About Anxiety
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What Happens During an Anxiety Attack?

Denise Griswold, MSc, LCAS
What Happens During an Anxiety Attack?

Panic disorder is one of the least understood types of anxiety by those that have never experienced an anxiety attack. People picture others who have these attacks as being too nervous and experiencing a lot of irrational fears. In reality, anxiety attacks are much more physical, and the symptoms can be so severe that they mimic deadly health disorders.

In this article, we'll explore what specifically happens during an anxiety attack, and what you can do to stop it.

The Severity of Your Anxiety

It should be noted that everyone's anxiety attack is a little different. Some people have panic attacks when they're simply overwhelmed by stress. Most people have anxiety attacks that are more of a reaction to physical experiences. So while the following represents the basics of an anxiety attack, it is by no means what happens to everyone.

The First Anxiety Attack

Most people that have anxiety attacks experience their first attack during a time when they are experiencing a considerable amount of stress in their life, but not necessarily, and the attack doesn't necessarily occur when that person is experiencing the most stress either.

In general, the first attack is often described as "coming out of nowhere." The first attack follows the same pattern as the attacks outlined below, but knowing the specific trigger can be difficult. Sometimes there is an identifiable source of stress or several sources but other times there may appear to be no trigger at all. 

Starts With a Feeling

Usually an anxiety attack begins because someone notices a feeling in their body. Anxiety attacks - or their more common name, panic attacks - cause what's known as "hypersensitivity." This is when your mind essentially monitors your body, so that it notices any change no matter how slight. Whenever your mind notices a change it focuses on it, which amplifies the experience. Many of these are changes that those without anxiety wouldn't notice, or would generally ignore, but a person with anxiety may be more aware of these changes.

Once the feeling is acknowledged, most people report they experience a flood of anxiety. Usually one of the following two thoughts occurs:

Sometimes the fear is health related, sometimes the fear is panic attack related, sometimes it's a little of both. One of the characteristics of those with panic disorder is that the fear of the anxiety attacks are often just as overwhelming as the fear for their health.

However, the main thing to realize is that these are physical sensations. The person with anxiety attacks isn't imagining these thoughts out of the blue. Rather, they're noticing physical changes in their body in a way that those without anxiety rarely notice. These physical sensations can begin subtle and become more pronounced, or they can be strong from the start, such as the case of heart palpitations.

Triggers include:

If some of those look like standard anxiety symptoms, that's because they are, and that's one of the more unfortunate problems with anxiety attacks. Those that have these attacks often experience anxiety about the possibility of experiencing an anxiety attack, which in turn actually triggers an attack.

It's possible for a panic attack to come out of nowhere, but generally they are slight triggers involved, followed by a significant rush of anxiety.

The Rush of Anxiety

The next group of symptoms tend to come in a wave. Your body experiences this immediate rush of pure adrenaline, and your heartbeat speeds up, you begin to feel nauseous, you may begin to experiencing shakiness, and you start to feel the same way you would feel if you were in a dangerous situation.

You also experience a heightened awareness of the way you feel. Generally we describe this as being "in your own head," but in other ways this relates back to the hypersensitivity. You are extremely aware of not only how you're feeling, but also various bodily functions. In some ways it can feel as though you're in control of your own heart and that you feel like it may stop soon. You start to feel like each symptom means something. These thoughts are difficult, if not impossible to control. As soon as the adrenaline comes, you'll likely start to feel even more nervous and anxious. 


Next comes a significant worsening of the symptoms, especially the scary ones like difficulty breathing and chest pains. You'll start to feel like you can't get a deep breath, and you may have a desire to yawn or cough only to feel weaker or feel your heartbeat speed up more. At this point you may be weak, extremely lightheaded, and/or feel your heart squeezed inside your chest.

This can be an incredibly scary part of the attack. However, most of these symptoms are caused by hyperventilation, which is in many cases preventable; albeit somewhat difficult to entirely prevent. Hyperventilation is the act of breathing out too much carbon dioxide because you're breathing too fast, too shallow, or more oxygen than your body needs.

Hyperventilation, unfortunately, creates a feeling of the exact opposite. It feels like you can't get enough air, which is why you have that desire to take deeper breaths. But when you do, or when you try to breathe in too fast or more air than you need, you actually make your hyperventilation worse. At this point the symptoms can be very severe, and often the person may seem to withdraw even further into their own head.

Feeling of Doom and Peak

At this point you'll often experience feelings of doom. Once again, this is entirely uncontrollable, and a natural reaction the symptoms. It's at this point where people feel like they're about to die, or as though something terrible is about to happen. All of these symptoms become more and more overwhelming.

Suddenly it peaks. You experience this intense dread, and it feels like time slows down to a stop. Then everything starts to drain slowly away. You start to feel a little bit better, but only marginally so, and often you'll be filled with a considerable amount of fatigue from that entire experience. You'll be sweaty, shaking, and possibly still have health anxiety or fears as a result. But you'll usually feel a tad bit better as it starts its slow but steady decline.

Anxiety attacks may have other symptoms as well. There are unusual symptoms like back pain, nerve firing, cold feet, and even itching. There are also severe symptoms like derealization (losing touch with reality). All of these are no more dangerous, but all of them can be very concerning to the person who is experiencing them.

Panic attacks are not dangerous events, and many who get them are completely healthy. But there are so many physical symptoms involved and so much anxiety that they often feel like something terrible is wrong with your health - even if you know you have an anxiety attack problem.

Can You Stop An Anxiety Attack?

So now that you know what these symptoms are like, the question is whether or not you can stop them. Once an attack starts, it is hard to completely stop, because the triggers already began. But you can do various activities to try to decrease the severity of the attack, and in some cases you may be able to prevent it from ever peaking.

Because so many of these symptoms are triggered uncontrollably, and because even many of the thoughts you have (like the feeling of doom) are a reaction to the anxiety and not your own way of thinking, it can sometimes be hard to stop an attack when it starts. Prevention is key.

But there are some strategies you can try. These include:

These activities may not be able to completely stop the attack but they can at least reduce how severe the attack is, and that could reduce the way it affects your life.

Still, the most important thing you can do is learn to control your anxiety and panic in general. Once you learn to cope with anxiety better, the attacks will become less frequent and may even stop altogether.

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