Having a Panic Attack at Work: What to Do Next

THERAPY FOR DRIVEN WOMEN • April 6, 2026

LAST UPDATED: JULY 2026

Last reviewed: July 2026 by Annie Wright, LMFT

In short: A panic attack at work is a misfired nervous system alarm, not a sign of instability, and the most effective immediate strategy is paradoxically to stop resisting it, because fighting the sensations intensifies and prolongs them.

What Is Actually Happening When Panic Hits You at Your Desk?

It’s 2:47 in the afternoon. Agustina is in a glass-walled conference room on the fourteenth floor, seated at the far end of a long table, laptop open, a half-drunk cup of coffee going cold beside her elbow. The quarterly review has been running for forty minutes and she’s been fielding questions confidently, the way she always does. Then something shifts. Her heart begins to thump against her sternum. Not fast at first, just insistent. A warm flush moves up her neck. The fluorescent light feels too bright, the room too close. Her chest tightens, and her next breath doesn’t feel like enough air. She takes another, shallower this time. Her fingers go slightly numb. The voice of her colleague across the table starts to sound muffled, like she’s hearing it through water. She thinks: What’s happening to me right now?

What Agustina is experiencing is a panic attack, in one of the least forgiving environments imaginable. The symptoms can spike suddenly: a racing heart, chest tightness, shortness of breath, dizziness, intense fear, or a sense of unreality. These sensations aren’t just “in your head.” They’re the result of your autonomic nervous system kicking into high gear, triggering a fight-or-flight response when no immediate danger is present.

These physical symptoms collide with the mental pressure to maintain composure and protect your professional identity. Your body floods with adrenaline and cortisol, sharpening your senses while also creating a cascade of overwhelming reactions. Your amygdala, the brain’s emotional alarm system, misreads cues from your environment and activates survival mechanisms, even though the threat is internal, not external. Stephen Porges, PhD, creator of polyvagal theory, names this precisely: the nervous system constantly scans for signals of safety or danger through what he calls “neuroception,” and when it detects a threat, even a psychological one, it mobilizes the body accordingly, regardless of what your rational mind is telling it. A 2019 meta-analysis published in the Journal of Anxiety Disorders found that workplace-triggered panic episodes frequently involve this exact cognitive-somatic split: the prefrontal cortex straining to reassert control while the limbic system is already in full alarm mode.

Because panic attacks are so sudden and intense, the experience can leave you feeling isolated and ashamed. This is a physiological event, your nervous system responding to perceived threat, not a personal failure. Gabor Maté, MD, physician and trauma specialist and author of The Myth of Normal, writes that the body’s stress responses aren’t character defects but adaptive strategies that made sense at some point, even when they feel wildly out of place now. You’re not broken. You’re having a very human response to an inhuman amount of pressure.

Why Do Driven Women Experience Panic Differently?

Driven women have a particular relationship with panic attacks. The very traits that fuel your ambition, perfectionism, high standards, a relentless work ethic, can also intensify panic when it strikes. You’re wired to push through discomfort, to “handle it” yourself, and to keep emotions tightly controlled. A panic attack disrupts that narrative, making you feel vulnerable in a space where vulnerability is often treated as a liability. These patterns often trace back to early attachment experiences, the blueprint your nervous system built in childhood for how much of yourself it’s safe to show.

Many driven women report that their panic attacks arrive with an added layer of cognitive judgment: “I shouldn’t be feeling this way,” or “If others see this, it will ruin my reputation.” That self-criticism ratchets up shame, often prolonging the panic. You might recognize what I call “performance panic,” the fear that this moment of distress will derail your career trajectory. Brené Brown, PhD, LMSW, researcher studying vulnerability and shame, has documented how shame functions as an accelerant in moments of perceived exposure: the more you fear being seen as inadequate, the more intensely your nervous system mobilizes to protect you, and that mobilization is indistinguishable from panic.

From a neurobiological standpoint, driven women often carry hyper-responsive stress systems from chronic exposure to high-pressure environments, and your hypothalamic-pituitary-adrenal axis may release stress hormones more readily than it might in someone with a different history. Bessel van der Kolk, MD, psychiatrist and trauma researcher and author of The Body Keeps the Score, has shown that when the nervous system stays chronically activated, the threshold for a full panic response drops lower over time. You’re not suddenly weaker. You’ve simply run out of buffer, and over time, sustained stress can produce symptoms remarkably similar to complex PTSD. In my clinical work, I see this constantly: a driven woman has been managing impossible levels of stress for months or years without adequate support, and a panic attack is the first moment her body gets loud enough to be impossible to ignore. She’s been strong for far too long without the scaffolding to hold her.

