Leave the fear behind by understanding what happens during a panic attack, what causes panic attacks, and how to get rid of panic attacks with Open’s breathwork techniques.
Key takeaways
- Panic attacks shut down blood flow to the prefrontal cortex, making advice to "calm down" physiologically impossible.
- An extended exhale physically reverses the hyperventilation loop by stimulating the vagus nerve to lower heart rate and blood pressure.
- Shifting out of panic requires physical feedback that proves safety to the nervous system.
Panic attacks grip you with fear from two sides: the physiological symptoms that cause your heart to race and the room to spin, and the psychological fear of the sensations in your body that feed a sensory feedback loop that keeps you locked in the panic state.
When your rational brain is overwhelmed by your nervous system, well-meaning advice to “ calm down” feels impossible. Learn what happens during a panic attack and how to use the power of your breath to shift back to calm with Open’s breathwork practices.
What Happens During a Panic Attack?
Panic attacks happen in an instant. When your sympathetic nervous system’s fight-or-flight response is triggered, your body is flooded with adrenaline, which triggers a cascade of physiological responses across multiple body systems.
Elevated adrenaline levels elevate your heart rate, causing blood and oxygen to rush into large muscle groups, briefly reducing blood flow to the brain. At the same time, increased circulation raises your body temperature and activates your sweat glands to help cool your body. Quick, shallow breaths and restricted airflow from a tightened diaphragm lower carbon dioxide levels, sending signals to the brain through the vagus nerve that you are in danger, which can prolong panic.
The common physiological and emotional symptoms of panic attacks are :
- Irregular or racing heartbeat
- Shortness of breath
- Chest tightness or pain
- Dizziness, feeling faint, or lightheadedness
- Numbness or tingling in the hands or feet
- Hot flashes or chills
- Trembling or shaking
- Nausea
- Sense of doom or danger
- Feeling detached from yourself or the world around you
Many people feel the physiological effects of a panic attack for several minutes afterward, with feelings like chest tightness lingering long after the initial episode has passed. Panic attacks are also physically exhausting and emotionally draining, which compounds how panic can interfere with daily life.
What Is the Hyperventilation Cycle?
The hyperventilation cycle is a well-studied aspect of panic attacks. Hyperventilation is triggered by a diaphragm that stops moving correctly because of involuntary spasms and tension associated with acute anxiety. The body compensates for diaphragmatic spasms by lifting the neck and shoulders to breathe, resulting in shallow breathing that lowers blood carbon dioxide levels and causes dizziness, chest pain, or tingling.
Experiencing these physical symptoms can cause the brain to panic more, keeping the cycle going with a sensory feedback loop.
What Causes Panic Attacks?
Beyond the biological cascade, the cause of panic attacks isn’t always clear. Some people may be more prone to panic attacks because of neurochemical balance, family history, underlying medical conditions, or past trauma. For others, panic attacks can be caused by major life changes, grief, and chronic stress. Sometimes, panic attacks occur when there is no apparent cause or danger.
Why Doesn’t “Calm Down” Work Physiologically?
The whole-body cascade of symptoms associated with a panic attack reduces blood flow to the brain and diverts oxygen away from the prefrontal cortex, the part of the brain responsible for logic and reasoning. With the amygdala in control and the brain’s reasoning center temporarily shut down, telling yourself or someone to “calm down” is ineffective.
During a panic attack, logic cannot override biological survival mechanisms. “Calm” does not happen on command. Calm happens when the nervous system feels safe. Neurologically, this can occur only when the heartbeat is steady and the breathing is rhythmic. This is why breathwork techniques like box breathing and extended exhale are effective tools for calm during a panic attack.
How Does an Extended Exhale Change Your Nervous System?
An extended exhale is an in-the-moment intervention that can halt a panic attack in its tracks. Consciously exhaling longer than you inhale stimulates the vagus nerve and triggers a parasympathetic nervous system shift, taking your body out of the fight or flight state. During vagus nerve activation, neurotransmitters are released that lower your blood pressure, slow your heart rate, and decrease cortisol to signal to your body that you are physically safe.
How to practice an extended exhale with the 4-7-8 breathwork technique:
- Inhale through the nose for four seconds
- Hold your breath for seven seconds
- Exhale through your mouth for eight seconds
- Repeat for several minutes
Exploring How to Get Rid of Panic Attacks with Open’s Breathwork Practices
Learning how to calm a panic attack with breathwork can be an effective tool for managing anxiety day-to-day. Somatic breathing exercises engage the diaphragm to reset the physiological responses that are triggered during a panic attack. Open’s breathwork practices for anxiety include:
Open’s seven-day Rewire Anxiety program includes 10-minute breathwork techniques for panic attacks to teach you practical tools to control the physiological response to anxiety. Key breathwork techniques in this program are box breath, extended exhale, and physiological sigh.
Panic Attack Physiology FAQs
Why do you feel dizzy and hot during a panic attack?
Panic attacks trigger a surge of adrenaline that makes your heart pump faster, raises your body temperature, and activates your sweat glands to prevent overheating. The sudden hot flashes and evaporating sweat can make you feel cold and clammy, while dizziness stems from reduced blood flow to the brain.
Why does your body feel like it’s numb or tingling during a panic attack?
The sudden shift in circulation and lower carbon dioxide levels from hyperventilation create the pins and needles sensation associated with panic attacks. The surge of adrenaline that accompanies your body’s fight-or-flight response redirects oxygen-rich blood away from your skin, hands, and feet and toward major muscle groups to prepare you to run or fight. While uncomfortable, this is a temporary physiological response to signals from the nervous system.
How can you stop a panic attack while sitting at your desk?
The quickest way to halt a panic attack at work is with extended-exhale practices or box-breathing exercises. Breathwork stimulates the vagus nerve to send biochemical signals to the brain to drop your heart rate and activate the parasympathetic nervous system.
What is the difference between a panic attack and an anxiety attack?
Anxiety attacks have a slow build-up, typically associated with a specific worry that keeps your cortisol levels elevated. Panic attacks are abrupt, triggered by an acute event that causes fear to spike within minutes. The physiological symptoms of a panic attack are more severe, with many people mistaking panic for a heart attack.
When do you need professional support for panic attacks?
You may need professional support when panic attacks are severe, cause an ongoing fear of future episodes, or occur frequently enough to interfere with daily life. Persistent fear of future attacks may cause you to start avoiding triggers, preventing you from socializing or going to work. You may also require professional support if you develop insomnia or severe physical symptoms, such as chest pain.
Breathe the Panic Away
Replace your fear of a panic attack with understanding. When you know what happens during a panic attack and why, the physiological symptoms feel less threatening. Open’s breathwork techniques guide you away from trying to think your way out of anxiety and toward somatic practices that help you regain control.
Join our in-person classes in LA or download the Open app to build a ritual for resilience.
*Safety note: Frequent panic attacks warrant professional support alongside practice. If you have any pre-existing health conditions or concerns, consult a qualified healthcare professional before beginning a new movement or breathwork practice.*