Understanding the “Panic” Within the Panic Disorder
Why it feels so overwhelming, and how science is finally catching up.
When we hear the word panic, we often associate it with fear or anxiety—but what if panic is something else entirely? Recent research suggests that our understanding of panic attacks might be due for a major shift—and with it, the way we treat panic disorder.
What is panic, really?
Panic is the body’s most extreme emergency response. It’s like your brain hits an internal red button, even when there’s no obvious threat. Your heart races, your chest tightens, your breathing quickens, and your thoughts spiral. It can feel like you're dying, losing control, or going crazy.
But in truth, a panic attack is your nervous system mistakenly believing you're in life-threatening danger—and flooding your body with stress chemicals to help you escape.
This reaction made sense in prehistoric times when we faced physical threats, but in modern life, it can be triggered by thoughts, stress, trauma, or seemingly nothing at all. For those with panic disorder, this intense response happens frequently, and often without warning.
New research, new understanding
Panic disorder is a deeply disruptive condition. And despite affecting millions of people, treatment options haven’t advanced much in decades—largely because panic has been treated as a version of general anxiety.
A study published in Nature Neuroscience (Kang et al., 2024) offers a fresh perspective. Researchers observed mice in different emotional states and found something fascinating: during panic, the brain released a neurochemical called PACAP—but when the mice were anxious or afraid, that chemical was absent. This suggests that panic and fear are not the same to the brain. They activate entirely different systems.
What does this mean for treatment? Anxiety is often treated with SSRIs, which regulate serotonin. But if panic involves PACAP, not serotonin, it makes sense that those treatments may fall short—and that a new, more targeted medication could be on the horizon.
How To Calm A Panic Attack
Understanding the biology can be empowering, but what about when you’re actually in it? When your body feels hijacked?
Here are some tools that can help interrupt the panic loop:
Name what’s happening – “This is a panic attack. I am safe, and it will pass.” Labelling it reduces fear of the unknown.
Slow your exhale – Try 4-6 second exhales. It activates your parasympathetic nervous system and slows your heart rate.
Ground your senses – Look around and name 5 things you can see, feel, hear, etc. This pulls you out of your head and into the present.
Hold cold – A cold pack on your neck or a splash of cold water can reset the nervous system.
Movement – Gentle walking, shaking out your arms, or stretching can help release the adrenaline surge.
No single tool works for everyone every time, but small, repeated actions send signals to your brain that you're not in danger—even when it feels like you are.
Long-Term Support And Healing
If you experience panic attacks often, the most important thing to know is: you’re not broken. Your body is doing something it believes is protective—but the system is overreacting.
Long-term support can include:
Therapy, especially CBT or somatic-based therapies, to work with the triggers and the body's response
Breathwork and nervous system regulation practices
Avoiding avoidance – gently facing feared situations to rebuild safety
Consistent self-regulation tools like yoga, cold exposure, or journaling
Panic is not a personality flaw. It’s not weakness. It’s a biological event that your body can learn to move through, and eventually, not trigger at all.
With better understanding—and more compassionate tools—we move closer to treating panic disorder not just with science, but with the self-awareness and support it truly requires.
Emma’s Experience with Panic Attacks
My first panic attack happened on a 10-hour hike in Cape Town. I blamed it on lack of sleep, not eating enough, and the heat—plus the very real risk of hiking on a tall mountain. It made sense at the time. Then months later, I had another one—this time trapped on the tarmac in a sweltering plane in Spain, with no air conditioning working and two people on either side of me. Again, I wrote it off: heat, claustrophobia, nothing more.
But then came the ones without any clear trigger. One on a calm flight to France. Another in the middle of the night, with no warning and nowhere to place the blame. My mind was racing with the darkest thoughts I’ve ever had, and I felt like I couldn’t get out of my own head. That’s when I realised—this wasn’t circumstantial discomfort. This was panic.
Since then, I’ve collected a toolkit of things that help:
Shaking out the body (releases built-up adrenaline and resets the nervous system)
Listening to a guided meditation (I personally love this one by Donna D’Cruz)
Humming (stimulates the vagus nerve through vocal cord vibrations, helping activate the body’s calming, parasympathetic response)
Cold exposure: showers, holding ice cubes in hand or mouth (sends a strong signal to the brain to focus on the body, interrupting panic)
Smelling essential oils (engages the senses and brings awareness back to the present)
Having stable blood sugar levels (EAT REGULARLY!) (prevents physical crashes that can mimic or trigger panic symptoms.)
Deep breathing (i.e., breathing in for 4 seconds, and out for 6 or longer) (calms the nervous system and slows the heart rate)
Realising others experience them too and swapping stories, tips and healing methods
The last time it happened, I locked eyes with myself in the bathroom mirror, repeating: “you are safe, you are safe, you are safe.”. I placed one hand on my head and one on my belly, drawing opposite circles. This immediately helped - I guess because it shifted my focus—and brought me back to the present.
Panic attacks are one of the most HORRENDOUS experiences — and I wouldn’t wish them upon anyone. But I’ve learned that they often carry an important message. Instead of pushing through or ignoring it, I try to honour what my body is asking for. At the time, mine was telling me to stop full-time travel and return home for a while. It helped.
Now, I support myself with small daily rituals that bring stability: eating regularly to keep my blood sugar balanced, having a gentle morning and evening routine, moving my body in ways that feel good (and resting completely when I need to - i.e., during first few days of my period), soft yoga, breathwork, meditation, journaling, and checking in with what I truly need — not just physically, but emotionally too.
If you’re going through something similar, please know you’re not alone — and that your body isn’t broken, it’s just trying to protect you. Panic might feel like it takes over everything, but it doesn’t define you. Little by little, you can build a life that feels safe again. There’s no quick fix, but there are tools, practices, and ways of being that can help you feel more grounded — and it all begins with meeting yourself gently, exactly where you are.