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What Happens During Anxiety Attack

Jude, 24 describes a typical anxiety attack.

“I live alone in a tiny studio apartments in East London. I was working on my laptop sitting at my desk on a day that was no different to any other day. Suddenly my heart started thumping: bang-bang-bang. I could hear the blood passing through my ears whoosh - whoosh - whoosh. I could see my chest banging up and down under my clothes. My hands were shaking and I couldn’t see my laptop screen because my eyes were blurry.

I started stripping off my clothes because I started to sweat. I jumped up to go into the bathroom and put my face in a sink of Cold water but I fell back on my chair. The strength in my legs had gone. My heart pumped harder and my breath started to get very fast. I knew the drill: breath slower. But I couldn’t.

My vision got worse like blood was pouring into my eyeballs. When I closed my eyes all I could see were stars. I thought I was going to die there and then, alone in my tiny apartment. I climbed off the chair and lay down on the floor. I’m not sure how much time passed before I was able to stand up. It could have been two minutes or an hour. I crawled into bed and slept for 12 hours straight through as if life had been drained away.”

If you’ve never had anxiety attack you will probably never understand what they are like.

People see anxiety attacks as being fear based when is the reality is they are extremely physical. The symptoms of an attack can be so severe that they can mimic a serious illness.

What happens during anxiety attack is different for everyone and there’s no two people who experience an anxiety attack the same way.

I will attempt to explain specifically what happens during an anxiety attack and what you can do to help yourself. I say 'attempt' because there's no absolutes; not even the doctors totally understand them.

Please bear in mind that the following information represents the basis of an anxiety attack but it’s different for everyone.

What Happens During Anxiety Attack

It Comes Out Of Nowhere

This can be the scariest moment of your life. It certainly was for me. I had never experienced an anxiety attack before.

I had been putting things in my wardrobe when I had this sensation of five heartbeats all at once. It was as if my heart had five pumps and they were all thumping at slightly different rhythms.

I started to feel a tingling in my hands and was convinced I was having a heart attack. I wondered if I should call for an ambulance because I thought I was going to die. I felt faint and had to sit on the bed with my head between my legs. I was lightheaded and had trouble thinking straight.

It lasted for about an hour. I was rooted to the bed and couldn’t move. Gradually, the symptoms abated and I was exhausted. It took me a couple of days to process what happened and feel sort of normal again.

Most of us who experience their first anxiety attack find that there was no warning and it comes out of nowhere. The one thing in common is that they may be experiencing high stress levels but what is so strange is that the attack does not usually happen at the time of high stress.

It Starts With Some Sensation

Often we know if and when an anxiety attack is coming because of unusual sensations in the body. These start at least an hour before the attack begins. If we are stressed it is normal to feel hypervigilant about our body and any changes so we may notice it.

The hypervigilance can make some of us particularly sensitive to any new sensations. We may think that something is wrong with us, which makes our fear levels increase. These sensations may be the same sensations that people without anxiety also have but they pay no attention to them.

However, this isn’t always the case that we notice these changes.

Psychologist Alicia Meuret, Southern Methodist University, Dallas undertook research in which she reported that many of her research participants underwent the new sensations but they didn’t notice them. Click here [i] here for a short video of Dr. Meuret explaining her findings.

Interestingly, the one thing Dr. Meuret discovered was that, even though the participants’ breathing rates increased, they reported no difference.

For me these sensations felt as if my blood had been mixed with Coke. It was a fizzy feeling through my whole body. Other people have reported feeling hot, spacey or losing their balance.

A Canadian writer Robin Sharma once said “What you focus on grows, what you think about expands, and what you dwell upon determines your destiny.”

I wondered how much of my panic attacks were because I focused on these sensations. As soon as I sensed the physical changes, I got scared and this flooded my body with anxiety.

It’s often the case that we focus on these sensations, in the hour before an anxiety attack, as being a serious health problem, which exacerbates the feeling of panic. We can’t assimilate that they are simply physical sensations.

What happens during anxiety attack? These sensations build up with some of these physiological and psychological symptoms:

  • Heart Palpitations or accelerated heart rate

  • Trembling

  • Sweating

  • Shortness of breath

  • Feelings of smothering

  • Or choking

  • Chest discomfort or pain

  • Nausea or stomach distress

  • Feeling dizzy

  • Unsteady

  • Light-headed

  • Feeling faint

  • Change of temperature sensations

  • Numbness or tingling sensations

  • Feeling detached from the body

  • Fear of going crazy

  • Fear of dying

The Anxiety and Depression Association of America (ADAA) states that 4[ii] or more of these symptoms or sensations will determine the onset of an anxiety attack.

