Ataques de panico: o que são, o que não são, e como tratar

She was at the supermarket, in the checkout line, when it started. Her heart was racing — too fast, way too fast. Shortness of breath. Blurred vision. Trembling hands. A wave of absolute terror that seemed to confirm what she had been dreading for weeks.

She left the store. Went to the ER. The tests came back normal. The doctor said: "It's anxiety. See a psychologist." And she thought: "But what if he's wrong? What if next time I actually die?"

That thought — "what if next time it's real?" — is what turns an isolated panic episode into panic disorder.

What a Panic Attack Actually Is

Clinically, a panic attack is a discrete episode of intense fear that peaks within minutes, accompanied by at least four of 13 somatic symptoms recognized by the DSM-5.

The most common symptoms include:

• Cardiovascular: palpitations, tachycardia, chest pain, sense of impending doom
• Respiratory: shortness of breath, choking sensation
• Neurological: dizziness, unsteadiness, derealization
• Thermal: hot flashes or chills, excessive sweating
• Cognitive: fear of losing control, fear of dying

Why It Happens: Through the Lens of the Nervous System

A panic attack doesn't come out of nowhere. It is the body's biological response to a threat that the nervous system detects — even when that threat doesn't exist in the external environment. In people prone to panic, this system becomes hypersensitive.

The trap of fearing fear itself

This is the core of panic disorder. It isn't the attack itself that keeps you trapped — it's the interpretation of the attack. When you believe the attack is dangerous, you begin to fear future situations where an attack might happen. This hypervigilance, in turn, increases the likelihood of new attacks.

"The first time I had a panic attack, I thought I was going to die. When I understood what was happening, everything changed. I wasn't going to die. But my body thought I was."

How Therapy Treats Panic Disorder

1. Psychoeducation

Understanding what a panic attack is — and what it isn't — already reduces the intensity of the fear.

2. Autonomic Regulation Techniques

Diaphragmatic breathing, grounding, vagal regulation.

3. Gradual Exposure

Gradual re-exposure to feared situations, at a safe pace.

4. EMDR or Brainspotting

When specific events triggered the first attack, EMDR accesses those memories and helps the brain process them.

5. Medication, When Needed

SSRIs may be indicated to reduce the hypersensitivity of the alarm system.

What to Expect from Treatment

Panic disorder has an excellent response to treatment. Most people experience significant improvement within 8–12 weeks.

A panic attack is not your body failing. It is your body protecting you from something it mistakenly believes is a threat.

Breaking Free from the Fear of Fear

Panic disorder can make you feel trapped in a body that betrays you. But there is a way out, and it's faster than you might think. The alarm system stops firing. The body remembers there is no threat. And life becomes a safe place to live again.

If you recognized yourself in these words, maybe it's time to talk. The first step can be simple: an initial conversation, no strings attached, to understand what you're going through and what makes sense right now.

About the Author

Dra. Mariana Lage · CRP 01/8814 · Clinical Psychologist

Trauma specialist, trained in EMDR through TraumaClinic / EMDR Brasil and in Brainspotting through the method of Dr. David Grand. Online sessions available for clients in Brazil, Brazilians living abroad, and English-speaking clients.