The Worst Thing That Can Happen When You Panic

When I was a kid, I was terribly afraid of the dark. I still remember the feeling I had when I would walk down the basement stairs at my grandparents’ house, or get up in the middle of the night to go to the bathroom.

My worst fear was of some indefinable something that lay beyond fear—would I get so scared I’d actually see something freaky? Could I go crazy from terror, or even scare myself to death?

I hear echoes of this “fear of what’s beyond fear” in many of the anxiety conditions I treat, and most clearly in Panic Disorder.

First, a quick description of Panic Disorder: Most of us at some point will have at least one panic attack, which is a sudden surge of fear along with physical symptoms—commonly things like a racing heart, shortness of breath, or feeling faint.

Having panic attacks doesn’t mean a person has a disorder; a person also has to really fear having more panic attacks, and generally will worry that the panic means something terrible like “I’m having a heart attack” or “I’m going crazy.” Panic attacks become a huge problem when we’re so afraid of them that we change our lives to avoid them. For example, I might stop using elevators, taking public transportation, or driving over bridges if these situations are tied to panic.

If you’ve had even one panic attack you know that they’re a miserable experience. There’s a gripping fear, a sense of impending doom, and anoverwhelming drive to escape the situation.

On top of the experience itself, panic in Panic Disorder usually triggers a fear that something else—beyond panic—is going to happen.

• I’ll pass out while driving and crash into someone.
• My tunnel vision will turn into blindness.
• I’ll get so panicked on a bridge that I’ll jump off it.
• I’ll lose my mind and do something horribly embarrassing.

And so on. We imagine that whatever it is will be qualitatively different from panic alone.

For the record, panic doesn't lead to these terrifying events. What is actually beyond panic? Panic—in the short term, just more panic. And then, inevitably, the body and mind stop generating the panic symptoms and the attack ends.

The best tested treatment for panic disorder—cognitive behavioral therapy(link is external)—focuses on training the mind to understand that panic is just panic—no less, and no more. With practice and hard work we can move through our fear and expectation of something worse than panic.

When we conquer our belief that panic is going to be worse than panic, we’re free to face the panic itself—which, let’s be honest, is plenty. And people tend to find that they can do it—they can deal with a panic attack when it’s stripped of its most terrifying forecasts for something worse. What makes panic overwhelming is what we imagine will happen.

I have to wonder how many other things in life are like panic—things we can deal with as they are, but we fear they’ll turn into more than we can handle. We can deal with an awkward and dreaded conversation—it will just be awkward, no better and no worse. We can face a busy work day on very little sleep—we may just be tired at times, no more than that. We can finish a tough workout—it’s going to hurt, then it will be over.

Again and again, our minds will create ghosts that we often treat as though they’re real, and that we believe are more than we can handle. When we face our lives as they actually are, we find we are enough.