What Happens During Anxiety Attack Onset?

The Build Up

It feels like the beginning of a wave; not dissimilar to the build up towards an orgasm.

The adrenaline is pumping and the heart rate is increasing. But then we may experience shakiness or nausea as the head rush begins. This is when our entire focus is based in our head, particularly the brain. The intensity of awareness is building to the point that we might forget anything that’s going on around us and that the whole world starts and ends with us.

The mind racing speeds up and thoughts feel out of control. They might come at us, firing a million questions at once, all focused on each symptom almost as if we’re in the ‘Bourne Identity’, the film with Matt Damon where nothing makes sense. We might feel the fear that Damon’s character felt as if our life depended on trying to control these thoughts and figure out what’s going on.

Over Breathing

The symptoms keep building until it becomes difficult to breathe. If we’ve had chest pains they may worsen. These symptoms are related to what is known as ‘hyperventilation’.

Hyperventilating, or over breathing can cause an anxiety attack or make them worse. The doctors are not clear if hyperventilation is a symptom or a cause because one ‘feeds’ off the other.

Many people who suffer from anxiety attacks may be hyperventilating without even knowing it. Approximately 60% of attacks are accompanied by hyperventilation. It’s important to understand that although it can feel as if we don’t have enough oxygen, it’s very much the case that the opposite is true and we have too much oxygen.

When we breathe too quickly, we don’t give our body long enough to retain carbon dioxide. We need carbon dioxide to extract oxygen from the blood. When we hyperventilate, our body has too much oxygen.

It feels scary because it’s like we can’t get a deep breath. It can feel like coughing or yawning makes us feel weaker. Often we feel like yawning but we can’t.

The heart might speed up and feel as if it’s being squeezed. All of this is caused by hyperventilation. We may find ourselves withdrawing further into our head all in effort to try and control what’s going on.

The Crescendo

This is the peak point when all of the symptoms become more intense and consequently more overwhelming. It’s at this point that we think something terrible is about to happen or we are about to die.

The dread becomes intense. Time stops dead. This is the ‘climax’ of the anxiety attack or the crest of the wave.

The Come Down

Once we’ve ridden the crest of the wave, the sea level slowly returns to normal. The dread, hyperventilation and shaking begin to drain away. We start to feel a little bit more in control although we’re exhausted, shaking and possibly sweating.

We may still have the thought that something is terribly wrong with our health but those thoughts will slowly decline.

What happens during anxiety attack isn’t dangerous and many people who get them are perfectly healthy. However, because so many physical symptoms are involved and it can feel like there is something very wrong, when and anxiety attack happens it just FEELS dangerous.


Is it possible to stop an anxiety attack? It doesn’t seem so. However, if you become aware of anxiety attack starting, there are things you can do, immediately, to minimise the symptoms as much as possible.

1. Talk to someone

Although this is counterintuitive, the problem with anxiety attacks is that you withdraw into yourself and get caught up with extreme thinking that’s an instinctive reaction to the anxiety.

Talking to someone acts as a distraction and pulls you away from the epicentre of the attack. As soon as you feel panicky, speak to someone. Tell them how you’re feeling and exactly what’s going on inside. By sharing your feelings it takes the intensity away from your racing thoughts.

I recommend that you think about someone you feel safe with that you could call on in the event of an anxiety attack. It would be someone that you could approach beforehand and have a discussion about anxiety attacks, how they affect you and ask your safe person to help.

I have one person who I can contact at a moments notice and it makes all the difference knowing I can share the experience with someone else.

2. Move

When an anxiety attack comes on, it’s very normal to want to stay in one place. However, moving seems to help. By moving around you burn off a little bit of the adrenaline that is coursing around the body.

It also helps by moving the blood around the body, which can have a positive effect on carbon dioxide and oxygen levels. This could help to decrease feelings of faintness.

3. Breathe

But not in the way you’d think. The best way to control your breathing is to increase the amount of carbon dioxide in your system. This can be done in two ways:

Either hold your breath for as long as is possible, up to 20 seconds at a time, and repeat this up to 6 times until you feel the hyperventilation dissipating.

Or, breathe in and out of a paper bag, which has the effect of getting you to re-inhale the carbon dioxide that will calm your breathing down.

**Please do not use this advice as a replacement for medical advice. This is simply my own opinion. Always see your doctor. ****





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