When it comes to panic attacks, it's easy to immediately think of extreme situations where everything seems to suddenly collapse. Instead, they're often a daily reality of silent fears and overwhelming bodily sensations that can severely impact your quality of life. In this article, I'd like to offer a direct and empathetic look at what panic attacks really are and how to cope with them, including through modern resources like online therapy.

Panic attacks: what's really happening?

Imagine it's a quiet day: the city flows as usual, nothing out of the ordinary seems to be happening. Suddenly, something inside changes course. Your heart starts pounding, your breathing becomes shallow, your chest feels constricted as if it's gasping for air. Your thoughts become confused, and an intense fear takes over, so much so that you might wonder if you're losing control or risking something very serious. These could be some of the signs of a panic attack. A panic attack isn't "just in the head," but a real biological response triggered by the nervous system in the face of perceived danger, often invisible or disproportionate to the objective situation. One might say that, like wearing glasses with very colored filters, reality becomes distorted and unclear. Those experiencing these episodes don't imagine them; they endure them, often with feelings of guilt or shame, as if they had failed in something important.

Why do panic attacks come on suddenly?

One of the most frequently asked questions is: "Why me?" or "Why now?" Panic attacks, however, don't function according to purely logical criteria. They are often the tip of the iceberg of an inner journey made up of unmet fears or emotional needs that have been put aside for too long. In some cases, they appear during seemingly peaceful periods, perhaps after a long period of stress, perhaps when the body and mind begin to rest. Other times, they manifest during an objectively stressful situation, but more often they emerge in response to thoughts or sensations that, while internal, evoke a threat.

Fear of fear: the vicious circle

Those who experience panic attacks often end up fearing their return more than anything else. This can lead to a fear of fear, that feeling that even a small symptom (a faster heartbeat, a slight sweating) can set the whole cycle in motion again. This spiral can lead to avoiding places or situations, limiting one's freedom. The result is a vicious cycle in which the person attempts to control every single bodily signal for fear of repeating those moments of terror. Paradoxically, the more one observes and controls oneself, the more internal tension grows.

The emotional roots of panic attacks

People often wonder if there's a single cause or if it's possible to "recover" quickly. The reality is that panic attacks often have deep emotional roots. They may be linked to past experiences, expectations, or patterns learned in childhood about how to cope with emotions or tolerate uncertainty. In other words, there are "lenses" within us that make us perceive certain signals as extremely threatening. Our personal history may have taught us to fear the intensity of certain emotions, to anticipate catastrophe, or to mistrust our own resources to cope with difficulties. In therapy, it often emerges that a panic attack, despite its painful intrusiveness, is the mind's way of signaling an overload, a cry for help that has gone unheard for too long. A panic attack is a sign that the body, wise and perfect in its laws, is telling us: "Look at me, the way you're dealing with things needs to change."

Panic attack treatment: where to start?

The key question then becomes: how can we escape this dynamic? There's no magic answer, but a path that begins with understanding our own emotional functioning, with a greater awareness of the connection between body and thoughts. In many cases, seeking professional help already represents a turning point, because often we need someone who can help us see from different perspectives and understand the signals from our internal world. An important aspect of therapy is creating a safe space where the person can finally feel accepted without judgment. Here, it's possible to explore not only symptoms, but also deepest fears, the origins of one's vulnerabilities, and the strengths often hidden by suffering. Time in therapy serves precisely to shed new light on one's experiences, recognizing the moments when our reactions developed as forms of protection, even when they now seem disproportionate or dysfunctional.

Online therapy as a tool for change

In recent years, online therapy has significantly revolutionized the ability to seek help for panic attacks. Thanks to secure digital tools and adapted therapeutic modalities, many people have been able to begin or continue their therapy even during challenging logistical times, such as during the pandemic or when they are unable to physically visit the office. A first appealing aspect of online therapy is the ability to access psychological support directly from home, which in some cases makes the first step easier, especially for those who feel stuck or fear stigma. The journey remains valuable, as the focus remains on the relationship and mutual trust. Physical distance often seems to ease some resistance, allowing for freer sharing. Of course, this doesn't mean online therapy is always the best solution for everyone: each person is different, as are their needs and preferences.

