© Ann Tarazevich
October 6, 2025
Marianne Waldenfels
Psychotherapist Klara Hanstein herself suffered from panic attacks. Here she explains how they arise - and how to overcome the fear.
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What exactly is a panic attack?
A panic attack is a sudden, very intense state of fear, usually without any real external danger. It often occurs without warning and is accompanied by strong physical symptoms: rapid heartbeat, shortness of breath, dizziness, trembling, tightness.
Many affected individuals think at that moment: "I'm dying" or "I'm losing control" even though the panic is physically harmless.
What happens in the body during a panic attack?
The body switches to emergency mode: adrenaline is released, the heart beats faster, breathing becomes shallower, muscles tense up, digestion and cognitive abilities are reduced.
In short: the body prepares for fight or flight even though there is no real threat. I like to refer to it as a "misfire of the nervous system."
And what about the brain?
In the brain, the amygdala, our "fear center," becomes active. It sounds the alarm, often even at small stimuli. At the same time, the prefrontal cortex, the part responsible for logical thinking, is inhibited. That's why people affected by a panic attack often can't stay rational or calm themselves.
Klara Hanstein's new book: Hey Panic, Calm Down!: 21 Ways to Deal with Panic Attacks - In Acute Cases and Long-Term. Kailash Publishing
How can we learn to calm our nervous system down again?
Since, as mentioned above, rational thinking in such an exceptional situation is not so easy, we can first work on our body: Breathing exercises directly affect the nervous system, body relaxation exercises help us out of rigidity and tension. Everything that does us good also helps our nervous system. This can also be walks in nature or time with loved ones. It takes small, regular steps. A nervous system that has been out of whack for a long time cannot be regulated in a day, it takes many repetitions.
What is the biggest mistake you can make when you realize you're having a panic attack?
The biggest mistake is to fight against the fear and build up strong resistance to it because you want to get rid of it. This pressure usually leads to counterpressure and the tension within us increases. A game changer can be to accept the fear, breathe calmly, perceive it, and let it flow through you. This way, you can more often feel that the fear cannot harm you.
How can breathing help during a panic attack? Is there a specific method that works particularly well?
Through our breathing, we have direct influence on our autonomic nervous system. Therefore, it can be an important tool in coping with panic attacks. It is important to breathe in calmly and to breathe out for longer. The prolonged exhalation signals our nervous system that it can return to relaxation.
What can you do against feelings of powerlessness and heart palpitations?
Physical symptoms should always be checked by a doctor. This also provides reassurance when you hear from a medical perspective that you are healthy. It can be helpful to repeatedly bring yourself back to the here and now. During a panic attack, our thoughts usually "gallop" away with us into terrible scenarios.
We vividly imagine losing control or dying of a heart attack, and the panic carousel starts spinning with us. That's why it's so important to connect with the here and now. To keep asking yourself: Is this the opinion of fear or reality? You can also feel the ground contact to anchor yourself more firmly in the present.
© Coco PR
Klara Hanstein is a clinical psychologist, psychotherapist—and anxiety expert.
What do people who suffer from panic attacks often have in common?
Many have gone through stressful experiences or intense stress phases. Often they have "functioned" outwardly for years until "the big bang" comes in the form of panic attacks. Panic attacks are usually a cry for help from our nervous system, which sees no other way than to release a lot of pent-up pressure through the valve of a panic attack.
Do you have two or three very simple tips that can be applied when you notice a panic attack building?
Breathe in calmly through your nose and exhale long through your mouth.
Let the panic flow through you.
Remember that these states will pass - the less you resist them, the faster they will go away.
Where can I find help if I suffer from panic attacks?
First see the general practitioner to medically clarify everything and then visit psychotherapists. There are also counseling centers or telephone counseling as a first point of contact. My new book "Hey Panic, Calm Down!" provides helpful knowledge and practical, easily applicable tools.
