In , a person worries a terrible situation will develop.

In panic, a person believes a terrible situation exists. They are in it, and they can't escape.

Anxiety can persist even when the feared situation is not likely to take place. If the person imagines what it would be like if the event were taking place, the amygdala—the part of the brain that releases —reacts. It releases stress hormones which cause alarm. In most people, alarm is quickly and automatically down-regulated to interest. The shift from alarm to interest allows the person to examine what is feared, recognize the feared event is unlikely, and lose interest in it.

But something else happens if a person lacks automatic down-regulation. The feeling of alarm continues. People sometimes say they have a vivid imagination. The continued alarm makes the imagination vivid. Since what is imagined feels so real, the person expects the terrible outcome to take place.

Panic takes vivid imagination one step further. Instead of believing the terrible outcome is about to take place, the person believes it is taking place, and that there is nothing the person can do to escape.

Thus, once in panic, there is little if anything a person can do: The answer is prevention. Panic can be prevented by training the mind to automatically down-regulate feelings of alarm to feelings of interest. A method to establish automatic down-regulation is detailed in my recently published book Panic Free: The 10-Day Program to End Panic, Anxiety, and Claustrophobia.