What Is a Panic Attack? Symptoms, Causes and What You Can Do
A panic attack can feel intensely physical, frightening and difficult to make sense of. Understanding what may be happening in your body and mind can make the experience feel a little less mysterious.
What is a panic attack?
A panic attack is a sudden surge of intense fear or discomfort that can bring both mental and physical symptoms. Your heart may race, your breathing may change, you may feel dizzy or disconnected from your surroundings and your mind can jump quickly to thoughts such as, “I’m going to faint,” “I’m losing control” or “Something terrible is happening.”
One of the confusing things about panic is that the intensity of the reaction may not match what is happening around you. Panic attacks can happen during stressful situations, but they can also appear without an obvious trigger.
Having a panic attack does not automatically mean you have panic disorder. Some people experience one or occasional panic attacks without developing an ongoing condition.
What does a panic attack feel like?
There is no single version of a panic attack. One person may notice their heartbeat first, while someone else becomes lightheaded, nauseous or overwhelmed by a sudden feeling of dread. Symptoms can also vary from one panic attack to another.
Common symptoms can include a racing or pounding heartbeat, sweating, trembling, shortness of breath, chest discomfort, nausea, dizziness, feeling faint, chills or hot flushes, numbness or tingling and a choking sensation.
The sensations themselves can then become part of the fear. You notice your heart beating faster, become frightened by the heartbeat, your fear increases and your physical reaction becomes even stronger.
What happens in your body during a panic attack?
One way to understand panic is to think about the body’s alarm system. When your brain believes there may be danger, your body prepares to respond quickly. Your heart rate can increase, your breathing may become faster, your muscles can tense and your attention may narrow towards whatever seems threatening.
Those reactions can be useful when there is an actual danger in front of you. During a panic attack, however, a similar alarm response can happen when there is no immediate threat that requires that level of reaction.
That is part of why panic can feel so physical. It is not simply a case of “thinking too much”. Your body is involved in the response too.
How long does a panic attack last?
Panic attacks usually develop quickly. The strongest part of the attack often happens relatively early, although the overall experience can last longer and the exact length varies between people.
Even when the most intense wave begins to settle, your body may not immediately feel normal again. You might still feel tired, shaky, emotional or unusually aware of your heartbeat, breathing or other physical sensations.
For some people, what happens after the attack becomes part of the pattern too. You may replay the experience, check your body for signs that another attack is starting or become worried about when the next one might happen.
Why do panic attacks happen?
There is not one single reason why panic attacks happen. Several factors may be involved, including stress, genetics, the way the nervous system responds to fear, physical sensations and the way those sensations are interpreted.
Sometimes the context seems obvious. You may have been under a lot of pressure, sleeping badly, experiencing a major life change or already feeling particularly anxious. At other times, the attack can seem to come completely out of nowhere.
Instead of searching for one perfect explanation, it can sometimes be more useful to look for patterns. What happened beforehand? What did you notice in your body first? What thoughts appeared? What did you do next?
Can panic attacks happen without a trigger?
Yes. A panic attack can happen without an obvious external trigger. You might be doing something completely ordinary when the symptoms begin, which can make the experience even more confusing.
That does not always mean there was no context at all. Sometimes the starting point is subtle or internal. You might notice your heartbeat after walking quickly, feel lightheaded because you have not eaten enough or become aware of an unfamiliar physical sensation while trying to fall asleep.
If that sensation is interpreted as dangerous, fear can escalate quickly.
What is the difference between a panic attack and panic disorder?
Having one panic attack does not automatically mean you have panic disorder.
Panic disorder generally involves repeated unexpected panic attacks together with ongoing worry about having another attack, concern about what those attacks mean or changes in behaviour designed to avoid another one. A qualified healthcare professional can assess whether someone’s experiences meet the criteria for panic disorder.
That distinction matters because an individual panic attack and panic disorder are not the same thing.
What can you do during a panic attack?
There is no single coping technique that works for everyone. For some people, slowing their breathing can help reduce the sense of urgency. Others find grounding techniques more useful, such as deliberately noticing what they can see, hear or physically feel around them.
Feeling your feet against the floor, holding a cool object, describing objects in the room or repeating a familiar sentence can sometimes help bring attention back to the present moment.
The useful question is not necessarily, “Which technique is supposed to work?” A better question may be, “What helps me stay with this moment without adding more fear to what my body is already doing?”
What happens after a panic attack?
After a panic attack, you may feel exhausted, emotional, embarrassed, frustrated or unusually sensitive to physical sensations. You might also start worrying about another attack happening.
That fear can gradually influence your behaviour. Someone may avoid the shop where their panic attack happened, stop using public transport, avoid driving or feel increasingly uncomfortable being alone.
If you notice your life becoming smaller because you are organising more and more of it around avoiding another panic attack, that is worth paying attention to.
When should you talk to a healthcare professional?
If panic attacks keep happening, you spend a lot of time worrying about having another one or you are beginning to avoid situations because of panic, speaking with a healthcare professional is a sensible next step.
They can discuss what you are experiencing, consider whether another physical or mental health condition could be contributing and talk through possible treatment options when appropriate.
If you believe you may be experiencing a medical emergency, contact emergency services.
Understanding panic can change the way you respond to it
One of the hardest things about a panic attack is how convincing it can feel. Your body reacts and your mind immediately tries to explain why. In that moment, it can be difficult to remember that an intense sensation does not automatically mean that you are in immediate danger.
Learning more about your own panic pattern can give you something more specific to work with. You can begin noticing what tends to happen before an attack, which sensations frighten you most, which thoughts appear automatically and what you usually do next.
Panic disorder can be treated, and talking therapies such as cognitive behavioural therapy are commonly used. Medication may also be considered in some situations with a healthcare professional.