I’ve lived with panic attacks for five years now. I’ve had so many panic attacks, I’ve stopped counting. Memories of my worst attacks stick in my mind like bad nightmares. The time I was house-sitting for my friend. The countless attacks in my college dorm room. I will never forget them. When I have panic attacks, I have the symptoms everyone always mentions. These are the symptoms you can quickly find with a Google search of “What is a panic attack?” The rapid, pounding heartbeat that feels like a giant bird is stuck in my chest, the sweaty palms, the nausea and the trembling. These are the terrifying physical symptoms of panic attacks, and chances are most people can say they’ve experienced something close to this at least once in their life. Panic attacks are more than a sudden feeling ofanxiety. They’re much more than the feeling you get when someone scares you and you say without thinking, “You almost gave me a panic attack!” Panic attacks can be incredibly traumatic experiences that happen over and over. What people don’t realize is the physical experience of panic attacks isn’t always the worst part. There are some pretty terrifying things that can go on inside your head. Some of my worst panic attacks involve two symptoms no one really talks about when they talk about panic disorder: derealization and depersonalization. Derealization is a fancy word for feeling like you are detached from your surroundings. When I experience this during panic attacks, everything around me feels unfamiliar. I could be in my bedroom, surrounded by things I’ve seen many times, like my cat, my bed or my clothes. Yet, I feel like I’m in a strange world. I feel like an alien who was beamed down into a random house. Not only this, but things around me appear foggy and fake. Becoming detached like this is terrifying. My brain is doing something incredibly strange I don’t understand and I’m stuck in my body, trying to make sense of it. During panic attacks, I need something to hold onto that I can rely on. The familiar is what I crave, but my mind makes seeing the familiar difficult. The people I love feel like strangers to me during panic attacks. It’s because of derealization that I worry about traveling to unfamiliar places. I love traveling, but the fear of unraveling can be enough to hold me back. Depersonalization is a completely different sensation than derealization. Sometimes, the two happen at the same time. Depersonalization is the “out of body” experience. I feel detached from myself, like I’m looking at myself from afar. It’s tough to remember what’s important to me during this experience. I’m just going through the motions with no purpose. Panic attacks leave me exhausted and searching for reminders of who I am and what makes me feel comfortable in my skin. A panic attack like this is a journey to find myself again. When I have them frequently, it’s like I’m constantly having to affirm who I am. For me, depersonalization and derealization are the most terrifying sensations because I know they are coming from my brain instead of my body. They’re the symptoms no one else can see and this makes them even scarier. Both sensations are met with this overwhelming feeling of going “crazy” and losing control over everything. Sometimes, I have a strange feeling that the entirety of the world’s problems, the news stories I hear daily, are on my shoulders. My panic attacks have themes like this. This feeling and the fear of going “crazy” make the panicking worse. I fall into a terrible cycle of panic that makes it hard to stop. I wish people understood panic attacks aren’t always just a pounding heart. They aren’t always a prolonging of that startled feeling when someone spooks you. The solution isn’t always to relax and breathe slowly. Sometimes, it is to hold on for dear life to what you know is real and remind yourself the people and things around you are familiar. It means trying not to freak out even more and wait patiently until the sensations pass, even though you want to scream and cry. During panic attacks, the body is doing what it knows to do when afraid and this can mean disconnecting from the world for a little while. I like to remind myself of this because it makes the panic attacks feel controllable. The body is doing what it needs to do. Panic attacks are a delicate dance between reality and fantasy. Although depersonalization and derealization are terrifying, I know they will pass. I know I will eventually get back to who I am and the people I love. My panic attacks can feel like a long and treacherous journey back to normalcy. Although I might feel “crazy” and out of control for a little while, the journey has a finish line. I try to remind myself of this when my heart starts pounding.