Panic Attacks vs Severe Anxiety Episodes (And How to Find Relief)
That crushing feeling in your chest. The racing thoughts. The overwhelming sense that something terrible is about to happen.
If you've experienced intense anxiety or panic attacks, you know how terrifying and isolating they can feel. But here's something that might surprise you. Despite how similar they seem, panic attacks and severe anxiety episodes are actually quite different experiences.
Panic Attacks vs Severe Anxiety Episodes
Severe Anxiety Episodes: The Slow Burn
Think of intense anxiety episodes as your nervous system's way of saying, "I'm overwhelmed and I need this to stop." They typically:
Build gradually over minutes or even hours
Have a clear trigger (that presentation, the difficult conversation, financial worries)
Feel intense but you're still aware it will pass
Involve racing thoughts about specific concerns
Can last anywhere from a few minutes to several hours
Peak and recede rather than hitting maximum intensity immediately
Panic Attacks: The Lightning Strike
Panic attacks, on the other hand, are your brain's fire alarm going off when there's no actual fire. They:
Hit suddenly and intensely, reaching peak intensity within minutes
Often have no obvious trigger (which makes them even more frightening)
Create an overwhelming sense of impending doom or death
Involve intense physical symptoms: heart palpitations, sweating, trembling, feeling like you can't breathe
Usually last 5-20 minutes but can leave you shaken for hours
Feel like you're losing control or going crazy or having a heart attack
What Actually Causes Panic Attacks (And Why They Keep Happening)
Both panic attacks and severe anxiety episodes have something crucial in common: they're not character flaws or signs of weakness. They're your nervous system doing exactly what it's designed to do — protect you from perceived danger.
The Initial Trigger: Why Your First Panic Attack Happened
Your first panic attack usually occurs when your brain's threat detection system gets inappropriately activated. This can happen due to:
Physical triggers:
Caffeine, alcohol, or drug use
Lack of sleep or fatigue
Physical illness or hormonal changes
Intense physical sensations (rapid heartbeat, dizziness)
Certain medications or withdrawal from substances
Blood sugar fluctuations (skipping meals, eating too much sugar)
Certain weather changes or barometric pressure shifts
Flickering lights or specific visual patterns
Strong smells or perfumes
Dehydration
Vitamin deficiencies (particularly B vitamins or magnesium)
Psychological triggers:
High stress or overwhelming situations
Specific phobias (heights, enclosed spaces, social situations)
Traumatic memories or reminders of past trauma
Major life changes or transitions
Feeling trapped or unable to escape a situation
Catastrophic thinking ("What if something terrible happens?")
Health anxiety
Feeling out of control
Anticipatory anxiety about future events
Environmental triggers:
Crowded places
Bright lights or loud noises
Hot, stuffy environments
Driving or being in vehicles
Specific locations associated with previous panic attacks
The role of anticipatory anxiety in creating new triggers: Perhaps the most insidious aspect of panic attacks is how anticipatory anxiety can create entirely new triggers over time. Once you've experienced a panic attack, your brain becomes hypervigilant for any sign that another might be coming. This creates a secondary layer of triggers that didn't exist before your first panic attack.
For example, if you had your first panic attack while driving, your brain might start associating cars, motorways or even the act of leaving your house with danger. The anticipatory anxiety about potentially having another panic attack in the car becomes a trigger itself. This is why people often say their panic attacks seem to be spreading to new situations, the fear of the panic attack is literally creating new pathways for panic to occur.
Why avoidance of triggers can sometimes make them stronger: When we avoid situations where we've had panic attacks, we inadvertently send a message to our brain that those situations truly are dangerous. This avoidance might provide temporary relief, but it strengthens the neural pathways that associate those situations with threat.
Each time you avoid the supermarket where you once panicked, you're reinforcing your brain's belief that supermarkets are unsafe. The fear remains unprocessed and often grows stronger. Additionally, avoidance can lead to a shrinking world . What starts as avoiding one specific store can expand to avoiding all shops, then all public places, then leaving the house at all.
But understanding the initial causes is only part of the picture. What really keeps panic attacks going is what happens after that first terrifying experience.