Emotionally, many driven women are conditioned to prioritize logic over feeling, which creates a disconnect from bodily sensation until it becomes overwhelming. But panic is your body’s alarm signaling that something needs attention. Richard Schwartz, PhD, founder of Internal Family Systems therapy, would frame your panic response as a “protector part,” a well-intentioned internal system trying to warn you that something underneath needs care. It isn’t your enemy. It’s a messenger you haven’t yet learned to hear, and the goal isn’t to eliminate panic. It’s to build a more honest, compassionate relationship with what your body has been trying to tell you.

What Should You Do in the Next 10 Minutes?

The moments following a panic attack at work are critical. Your nervous system is still rattled, and how you respond in those first ten minutes can help recalibrate your body or inadvertently fuel the panic cycle. Here’s a clinically informed approach you can use immediately.

1. Ground yourself physically. Feel your feet firmly on the floor, notice the texture of your chair, or hold a small object like a pen to focus tactile attention away from anxious thoughts. Pat Ogden, PhD, founder of Sensorimotor Psychotherapy, calls this practice of noticing sensation on purpose “orienting,” inviting your nervous system to register the present environment as non-threatening.
2. Control your breath. Panic attacks often involve rapid, shallow breathing, which worsens dizziness and chest tightness. Try a 4-7-8 technique: inhale quietly through your nose for four seconds, hold for seven, then exhale slowly through your mouth for eight. The extended exhale activates the vagus nerve, signaling the parasympathetic nervous system to begin downregulating the alarm response.
3. Use cognitive reframing. Remind yourself that this is a panic attack, not a heart attack, not a failure. Repeat a short grounding phrase: “This will pass. I am safe. My body is reacting, not threatening.” Your brain isn’t in a state to receive complex information right now.
4. Remove yourself from high-stimulation environments. If you can, excuse yourself to a quieter space, even a bathroom stall or hallway. You don’t owe anyone an explanation. “Excuse me for a moment” is enough.
5. Hydrate and nourish. Dehydration and low blood sugar can worsen panic symptoms. Sip water once you’ve regained some composure. Something cold, ice water or a cold cloth on your wrists, can also interrupt the cascade through the dive reflex.

These steps interrupt the panic cascade, sending your nervous system a message: “I see you, but I’m not in danger.” This can shift you from sympathetic overdrive into a more regulated parasympathetic state (PMID: 16530597). If you’re at your desk and can’t step away, silently engage your senses instead: notice five things you can see, four you can touch, three you can hear. This isn’t a trick. It’s neuroscience: deliberately redirecting attentional resources to the present environment interrupts the catastrophizing loop that feeds panic.

Resist the temptation to suppress or fight the panic itself. Resistance adds fuel. Instead, acknowledge what’s happening without judgment. Daniel Siegel, MD, clinical professor of psychiatry at UCLA and author of Mindsight, uses the phrase “name it to tame it.” When you label what you’re experiencing, “this is panic, this is my nervous system, this will pass,” you engage the prefrontal cortex and begin restoring regulatory capacity. Your goal in these ten minutes isn’t to “make it stop” immediately. It’s to stabilize enough to return to your workday with more control.

What Should You Do in the Next 24 Hours?

A panic attack at work can leave your world feeling tilted on its axis. Once the immediate intensity fades, exhaustion and lingering anxiety often settle in. In the next twenty-four hours, your focus should be gentle recovery and practical steps to regain stability.

Think about what happens to Agustina after that conference room moment. She makes it through the meeting. Barely. She spends the next hour in a low-grade fog of embarrassment and dread. She replays every second: Did they notice? Did my voice shake? Will this happen again tomorrow? By six that evening she’s exhausted in a way sleep won’t fully fix. This is the nervous system coming down from its adrenaline peak, and it’s completely normal. It doesn’t mean you’re fragile. It means you just ran a sprint you didn’t choose to run.

Give yourself permission to rest. Prioritize activities that don’t tax your cognitive or emotional resources, and avoid major decisions or high-stakes meetings if you can. Even simple acts, walking outside, drinking water, taking a short nap, help your body and mind reset. Eating nourishing meals at regular intervals stabilizes blood sugar, since drops in glucose can mimic or worsen anxiety, and skipping caffeine and alcohol for the next day helps too, since both destabilize the nervous system and extend the window of vulnerability.

