When Panic Attacks: What Keeps Panic Disorder Going

Understanding Panic Attacks

Panic attacks can feel sudden, overwhelming, and deeply frightening. Many people describe them as coming “out of the blue,” with intense physical sensations such as a racing heart, shortness of breath, dizziness, or chest tightness. While panic attacks themselves are not dangerous, the fear and confusion surrounding them can gradually lead to panic disorder. Understanding what keeps panic going is an important first step toward recovery.

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Why Panic Attacks Happen

According to the Centre for Clinical Interventions (CCI), panic attacks are often described as a “false alarm” of the body’s threat system. The fight-or-flight response is activated even though there is no real physical danger present (CCI, When Panic Attacks: Module 2). Stressful life events, ongoing pressure, or periods of heightened vulnerability can increase the likelihood of an initial panic attack. Once someone has experienced one, it is common to become more alert to bodily sensations and worried about what they might mean.

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How Panic Disorder Develops

Panic disorder develops when anxiety becomes focused on the panic itself. Normal bodily sensations, such as a faster heartbeat or lightheadedness, may be misinterpreted as signs of something catastrophic, like having a heart attack, losing control, or “going crazy.” These catastrophic interpretations increase fear, which in turn intensifies physical sensations, creating a vicious cycle of panic. The more attention is paid to the body, the more threatening these sensations can feel.

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The Role of Avoidance and Safety Behaviours

Over time, people often try to cope with this fear through avoidance and safety behaviours. Avoidance may include staying away from places where panic attacks have occurred before, such as crowded spaces, meetings, or exercise environments. Safety behaviours are more subtle and can include sitting near exits, carrying medication or water “just in case,” constantly checking one’s body, or using controlled breathing to prevent panic sensations. While these strategies can reduce anxiety in the short term, they prevent people from learning that panic sensations are uncomfortable but not dangerous. As a result, fear of panic remains strong.

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How Panic Disorder Is Maintained

CCI explains that this combination of catastrophic thinking, heightened focus on bodily sensations, avoidance, and safety behaviours is what maintains panic disorder over time (CCI, When Panic Attacks: Module 2). Each time anxiety decreases because of avoidance or safety behaviours, the brain learns that panic was only escaped, not survived. This reinforces the belief that panic is something to fear.

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Psychotherapy and Recovery

Psychotherapy, particularly cognitive behavioural therapy (CBT), is an effective approach for breaking this cycle. In therapy, clients learn how panic works, how anxiety affects the body, and how thoughts influence emotional responses. Gradually, therapy focuses on reducing avoidance and safety behaviours, and helping individuals face feared sensations and situations in a safe, structured way. This allows new learning to occur: that panic rises, peaks, and falls on its own, and that people are capable of coping even when anxiety is present.

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Supporting Change at Reflections Psychotherapy Clinic

At Reflections Psychotherapy Clinic in Markham, therapists work collaboratively with clients to understand their unique panic cycle and develop practical, compassionate strategies for change. By addressing both the fear of panic and the behaviours that keep it going, psychotherapy helps clients regain confidence, reduce anxiety, and reconnect with daily life in meaningful ways.

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Conclusion

If panic attacks have begun to limit your world, support is available. With the right understanding and guidance, it is possible to step out of the panic cycle and move toward a calmer, more empowered relationship with anxiety.

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Reference

Centre for Clinical Interventions. (n.d.). When Panic Attacks: Module 2 – What Keeps Panic Disorder Going. Government of Western Australia.