racing feels frightening.
You might avoid public transport because you're afraid of becoming trapped.
You might avoid driving, shopping, travelling, being alone, crowded places, or situations where getting help might feel difficult.
You may always want someone with you.
You may sit near exits.
You may carry things that make you feel safer.
These behaviours are understandable.
They are ways of trying to protect yourself from another frightening experience.
But when your life becomes increasingly organised around preventing panic, your world can gradually become smaller.
This is sometimes described as “fear of fear.” Avoidance can reinforce the belief that the situation or sensation is dangerous, making the fear harder to loosen over time.
How we can work with panic attacks in therapy
Our work would begin by understanding your particular experience of panic.
We might explore:
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What happens before an attack
What were you doing? What were you thinking? What sensations did you notice first?
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What you think the sensations mean
What do you fear is happening when your heart races, you feel dizzy, or your breathing changes?
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What you do during an attack
Do you escape, seek reassurance, monitor your body, try to control your breathing, or immediately look for help?
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What happens afterwards
Do you replay the attack? Search your symptoms? Avoid the situation? Worry about when it might happen again?
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What has changed in your life
Are there places, activities, or situations you have stopped doing because of the possibility of panic?
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What are you afraid would happen?
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Sometimes the fear underneath panic is very specific:
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“I'll faint.”
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“I'll have a heart attack.”
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“I'll embarrass myself.”
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“I'll lose control.”
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“No one will help me.”
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“I'll be trapped.”
Understanding the feared outcome can help us understand the panic cycle itself. Depending on your needs, we may draw primarily from Cognitive Behavioural Therapy (CBT), alongside elements of Acceptance and Commitment Therapy (ACT) and Schema Therapy where appropriate.
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CBT is a well-established psychological treatment for panic disorder. It can involve understanding the relationship between bodily sensations, interpretations, emotions, and behaviours, and may include exposure-based work when appropriate.
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ACT can help you develop a different relationship with fear and uncomfortable bodily sensations, particularly when attempts to control or eliminate anxiety have begun to restrict your life.
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Schema Therapy can be useful when panic is connected with deeper patterns around vulnerability, safety, control, dependence, or fears of being unable to cope.
The aim is not to promise that you will never experience anxiety again. It is to help you become less afraid of the sensations, less dependent on safety behaviours, and more confident in your ability to cope when anxiety arises.
Taking the First Step
You don't need to wait until panic has completely taken over your life.
You might be having occasional attacks but already worrying constantly about the next one.
You might be avoiding places you used to enjoy.
Or you may simply be tired of being afraid of what your own body might do.
You don't have to arrive knowing exactly what is happening.
We can begin by making sense of the experience together.
If you'd like to explore whether working together could be a good fit, you can arrange a short introductory call.