Addressing the crisis, not just extinguishing it

When it comes to panic attacks, the natural instinct is to seek quick solutions to make them go away. However, the risk is that we simply "put out the fire," without ever truly addressing its causes. Instead, true change comes from working not only on the symptoms but also on the deep roots that fuel them. This process often involves a willingness to confront parts of ourselves that cause fear, gradually learning to tolerate uncertainty and listen to the needs and emotions we previously sought to silence. One of the key aspects of therapy is learning to distinguish between real danger and perceived danger. Here, it can be helpful to think of a panic attack as a siren that goes off excessively: not because something truly serious is about to happen, but because the system has learned to react in advance to keep us "safe."

Small daily victories

In the process of treating panic attacks, it's important to recognize and celebrate even small steps forward. It often begins with the ability to remain, even for just a few moments, in situations that were previously too frightening. Then, over time, we move on to rediscovering places, activities, and emotions that seemed lost. Every step forward, however small, is like a window that opens and allows fresh air to enter our lives. It's important to remember that the path isn't always linear: there may be setbacks, pauses, and setbacks. But all these moments are, in their own way, part of change. There's no need to be discouraged or judged for a few setbacks: the road to greater emotional freedom is made up of trial, error, and correction. Confidence in the possibility of change is built in this constant back-and-forth, like a slow dance in which new steps arise even from hesitations.

Working on deep patterns

One of the key elements in treating panic attacks is exploring so-called "schemas"—deep patterns that govern how we think, feel, and react. These patterns often form in childhood and become a sort of "filter" through which we interpret current situations. For example, if we have a deeply rooted belief that we can't cope alone, every intense bodily sensation will be interpreted as an uncontrollable threat. In therapy, including online therapy, we work to strengthen a more balanced dialogue between the various internal parts, often in conflict. The fearful part and the compulsive reaction, the shameful part and the angry part: all deserve to be listened to, but also to be contained and guided. The therapist then becomes a point of reference for gradually experiencing greater confidence in managing one's emotions.

Questions to Unlock Change

If you were to ask yourself some questions to begin looking at panic attacks in a new way, what would you ask yourself? Try asking yourself these questions: "What do I really feel in my body when I'm anxious?", "What emotions am I trying to avoid or control?", "When was the first time I felt this fear?" These are not easy questions, nor are they obvious. Yet, stopping to listen to them deeply can be the first step toward breaking the automatism that fuels the problem. Remember that curiosity, combined with self-empathy, is one of the most powerful tools for change.

Humour and irony along the way

It may seem strange to suggest bringing humor into such a slippery territory as panic attacks. Yet, even in difficult times, knowing how to see with a hint of irony one's tendency to catastrophize or "predict the unexpected" can at least partially ease the tension and allow one to discover new possibilities. Irony, used gently, helps one not to completely identify with one's symptoms and to distinguish who I am from my fears.

Towards a new internal dialogue

Ultimately, working through panic attacks means learning to build a new internal dialogue, one that's kinder but also more solid and realistic. Often, those who have experienced these attacks feel "broken" or defective. Nothing could be further from the truth: the mind simply tries to protect us, even if sometimes it does so in the least helpful ways. Therapy—whether in person or online—is a space where you can experience trust, reconnect with yourself, and recognize the value of your experiences. Every journey is unique; everyone has their own time and way of flourishing, even after difficult times. There's no one-size-fits-all recipe, but there's certainly the opportunity to learn to feel, embrace, and integrate your emotions, step by step. Start viewing your panic attacks as signals worth listening to, not as enemies to be destroyed. Recognizing this is already transformational: the beginning of a healing journey that you can also approach through new methods, such as online therapy. And even if the climb may seem steep now, remember that every journey toward awareness begins precisely by accepting what moves within us, without judgment, and then guiding your story in the direction you truly feel you want to go. If you want a new starting point for dealing with panic attacks, know that asking for help is already an act of courage and authenticity.