Impermanence and panic: What to do When It Feels LIke it will never End

Panic attacks can be intense and distressing. Thankfully, they also respond to treatment.

Here is one of the cruelest things a panic attack does to you: it convinces you that it is permanent.

Your heart is hammering. You can’t get a full breath. Your hands are tingling, your chest is tight, your brain is screaming DANGER DANGER DANGER in every direction at once — and somewhere underneath all of that, a very loud voice is saying: This is never going to stop.

That voice is lying to you. Buddhist psychology has known this for over two thousand years. And today we’re going to talk about why that matters — practically, in the middle of your actual panic attack, not just philosophically from a comfortable distance. As a Maryland anxiety therapist, I see every week how people can find their way out of panic and distress.

This post is part of an ongoing series on what Buddhist psychological concepts can teach us about anxiety and anxiety therapy. If you’re just joining us, you might want to start with the overview post on Buddhist psychology and anxiety, or the post on the second arrow. But you’re also welcome to start here. We’ll catch you up as we go.

First, a word about panic attacks

Before we get to the Buddhist psychology piece, let me say a quick word, because panic attacks are their own particular beast within the broader anxiety family.

Panic attacks are intense, sudden surges of fear accompanied by a cascade of physical symptoms — racing or pounding heart, shortness of breath, dizziness, tingling in the hands or feet, chest tightness, a sense of unreality, or a terrifying feeling that you are losing control or dying. If you’ve had one, you know: they are not subtle. They are loud and physical and all-consuming in a way that garden-variety anxiety often isn’t. (I wrote a longer post on understanding and coping with panic attacks if you want to go deeper on the basics.)

One of the most important things to understand about panic attacks is that they are, at their physiological core, a false alarm. Your threat-detection system — the amygdala, the fight-or-flight response — has fired as though you are in immediate danger, even when you aren’t. The symptoms are real. The perceived danger is not.

Which brings us to the second important thing: panic attacks end. They always do. The average panic attack peaks within about ten minutes and typically subsides within twenty to thirty. This is not a forever event. It is a weather system, and it passes.

This is exactly where impermanence comes in.

Anicca (Impermance): Let’s get into it

In Buddhist psychology, anicca is the teaching of impermanence. Everything that arises also passes. Everything that begins also ends. This is not pessimism; it’s an observation about the nature of reality that applies to pleasant experiences just as much as unpleasant ones.

In the overview post, I introduced anicca with this framing: “This too shall pass” is not a platitude. It is an observable fact. I believe that. And I want to go much deeper here on what it actually means to use that observable fact when you are in the thick of a panic attack and your nervous system is insisting otherwise.

Because here’s the thing: intellectually knowing that panic attacks are temporary is different from being able to access that knowledge when you’re actively in one. The panic brain is not in a very receptive state for calm philosophical reflection. So we need to make impermanence more than an idea. We need to make it a felt, practiced, embodied knowing.

Why Panic Feels Like Forever (brain geek detour here)

Here’s what’s happening in your nervous system during a panic attack that makes impermanence so hard to access: when your amygdala fires the alarm, it essentially drowns out the prefrontal cortex (the part of your brain responsible for logical reasoning, perspective-taking, and remembering things like “I’ve survived every panic attack I’ve ever had.”)

In a very real neurological sense, the panic brain cannot easily access past experience to remind itself that this has always ended before. It is stuck in a hyper-present, hyper-threat state where NOW feels like ALWAYS.

This is also why the techniques that help with panic are physical and grounding first, cognitive second. You can’t think your way out of an activated amygdala. It doesn’t speak the language of logic. You have to work with the body to start calming the nervous system enough that the prefrontal cortex can come back online. Then the cognitive piece (like “this is impermanent”) can actually land.

So yes: anicca is a cognitive reframe. But it works best when we pair it with some embodied practice that helps get us there.

Anicca As a Practical Tool during panic: 3 ways in

Waves are always in motion. We can watch the waves within and ride out intense ones.

1. Name the wave

Panic, like all emotions, moves in a wave. It rises, it crests, it recedes. Waves don’t last forever. Even the biggest ones break.

When you’re in the middle of a panic attack, one of the most useful things you can do is name what’s happening as a wave rather than a flood. Try something like:

“This is the wave rising. I’m near the crest. It’s going to start receding.”

Or simpler: “Wave. This is a wave.”

This isn’t toxic positivity. You’re not pretending it doesn’t hurt. You’re orienting yourself to the shape of what’s happening — and the shape includes an ending. This connects to a mindfulness practice called noting, where you observe and label your experience rather than being swept away by it. When you name the wave, you activate the prefrontal cortex. You create a tiny bit of breathing room between you and the experience. And in that breathing room, anicca becomes accessible.

2. Look for evidence of change

Buddhist teachers often point out that impermanence isn’t just a theory. It’s something we can observe directly. Your anxiety is not static. It is constantly in flux. Even at its most intense, it is changing moment to moment.

Here’s a small experiment to try the next time you feel anxiety or panic rising: instead of trying to make the feeling stop, get genuinely curious about it. Notice how it moves. Is it more intense in your chest or your throat? Does it move around? Does it ebb even slightly between one breath and the next?

You’re not trying to analyze yourself out of the experience. You’re practicing noticing impermanence in real time. What many people find, when they start paying attention this way, is that the experience is actually less monolithic than it felt, more like a collection of sensations, all of them in motion, none of them perfectly still.

3. Recall your evidence

This one requires some prep work, which I’ll come back to. But the basic idea is this: you have survived every panic attack you have ever had. That is not a small thing. That is a track record.