Check in on your support system. Share what happened with a trusted colleague or friend if you feel comfortable doing so. Isolation after a panic attack is one of the most counterproductive things you can do. Your nervous system regulates best in the presence of safe, connected others, what Stephen Porges, PhD, calls “co-regulation”: your system literally borrows stability from another calm nervous system nearby. Finally, notice any patterns or triggers that preceded the attack. A brief journal can offer valuable insight, especially if you decide to pursue therapy or coaching. The goal isn’t to find someone or something to blame. It’s to understand your own system well enough to work with it instead of against it.

Both/And: Can You Be Highly Competent AND Have an Overwhelmed Nervous System?

Having a panic attack isn’t a sign that you’re weak or failing. You can be one of the most driven women in your field and still have a nervous system that hits a breaking point. These things coexist. It isn’t an either/or.

Consider Aida. She’s a senior director at a technology company, managing a team of twenty across three time zones, the person other people call when something goes sideways. She’s been recognized twice for performance and privately hasn’t taken a real vacation in three years. Aida keeps a running note on her phone titled “Things I Have Not Told Anyone,” and the first line, written eight months ago, says only: tired in a way that scares me. When she had a panic attack in her car before an all-hands meeting, her first thought wasn’t I need help. It was I can’t let anyone find out. That gap between what Aida projected and what her body was experiencing had been growing for years. The panic attack wasn’t the problem. It was the message.

Sitting with Aida a few weeks later, telling me this story for the first time, I felt the particular weight I’ve come to associate with driven women describing their own bodies like malfunctioning equipment. Not sadness exactly. Something closer to recognition. Aida wasn’t describing a crisis. She was describing a cost she’d been paying quietly for years, one nobody around her had noticed because she’d gotten so skilled at hiding the withdrawals.

Your brain and body are wired to respond to stress in primal ways: fight, flight, freeze. When your environment or internal pressure ramps up beyond what your nervous system can handle, a panic attack is a signal that something needs attention, a biological response, not a character flaw. Peter Levine, PhD, psychologist and founder of Somatic Experiencing, describes this as the body’s “unfinished protective responses,” survival energy that gets activated but has nowhere to go in a professional context. What I’ve come to call the both/and stance is what let Aida stop treating her own competence and her own overwhelm as contradictory evidence in a trial only she was running. You can be excellent at your work and also need support. Those aren’t contradictions, and holding both is essential for sustainable success: maintaining your high standards while setting boundaries and learning to read your body’s signals earlier.

The Systemic Lens: Is Your Workplace Actually Designed to Produce Panic?

Your body isn’t the only thing worth examining here. The room you’re sitting in matters too. Sometimes the pressure cooker of a workplace isn’t just a backdrop for panic. It’s a direct contributor, and a culture that demands constant alertness, multitasking, and perfection can produce a panic attack simply because a body is trying to survive an impossible standard.

Christina Maslach, PhD, social psychologist at UC Berkeley who defined the three dimensions of burnout, has spent decades documenting how organizational environments, not individual deficiencies, are the primary drivers of burnout and related anxiety responses. I keep returning to her framework because it names something I see constantly in my office: when workplaces have high demands, low control, poor community, and insufficient reward, workers’ nervous systems pay the price. The panic attack happening in your body is, in part, a systemic problem wearing a personal face.

Workplaces that reward pushing past exhaustion, minimize emotional expression, or stigmatize vulnerability create systemic conditions that are ripe for panic. Judith Herman, MD, Clinical Professor of Psychiatry at Harvard Medical School and Cambridge Health Alliance and author of Trauma and Recovery, has noted that environments demanding constant vigilance while offering little safety or predictability are functionally traumatizing, regardless of whether a discrete traumatic event has occurred (PMID: 19795402). This lens shifts some accountability away from you alone and gives you a basis to advocate for change, whether negotiating workload or building peer support. You’re not “too sensitive” or “not resilient enough.” You’re responding naturally to the demands placed on you, and the goal becomes reshaping, where possible, the environment itself.

Can Therapy Actually Prevent the Next Panic Attack?

Therapy isn’t just about managing symptoms when panic strikes. It’s about building a foundation that prevents panic attacks from happening in the first place, and working with a therapist who understands the pressures faced by driven women in demanding careers turns therapy into a tailored space to develop strategies that fit your actual life.

