When do you need urgent help?
Call local emergency services for sudden crushing chest pain, severe difficulty breathing, loss of consciousness with ongoing symptoms or sudden trouble speaking. Chest pain and severe breathlessness during pregnancy or after childbirth also need urgent care. Seek medical assessment for a first or noticeably different episode.
What can panic attacks feel like in women?
Your heart suddenly races on the tram. A few minutes later it settles, but you are still listening to your body and wondering whether to keep going.
- Your heart races, your hands shake or you break into a sweat.
- You feel short of breath, dizzy or suddenly hot.
- A wave of fear comes on suddenly; you want to leave or call someone.
Yav in the institute’s framework means what is happening now: sensations, circumstances and how the episode affected your day. Discuss repeated episodes and fear of another attack with a doctor.
Can hormones play a role?
Some women feel more anxious before a period. If this repeats and eases after your period starts, make a note of the pattern and discuss it with a doctor. Record anxiety on other days as well.
Hot flushes, night sweats and changes in your periods can accompany perimenopause. After childbirth, tell your clinician when episodes began, how you are sleeping and how much anxiety disrupts daily life. One situation cannot establish a link to hormonal changes.
What should you note and discuss with a doctor?
- Record the date, duration, symptoms and day of your cycle. Count the first day of bleeding as day one.
- Note sleep, hot flushes, caffeine and recent changes in medicines, supplements or contraception. A first entry could read: “Three days before my period, after a poor night’s sleep, my heart raced for about ten minutes.”
- Ask whether your heart rhythm or thyroid should be checked. Your clinician will decide if an ECG or tests make sense after taking your history and examining you. A standard hormone panel will not answer everyone’s questions.
Notes can help you spot a pattern. If symptoms interfere with life or change, seek advice without waiting to track several cycles.
Why can fear return?
You notice your heartbeat → think “something terrible is happening” → feel more frightened → want to check your pulse again and again. That is one way a fear cycle can develop.
Think of a sensitive alarm. The siren calls for attention, but its sound cannot tell you what set it off.
| Pressure | A more useful response |
|---|---|
| “It’s just hormones.” | Note when it happened and discuss any recurrence with a doctor. |
| “Pull yourself together. You’re fine.” | Ask what would help: staying nearby or calling for help. |
| “Figure out the cause right now.” | Once things feel calmer, describe one situation in your own words. |
Feeling frightened does not make you weak. You can go to an appointment with questions and without a ready explanation.
What can you explore in past experience?
Nav in Alexander Zharkov’s approach means past experience and learned rules, including those we pick up in our families. The institute uses the image of a breach in your boundaries for the feeling that someone else’s urgency or anxiety becomes yours and it is hard to ask for a pause.
- What was happening beforehand and what did I feel first?
- What was hard to let myself do: step out, pause a conversation or ask for help?
- Which rule did I hear in my head: “I must manage on my own” or “I must not hold anyone up”?
What can you do during a familiar episode?
During a familiar episode, follow the plan agreed with your clinician. If you are somewhere safe and can sit comfortably, try this short practice of noticing physical support.
- Place both feet on the floor and feel the seat supporting your weight.
- Rest your hands on your thighs. Let your breathing follow a comfortable rhythm without forcing it.
- Look at one nearby object and name its colour.
Stop if the exercise increases discomfort. For more steps, see the guide for a familiar panic attack.
How can you rebuild support in everyday life?
Prav in the institute’s framework is the direction of your next decisions. Once the immediate wave has passed, choose one action that would give you more support. The institute calls this energetic sovereignty: knowing what you are responsible for and where you can set a boundary.
- Choose someone you can say this to: “I need a moment. Please stay with me.”
- Leave one short break between meetings or tasks.
- Write down one question for your doctor and one boundary you want to set at home or at work.
The institute’s 40-day programme has six stages exploring attention to the body, emotions, thoughts and familiar patterns.
How can healthcare and work with Zhiva fit together?
| Format | What it addresses |
|---|---|
| Healthcare | Assessment of symptoms and possible causes, treatment and follow-up. |
| The institute’s consultation | A conversation about one life situation, learned rules and the next decision. |
Katerina’s personal account
Katerina recorded her 40-day programme review inside a car. She recalls feeling rushed in daily life and says that during the programme her thoughts became clearer and she could look for solutions more calmly. Her video covers her own experience and sleep; it does not discuss panic attacks.
Katerina, wearing a black jacket, records her video review of the 40-day programme inside a car.
Questions about cycles, episodes and support
Can panic attacks feel worse before a period?
Some women notice more anxiety before their period. If this repeats, note which days feel worse and when symptoms settle, then share the pattern with your doctor.
Can an episode happen at night during perimenopause?
Panic attacks can happen at night, and perimenopause can involve hot flushes and night sweats. If you wake for the first time with a racing heart or breathlessness, check the urgent warning signs and seek medical assessment.
Do I need hormone tests straight away?
First tell your doctor when the episodes began, what has changed in your cycle and which medicines or supplements you take. After taking your history and examining you, your doctor can decide what to check.
What can I bring to a personal consultation?
One recurring situation is enough, such as a difficult conversation that leaves you tense afterwards. Alexander Zharkov leads the consultation by text and it costs €30.
Where can you start exploring your situation?
If you want to explore one recurring situation after the immediate episode, start there. Quantum Diagnostics is an individual text consultation with Alexander Zharkov about past experience, present circumstances and a possible next step.
Individual text consultation · €30. Continuing a programme is optional.
How the personal consultation works