Understanding Panic Attacks: 5 Things You Must Know to Stop Them

This article examines panic attacks and panic disorder through current neuroscience and clinical evidence, presenting both the neurological mechanisms and the evidence-based interventions available. The 2024 Salk Institute / Nature Neuroscience discovery of the PACAP pathway — a neurological mechanism that goes beyond the classical amygdala-centred model of panic — is examined alongside established dual-pathway research. India-specific data is presented: India's National Mental Health Survey documents 44.9 million Indians living with anxiety disorders, with an 82.9% treatment gap. Five evidence-based immediate interventions are presented: 4-6 diaphragmatic breathing, the 4-7-8 technique, 5-4-3-2-1 sensory grounding, cold water vagal stimulation, and cognitive reframing. Long-term treatment approaches including CBT (70–90% response rates), exposure therapy, pharmacotherapy, and Pranayama as a vagal regulation practice are examined. The DSM-5 diagnostic criteria are clearly presented and distinguished from generalised anxiety and cardiac events. The article addresses India's specific treatment gap and cultural barriers to mental health care.