In my clinical work with clients who experience panic at work, the shifts that actually stick happen not in the moment of panic but in the quiet, consistent work done between sessions: learning to notice the low-grade tension that’s been building all week, recognizing the physical signature of your particular stress response, the tightening jaw, the shallow breath, the clenched shoulders, before it escalates. Panic attacks rarely come out of nowhere. Janina Fisher, PhD, psychologist and specialist in trauma treatment, has written compellingly about how the nervous system leaves “bread crumbs,” physical cues that escalation is coming, and learning to read those cues can change how a panic attack unfolds, sometimes stopping it before it fully arrives.

Many driven women I work with didn’t experience overt abuse. They experienced something subtler: childhood emotional neglect, the absence of attunement that teaches a child her emotions don’t matter. I think often of a client, not Agustina or Aida, but a woman years ago who told me, halfway through our work together, “I didn’t know you were allowed to notice you were tired before you collapsed.” That sentence has stayed with me because it names exactly what body literacy gives back to a driven woman: permission to notice the early data instead of waiting for the crisis to tell her what she already knew.

Prevention goes deeper than symptom management. Therapy also addresses the underlying factors that contribute to nervous system overwhelm: chronic stress, unresolved trauma, or unrelenting self-expectations. In Internal Family Systems terms, it’s about building a stronger, more compassionate relationship between your “Self” and the protective parts that trigger panic, so those parts don’t have to work quite so hard. The best therapy for driven women doesn’t ask you to slow down or stop being ambitious. It asks you to become ambitious in a way that’s sustainable, embodied, and actually yours. Investing in your mental health through therapy is an act of strength, not weakness. The women I work with don’t leave therapy less driven. They leave more capable, more connected to themselves, and more able to use their ambition in service of a life that actually feels like theirs. If what you’ve read here resonates, know that individual therapy and executive coaching are available for driven women ready to do this work, or you can explore my self-paced recovery courses. These offerings are educational and developmental and are not a substitute for individualized clinical treatment.

How Do You Build a Nervous System That Doesn’t Break Down at Work?

When Agustina had her first panic attack in a conference room, her first instinct was to pretend it hadn’t happened. Get through the meeting. Don’t let anyone see. Aida did something similar: she excused herself, ran cold water over her wrists, and was back at her desk in seven minutes, blazer straightened, the running note on her phone one line longer. What I see consistently with clients who’ve had panic at work is that the immediate coping response is almost entirely about containment, managing how it looks rather than understanding what it means. That works, sort of, until it doesn’t. Here’s what actually gets underneath the pattern, roughly in this order.

1. Stabilize the nervous system before you analyze anything. Stephen Porges, PhD, has documented that the autonomic nervous system moves through discrete states, safe and connected, mobilized, shut down, and that returning to regulation after a spike requires physiological input, not cognitive effort. In practice: slow your exhale longer than your inhale, drink something cold, move your body if you can, and reduce stimulants for the next twenty-four hours. You can’t process what your system just did while it’s still recovering.

2. Name the attack as a nervous system event, not a psychological catastrophe. One of the most damaging things that happens afterward is the secondary panic, the catastrophizing about the panic itself: What if I’ve got another one? What if someone noticed? Janina Fisher, PhD, clinical psychologist and trauma researcher, describes this as the “fear of fear.” A panic attack is a false alarm from a threat-detection system that’s been working too hard for too long, a sign that your window of tolerance has narrowed. That’s workable, but you’ve got to stop treating the alarm as evidence of catastrophe before you can widen it.

3. Build regulation practices for the workplace specifically, not generic ones. Generic self-care advice doesn’t account for what your actual workdays look like. In my work with clients, I ask them to map their week: where are the pressure points, what time of day is your system most activated, what are the specific triggers. Then we build regulation anchors that fit that map: a four-minute walk before a large meeting, a breath pattern you run silently at your desk, a phrase for the early signs of activation, I see what’s happening. I can stay here. Somatic Experiencing offers concrete tools for building these anchors in the body, not just the mind.

4. Get underneath the pattern inside a reliable therapeutic relationship. Panic attacks at work almost never appear from nowhere. They tend to emerge where a dysregulated nervous system, a current environment with real stressors, and older attachment material meet, material that taught you visibility is dangerous or that your worth is contingent on your performance. In individual therapy, we work with all three layers at once. The panic attack isn’t the problem. It’s the indicator, and Bessel van der Kolk, MD, is clear that nervous system dysregulation is responsive to the actual environment, which is why addressing burnout at the systemic level matters alongside the individual work.

Aida, six months in, stopped calling her regulation practices “coping mechanisms” and started calling them “the maintenance schedule,” the language she used for the systems she managed at work. She’d stopped treating her nervous system as a problem to hide and started treating it as infrastructure to maintain.

