A panic attack often strikes without warning, and for many people it feels as though something is seriously wrong with their body. The heart races, breathing becomes difficult, and a sense of losing control sets in. It is a frightening experience, but panic attacks themselves are not dangerous, and there are treatments that genuinely make a difference. In this article we explain what happens during a panic attack, when it may point to panic disorder, and the approach used at Mavera GGZ in Rotterdam.
What actually happens during a panic attack?
A panic attack is a sudden wave of intense fear that peaks within minutes. The body shifts into a kind of survival mode, often called the fight-or-flight response, even though there is no real danger present.
Common physical symptoms include:
- A racing or pounding heart
- Shortness of breath or a tight feeling in the chest
- Dizziness or feeling light-headed
- Trembling or shaking
- Sweating
- Tingling in the hands or feet
- Nausea or an upset stomach
- A sense of pressure or tightness across the chest
Cognitive symptoms play just as important a role:
- Fear of losing control
- Fear of “going crazy”
- A strong sense of unreality, as if detached from yourself or your surroundings
- Fear of dying, even when nothing is medically wrong
It is this combination of bodily sensations and the thoughts they trigger that makes a panic attack feel so overwhelming. The brain interprets harmless physical signals as a sign of mortal danger, which only feeds the fear further.
Important: always have physical symptoms checked
Sudden chest pain, or symptoms that feel different or more severe than usual, should always be assessed by a doctor. Panic symptoms can resemble those of, for example, a heart problem. If you are unsure, or feel seriously unwell, call 112 (in the Netherlands) or go to A&E. It is always sensible to rule out a physical cause first, before attributing symptoms to panic.
A single panic attack, or panic disorder?
A single panic attack is not a disorder in itself. Many people experience one at some point, often triggered by stress, sleep deprivation, or a difficult life event, without it ever happening again.
Panic disorder, always established by a qualified clinician as a preliminary DSM-5 classification, is considered when, alongside recurring panic attacks, someone also experiences:
- Persistent fear of having another attack, often lasting weeks
- Behavioural changes aimed at preventing attacks, such as avoiding certain places, activities, or physical exertion
- Ongoing worry about the consequences of an attack, such as fainting, having a heart attack, or losing control in public
This distinction matters, because the fear of a future attack often keeps the problem going longer than the attacks themselves.
The vicious cycle: fear of the fear
What tends to maintain panic disorder is usually not the attack itself, but the fear of fear. Someone notices a harmless bodily sensation, such as slight dizziness, and immediately interprets it as the start of another attack. That thought raises tension, which in turn intensifies the physical sensations, almost guaranteeing the attack unfolds.
Avoiding situations such as busy shops, public transport, or exercise then prevents the body from ever learning that these sensations are not dangerous. In this way, avoidance keeps the problem alive rather than solving it.
What really helps: treatment at Mavera GGZ
At Mavera GGZ in Rotterdam, we work with evidence-based methods to address panic symptoms. The starting point is helping you understand what is happening in your body and mind, and gradually rebuilding your confidence step by step.
Cognitive behavioural therapy (CBT) usually forms the basis of treatment. In CBT you learn to recognise the anxious thoughts that make a panic attack worse, and to test these thoughts against reality.
Gradual exposure to bodily sensations is a core component. Under guidance, you learn to safely get used to sensations such as a racing heart or dizziness, often through targeted exercises. The goal is for your body and brain to experience that these sensations may be uncomfortable, but are not dangerous.
In some cases this is combined with pharmacotherapy, supervised by our psychiatrist, for example when symptoms are severe enough that starting therapy alone is difficult. Medication is always discussed on an individual basis and is never a goal in itself.
For those who prefer to start from home, we also offer online therapy, applying the same evidence-based techniques remotely.
What does the treatment pathway look like?
A referral from your GP (huisarts) is required for specialist mental health care in the Netherlands. After referral, an intake conversation takes place in which we map out together what is going on and which approach suits you best. Our clinicians are BIG-registered and work closely with our psychiatrist whenever needed.
At Mavera GGZ, care is available in Dutch, Turkish, English, Ukrainian, Polish, Uyghur, and Arabic, so you can discuss your symptoms in the language you feel most comfortable in.
In summary
Panic attacks can feel overwhelming, but they are not dangerous in themselves and can be treated effectively. By learning to understand what is happening in your body and gradually breaking the cycle of fearing the fear, many people regain a sense of control over daily life. If you have any doubts about physical symptoms, always consult your GP first, or call 112 in an emergency.
Wondering whether treatment at Mavera GGZ is right for you? Get in touch by phone at 010–254 38 96 or by email at info@maveraggz.nl. We are located at Rozenlaan 115, Rotterdam.
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