When the panic brain insists this is forever, you can respond — not by arguing with it, but by gently presenting evidence:

“I know it feels like this is permanent. I’ve felt this way before. It passed before. My nervous system knows how to come back down.”

This is not the same as dismissing what you’re feeling. It is calling on your own personal history with impermanence. You have already lived it. You already know it’s true. You’re just helping your nervous system remember.

Practice this before you need it

Sadly, none of these tools are at their most effective if you’re meeting them for the first time in the middle of a panic attack. Your brain loves to default to familiar, practiced pathways, especially under stress. If “wave, this is a wave” is a new thought you’ve never practiced before, it’s going to be a lot harder to access when your amygdala has the microphone.

So the goal is to practice working with impermanence before you need it in crisis. Kinda like how you want to practice a whole lot of free throws before you’re trying to make that winning shot at the end of the championship basketball game. Some ways to practice (basketballs not required):

Meditate on impermanence in low-stakes moments. When you’re washing dishes, sitting in traffic, or just having a quiet moment, practice noticing how your experience is always in flux. Sensations arising, shifting, fading. Thoughts appearing and dissolving.

Work with smaller anxieties first. The next time you feel a mild flutter of anxiety, practice naming it as a wave. Notice how it moves. Notice that it changes. Build the felt sense of impermanence at a lower intensity so it’s more available at higher ones.

Keep a brief log of “it passed” moments. This sounds almost embarrassingly simple, but it is genuinely useful. After a hard moment of anxiety passes, take thirty seconds and write down: I felt [X]. It passed. Over time, this becomes your personal evidence base for impermanence. When the panic brain says never, you have a list that says actually, always.

‍ In the middle of a panic attack? Press PAUSE and use these skills.

Immediate help for panic attacks

Let me bring this all together into something you can actually use if you’re in the middle of acute anxiety or panic:

First: Name what’s happening. “This is a panic attack. I know what this is.” Labeling activates the prefrontal cortex and starts to turn down the alarm. You’re not in danger. Your nervous system has misfired. You know what this is.

Second: Work with the body. Slow, deep breaths — four-count inhale, hold, four-count exhale — help activate the parasympathetic nervous system. Grounding techniques like the 5-4-3-2-1 sensory scan (5 things you can see, 4 things you can hear, 3 things you can feel, 2 things you can smell, 1 thing you can taste) also help bring you back into your body and out of the spiral.

Third: Bring in impermanence. Once you’ve taken even a few breaths and named what’s happening, try orienting to impermanence. “This is a wave. It is already moving. It will pass.” Or even shorter: “This passes.” Just a word or phrase that points your attention toward the truth your nervous system needs to hear.

Fourth: Watch for the second arrow. As the panic peaks and begins to recede, your inner critic may show up Why am I like this? When will I ever get this under control? This is the second arrow, and it’s worth recognizing it for what it is: not helpful accountability, but an additional wound on top of an already hard experience. Let it pass too. It’s also impermanent.

The double edge of impermanence

A little moment of caution here, because impermanence is a teaching that cuts both ways.

Yes, it means panic attacks pass. Hard feelings pass. This acute suffering you’re in right now will not last forever.

But it also means good things pass. Comfort is impermanent. Safety is impermanent. Pleasant states are impermanent too.

Anxiety often responds to this realization by gripping harder. See? I KNEW I couldn’t trust good feelings. I need to hold on tight and never let go.

This is clinging (what Buddhist psychology calls tanha) and what I wrote about in the overview post as one of the main engines keeping anxiety going. The antidote isn’t to be nihilistic about impermanence, but to develop what Buddhist teachers call equanimity: a kind of steady, grounded presence that can be with whatever is arising without needing to either grip it or push it away.

That’s a bigger practice, and truly the work of a lifetime, not a blog post. But it starts here: with learning to trust that this moment, including this hard moment, is moving. It is not forever. And you can be with it.

When insight isn’t enough

If you are experiencing frequent, severe panic attacks, Buddhist philosophy is a wonderful complement to treatment. But it is not a substitute for it.

Panic disorder responds very well to therapy, particularly approaches that combine cognitive-behavioral skills with mindfulness-based tools. If panic attacks are running your life — if you’re avoiding places, canceling plans, living in dread of the next one — that’s exactly the kind of thing anxiety treatment is designed to help with. You don’t have to white-knuckle this alone.

Bringing this all back around

Panic’s loudest lie is that it is permanent. And impermanence (anicca, this 2,500-year-old observation about the nature of all experience) is one of the most direct answers to that lie.

This too shall pass. Not as a platitude. As a fact. As something you have already lived, every time you’ve come out the other side of a hard moment.

The wave rises. The wave crests. The wave recedes.

It always has. It always will.

ready to work with a maryland anxiety therapist?

I offer specialized anxiety therapy in College Park, MD, and online throughout Maryland. My approach is warm but direct, practical, and integrates both evidence-based Western therapies and mindfulness-based approaches (including the Buddhist psychological concepts we’ve been exploring here, if you’re down for that). If panic attacks are part of your life and you’d like to change that, I’d love to connect. You can contact me to set up a free 15-minute consultation call to see if we’d be a good fit to work together.

Other services I offer include hypnotherapy, mindfulness-based therapy, life coaching, and support for LGBTQIA+ clients. Additional information is available on my home page.

About the author:

Beth Charbonneau, LCSW-C, is a Maryland therapist, specializing in anxiety therapy and treatment. With over 20 years of experience, she brings a holistic approach to calming the mind and body, and encourages her clients to feel empowered to find more joy in life. More information about her practice can be found on her website.