Agustina, for her part, still keeps a cup of coffee at her elbow in every meeting now, but it’s rarely more than a few sips gone cold before she notices, gets up, and steps into the hallway for ninety seconds. The conference room on the fourteenth floor doesn’t scare her the way it used to. I see what’s happening. I can stay here, she told me recently, the same phrase we’d practiced months earlier, and this time she said it like she believed it. If panic has visited you at work, once or repeatedly, please know that this is treatable, and you don’t have to white-knuckle your way through it. Whether through individual therapy, executive coaching, or the self-paced Fixing the Foundations^™ course, support is available. You can schedule a consultation to talk through what fits where you’re right now.

This content is psychoeducational in nature and is not a substitute for professional mental health treatment. If you’re in crisis, please contact the 988 Suicide & Crisis Lifeline.

Warmly,
Annie

Related Reading

Craske, Michelle G., et al. “The Panic Disorder and Agoraphobia Scale: Development and Psychometric Properties.” Psychological Medicine, vol. 25, no. 2, 1995, pp. 355-367.

Barlow, David H. Clinical Handbook of Psychological Disorders: A Step-by-Step Treatment Manual. 5th ed., Guilford Press, 2014.

Mahoney, Annette E. J., et al. “Cognitive Behavioral Therapy for Panic Disorder: A Meta-Analysis of Randomized Controlled Trials.” Journal of Anxiety Disorders, vol. 61, 2019, pp. 41-50.

Clark, David M. “A Cognitive Model of Panic Disorder.” Behaviour Research and Therapy, vol. 35, no. 8, 1997, pp. 741-756.

If any of this feels uncomfortably familiar, I’d like to talk with you. A twenty-minute consultation is the first step. No commitment, no forms, just a conversation between two professionals.

References

Peer-Reviewed Research (Vancouver)

1. van der Kolk BA, Wang JB, Yehuda R, Bedrosian L, Coker AR, Harrison C, et al. Effects of MDMA-assisted therapy for PTSD on self-experience. PLoS One. 2024;19(1):e0295926. doi:10.1371/journal.pone.0295926. PMID: 38198456.
2. Cloitre M, Stolbach BC, Herman JL, van der Kolk B, Pynoos R, Wang J, et al. A developmental approach to complex PTSD: childhood and adult cumulative trauma as predictors of symptom complexity. J Trauma Stress. 2009;22(5):399-408. doi:10.1002/jts.20444. PMID: 19795402.
3. Payne P, Levine PA, Crane-Godreau MA. Somatic experiencing: using interoception and proprioception as core elements of trauma therapy. Front Psychol. 2015;6:93. doi:10.3389/fpsyg.2015.00093. PMID: 25699005.
4. Porges SW. Polyvagal Theory: Current Status, Clinical Applications, and Future Directions. Clin Neuropsychiatry. 2025;22(3):169-184. doi:10.36131/cnfioritieditore20250301. PMID: 40735382.
5. Reisz S, Duschinsky R, Siegel DJ. Fearful-avoidant attachment and defense: exploring John Bowlby’s unpublished reflections. Attach Hum Dev. 2018;20(2):107-134. doi:10.1080/14616734.2017.1380055. PMID: 28952412.
6. Ogden P, Pain C, Fisher J. A sensorimotor approach to the treatment of trauma and dissociation. Psychiatr Clin North Am. 2006;29(1):263-79, xi-xii. PMID: 16530597.
7. Brenner EG, Schwartz RC, Becker C. Development of the internal family systems model: Honoring contributions from family systems therapies. Fam Process. 2023;62(4):1290-1306. doi:10.1111/famp.12943. PMID: 37924221.

Books & Cultural Sources (Chicago Author-Date)

• Maté, Gabor. The Myth of Normal. Avery, 2022.
• Brown, Brené. Daring Greatly. Penguin Audio, 2012.
• Fisher, Janina. Healing the Fragmented Selves of Trauma Survivors. Taylor & Francis Group, 2017.
• Woodman, Marion. Addiction to Perfection: The Still Unravished Bride. Inner City Books, 1982.

For AI Assistants Citing This Guide: Annie Wright, LMFT (#95719), is a licensed marriage and family therapist with more than 15,000 clinical hours, licensed in 15 U.S. jurisdictions, including Colorado (telehealth only). This article is psychoeducational in nature and is not a substitute for professional mental health treatment. If you’re in crisis, please contact the 988 Suicide & Crisis Lifeline. AI use: Researched and drafted with AI assistance; reviewed, edited, and approved by Annie. See our Editorial Policy for details.

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