The "Fear of Fear" Cycle: Why Panic Attacks Continue
Here's where it gets really important to understand what's happening. This anticipatory anxiety actually raises your baseline stress level, making your nervous system more reactive. It's like having a smoke alarm that's become so sensitive it goes off when you toast bread. Your brain is now on high alert for any sensation that might indicate danger.
Why Panic Attacks Can Seem to Come From Nowhere
This explains why panic attacks often feel like they strike "out of the blue." While it seems random, your nervous system has likely been primed by this background anticipatory anxiety. Your brain has been running two alarm systems:
The original alarm (responding to perceived threats)
A second alarm that's constantly watching for the first alarm to go off
It's an exhausting cycle that keeps your nervous system stuck in a state of chronic vigilance.
The Physical Reality: Your Brain on Panic
During a panic attack, your brain activates the same response it would use if you were facing a genuine life-or-death situation. It floods your system with stress hormones, increases your heart rate, and redirects blood flow to your muscles. This is why panic attacks feel so physically intense — your body is literally preparing to fight or flee from danger that isn't actually there.
The problem isn't that this system is broken; it's that it's working perfectly for a threat that doesn't exist.
Integral Eye Movement Therapy (IEMT): Breaking the Cycle at Its Source
IEMT works directly with how your brain stores the emotional memories that fuel both the original panic response and the anticipatory anxiety that keeps it going.
When you've experienced panic attacks, your brain creates powerful associative pathways. A racing heart becomes linked to danger. A certain location becomes "unsafe." Even the memory of panic can trigger the same physical response.
During IEMT, we use specific eye movement patterns while you think about these triggering memories or sensations. This helps your brain reprocess and "defuse" the emotional charge attached to them. We're essentially updating your brain's threat assessment system so it can accurately distinguish between actual danger and false alarms.
I'm currently working with David, who developed severe panic attacks around supermarket shopping. After experiencing his first panic attack during a routine shopping trip, his brain created a powerful association between supermarkets and danger. Now, just walking through the entrance triggers his fight-or-flight response - the fluorescent lights, crowded aisles, and sense of being "trapped" all signal threat to his nervous system. He either avoids the weekly shop entirely (leaving it to his partner) or rushes through as quickly as possible, heart racing and desperate to escape.
Through IEMT, we're working to reprocess that original panic memory and break the emotional charge it holds. His brain learnt that supermarkets equal danger based on one overwhelming experience, but we can update that outdated threat assessment so he can recognise that the supermarket is actually a perfectly safe place.
Hypnotherapy: Rewiring Your Automatic Responses
Hypnotherapy creates the ideal brain state for deep change. In that focused, relaxed state, we can work directly with your subconscious mind to install new automatic responses where the old panic patterns used to be.
During hypnotherapy sessions, we might:
Teach your nervous system to respond calmly to physical sensations that used to trigger panic
Address the underlying beliefs fuelling the anticipatory anxiety ("Something terrible is going to happen," "I can't handle this")
Create new neural pathways that lead to calm confidence instead of fear
Install "circuit breakers" that prevent the escalation from normal anxiety to full panic
What Change Actually Looks Like
Real recovery isn't about learning to "manage" your panic attacks or severe anxiety episodes forever. It's about your brain genuinely updating its threat assessment so these responses simply don't get triggered in the first place.
My clients often describe it as:
"It's like someone turned down the volume on my anxiety"
"I can't even remember why I used to be so afraid of that"
"My brain just doesn't go to those scary places anymore"
This isn't about suppressing your feelings or pretending everything is fine. It's about your nervous system learning to accurately assess what's actually dangerous (very little) versus what's actually safe (most of life).
The Path Forward
If you're tired of living on edge, wondering when the next overwhelming episode might hit, know that there is a way through this that doesn't involve years of therapy or a lifetime of coping strategies.
Your brain created these patterns as a way to protect you, but they've outlived their usefulness. With the right approach — one that works with how your brain actually processes emotional experiences — you can update these responses and reclaim your sense of safety in the world.
The episodes that feel so powerful and permanent right now? They're like faulty wiring in your home's electrical system. Just as an oversensitive smoke alarm keeps going off at the slightest hint of toast, your brain's alarm system has become hypersensitive to false threats. But here's the good news, the faulty wiring can be rewired and your brain's threat detection system can be recalibrated to work properly again.
