“The doctor said I had a panic attack… but I genuinely thought I was dying.”

These are words I often hear from clients who arrive in the counselling room after experiencing their first panic attack. And I completely understand why they feel confused.

Perhaps they have been to the doctors or A&E and sat for hours, waiting to find out what is wrong with them. They have had their heart checked, blood tests, or other investigations. The doctor says everything has come back normal.

‘Normal, what I felt was anything but normal’ they tell me.

Their heart was racing. Their chest felt tight. They couldn’t seem to get enough air.

They felt dizzy, shaky or sick.  They may of experienced tingling or numbness, felt detached from everything around them, or suddenly became convinced that something terrible was happening.

And then comes the question:

“Why did this happen to me?”

But often, there’s another question that is even harder to understand:

“Why did it happen when I was safe?”

“I was just sitting at home…”

One of the things people find particularly confusing about panic attacks is that they don’t always happen when we’re consciously feeling stressed.

A client might tell me:

“I wasn’t doing anything. I was at home, sitting on the sofa, trying to relax. Nothing was happening. I felt fine.”

And suddenly, out of nowhere, their body goes into alarm mode.

This can be terrifying.

We tend to imagine that anxiety should happen when something frightening is happening. If we’re in danger, it makes sense for our heart to race and our breathing to change.

But our body’s alarm system doesn’t always work that neatly.

A panic attack can happen when you’re sitting safely at home, lying in bed, driving, shopping, or even enjoying a quiet moment.

The sensations are real.

The racing heart is real. The breathlessness is real. The dizziness is real. The fear is real.

But those physical sensations don’t necessarily mean that you’re in physical danger.

So, what is actually happening?

Our bodies have a clever alarm system designed to protect us.

When our brain perceives danger, it can activate our fight, flight or freeze response. Adrenaline and other stress hormones are released, our heart rate increases, our breathing changes and our muscles prepare to respond.

This is useful when we genuinely need to run away from something or protect ourselves.

But sometimes the alarm system can become overly sensitive.

It can respond to thoughts, sensations, stress, memories or changes within our body, rather than an obvious external threat

And sometimes, there doesn’t seem to be a trigger at all.

That can make the experience even more frightening.

The first thing you notice is your heart beating faster.

You think:

“What’s happening to me?”

Then perhaps:

“Something must be wrong.”

Fear increases. Adrenaline increases. Your heart beats faster. Your breathing changes further.

And suddenly, you’re caught in a cycle of panic, without yet having the tools to understand what’s happening or help your nervous system settle back into a sense of safety.

“But I’m still not convinced it’s anxiety…”

I think this is an important part of the conversation.

If you’ve experienced frightening physical symptoms, it’s completely understandable to want reassurance that nothing medical is wrong.

New, severe or unusual physical symptoms should always be appropriately assessed by a medical professional.

And even after you’ve been checked and told that everything is okay, it can take time to believe it.

Because your experience was so real.

You might think:

“But it felt like my heart was going to stop.”

“I couldn’t breathe.”

“I thought I was going to faint.”

“How can anxiety possibly make me feel like that?”

The answer is that anxiety and panic involve the body as well as the mind.

A panic attack isn’t imaginary.

It isn’t someone “making a fuss”.

And it isn’t simply something you can switch off by telling yourself to calm down.

Understanding what is happening inside your body can be an important first step towards taking some of the fear out of it.

What happens when you’ve been coping for a long time?

This is where I think the question “You look like you’re coping… but are you?” becomes particularly relevant.

Many of us become very good at coping.

We keep working. We look after our families. We manage difficult relationships.

We deal with loss. We navigate uncertainty. We keep appointments, answer emails, do the school run and carry on.

Sometimes there simply isn’t time to stop and ask ourselves how are we actually doing?

We can become so focused on getting through something that we don’t notice what it is costing us.

And sometimes, when life finally becomes quieter, our body may begin to tell us that it has had enough.

That doesn’t mean that every panic attack is caused by a build-up of stress, and there isn’t always one clear reason why someone experiences panic.

But it can be helpful to become curious rather than critical.

Instead of:

“What’s wrong with me?”

Perhaps we can begin to ask:

“What has my body been carrying?”

“What have I been dealing with?”

“Have I actually had a chance to stop?”

The fear of having another panic attack

For many people, the first panic attack is frightening.

The second fear is having another one.

You might start monitoring your heart.

Checking your breathing.

Avoiding exercise because your heart beating faster reminds you of the first attack.

You might stop going places alone.

You might avoid driving.

You might sit near an exit.

You might begin avoiding situations where you think you couldn’t easily escape.

And gradually, your world can become smaller.

The fear isn’t necessarily just “I’m going to have a panic attack.”

It becomes:

“What if something happens and I can’t cope?”

This is often where understanding the panic cycle becomes so important.

How can counselling help?

If panic attacks feel physical, you might wonder how talking to someone could possibly help.

Counselling isn’t about telling you that it’s “all in your head”.

It’s about understanding what is happening in your body, what might be contributing to the anxiety and what keeps the cycle going.

In counselling, we can slow things down.

We can explore what happens before the panic begins.

What are you noticing in your body?

What thoughts appear?

What do you do when you feel those sensations?

Do you check your pulse?

Do you try to escape?

Do you seek reassurance?

Do you avoid certain places or activities?

Understanding these patterns can help you recognise the cycle rather than feeling completely at its mercy.

We can also explore what’s happening in your wider life.

Perhaps there is ongoing stress.

A relationship that feels difficult. Grief. Pressure. Change. Exhaustion. Or perhaps there isn’t one obvious explanation. That’s okay too.

Counselling isn’t about finding one perfect reason for every panic attack.

It’s about helping you understand yourself, your responses and your experiences.

We can also look at practical ways of responding when anxiety begins to rise, including grounding, breathing, relaxation and becoming more aware of what is happening without immediately interpreting every physical sensation as danger.

Learning to trust your body again

The goal isn’t necessarily to never feel anxious again.

Anxiety is part of being human.

The goal can be to develop a different relationship with those sensations.

Instead of:

“My heart is racing. Something is terribly wrong.”

Perhaps, over time, you can reach:

“I recognise this feeling. My body is having a panic response. It feels frightening, but I know what is happening. I can get through this.”

That change can be incredibly powerful.

Because sometimes the fear of having another panic attack can become almost as limiting as the panic itself.

You don’t have to face that fear alone.

Counselling can offer you a space to slow things down, understand what you’re experiencing and begin to feel more confident in your ability to cope.

Perhaps you look like you’re coping.

Perhaps everyone around you thinks you’re coping.

But maybe, underneath it all, you’re exhausted from holding everything together.

Maybe it’s time to stop for a moment and ask yourself: “How am I really doing?”

Could counselling help you?

If panic attacks, anxiety or the fear of having another panic attack is beginning to affect your everyday life, counselling could give you the space to explore what is happening and find ways forward.

If you’d like to talk about whether counselling might be right for you, drop me a message. We can have an initial conversation about what you’re experiencing and whether I might be the right person to support you.

A safe space to talk, explore, understand and move forward.

Please remember that counselling should not replace medical assessment. If you experience new, severe or concerning physical symptoms, seek appropriate medical advice.