Educational reference
About this symptom
During an attack, many people fear that they are having a heart attack, are about to collapse, are losing control, or are going mad. Some describe a sense of detachment from themselves or their surroundings, which can be frightening in itself.
These fears are not irrational given what the body is doing. The sensations of a panic attack are intense and arrive suddenly, and interpreting them as dangerous is an understandable response, especially the first time.
The interpretation is also what escalates the attack. Reading a racing heart as a sign of imminent harm produces more fear, which strengthens the sensation. Much of the psychological treatment for panic works on this link, testing the predictions in practice rather than by reassurance alone.
Repeated reassurance from others tends to lose its effect and can become part of the pattern, much as checking does in other conditions. Where fears concern physical health, proper assessment is appropriate first, so that reassurance rests on something.