The Night My Heart Raced

Arjun, twenty-nine, was in a crowded Mumbai local train when his heart suddenly pounded, his hands tingled, his chest tightened and he felt sure he was dying. He got off at the next station and sat on the platform, shaki…

Arjun, twenty-nine, was in a crowded Mumbai local train when his heart suddenly pounded, his hands tingled, his chest tightened and he felt sure he was dying. He got off at the next station and sat on the platform, shaking. Doctors at the hospital did tests and found his heart was healthy.

Two weeks later it happened again, at home. Now Arjun lives in fear of the next attack. He avoids trains, then lifts, then crowded markets, and finally he starts refusing to leave the house without his brother. His world is shrinking, and he is ashamed of it.

His brother takes him to a psychologist who explains that these sudden waves are panic attacks: the body's alarm going off without real danger. They peak within minutes and then fall, though they feel terrifying. The fear of fear, and avoiding places, keeps the cycle alive. Arjun learns slow breathing, how to ride out a wave without running, and a step-by-step plan to return to the train, starting with one station. After some weeks he travels alone again. "The attacks did not kill me," he says. "Hiding from them nearly did."

Looking back, Arjun says the hardest part was the shame. Once he told his family honestly what was happening, they stopped guessing and started helping, and he no longer felt he was facing it alone.

How to recognise it

• Sudden surges of fear with pounding heart, breathlessness, dizziness, shaking or a sense of doom.

• The peak lasts minutes, but worry about another attack lingers for weeks.

• Medical checks find no heart or lung cause.

• Avoiding places where escape feels hard, such as trains, crowds or being alone.

• Life steadily narrowing because of avoidance.

What this story explains

This story shows panic disorder and agoraphobia, and the anxiety cycle where fear of the body's signals and avoidance keep the problem going.

Probable root causes

• A sensitive alarm system in the brain, sometimes running in families.

• Ongoing stress, poor sleep or too much caffeine.

• Misreading normal body sensations as danger.

• Avoidance that teaches the brain the places are unsafe.

• Earlier frightening experiences or a major life strain.

What to do

1. First get a medical check to rule out physical causes, then trust the result.

2. Stay where you are during an attack and breathe out slowly, longer than you breathe in.

3. Remind yourself: 'This is a panic wave. It will pass.'

4. Ground yourself by naming five things you can see.

5. Make a small ladder of avoided places and practise them step by step.

6. Reduce caffeine and keep regular sleep.

Whom to consult

• Family doctor to check heart, thyroid and other causes after the first attack.

• Clinical psychologist for talking therapy that treats panic well.

• Psychiatrist if attacks are frequent, severe or the person is housebound; in the case of chest pain that feels different or any emergency, go to the nearest hospital.

Do and don’t

How to behave and communicate

• Use a steady, quiet voice: "I am here. This will pass. Breathe out slowly with me."

• Do not argue about whether the fear is rational.

• Stay with them through the wave without crowding them.

• Afterwards ask: "What helped most just now?"

• Be consistent and patient across weeks.