Panic attacks: signs, causes, and treatment

A panic attack feels like it comes out of nowhere. It’s sudden, unexpected, and fills you with an intense feeling of fear––sometimes without a clear trigger.

Panic attacks are paired with physical symptoms like heart palpitations, sweating, chills, lightheadedness, trouble breathing, and nausea (Cackovic, 2020). Some people describe feeling like they're having a heart attack or like they’re going to die. 

If you’ve ever had a panic attack, know that you’re not alone. Researchers estimate that one third of all people experience a panic attack at least once in their lifetime (Kessler, 2006).

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A panic attack is usually described as a sudden, intense fear not necessarily related to any particular trigger. Symptoms can last from a few minutes to an hour and can include: 

• Pounding or rapid heart rate

• Sweating or feeling hot

• Shaking or chills

• Numbness

• Dizziness or lightheadedness

• Nausea or upset stomach

• Chest pain

• Feeling like you can’t breathe

• Feeling like you’re being choked or smothered

• Feeling detached from yourself or reality 

• Fear of losing control, “going crazy,” or dying

The exact cause of panic attacks is still up for debate, but researchers have two theories.

One is some people have a buildup of serotonin, a chemical in the brain that regulates mood. This can lead the nervous system to perceive a threat where there is none. Another theory posits that low levels of chemicals called endorphins can trigger feelings that lead to panic attacks (Cackovic, 2020; Zagon, 2017).

Panic attacks are more common in people with depression. Females are also more likely than males to have panic disorder. Genetics seems to play a role as well. People with a close family member with panic disorder have a 40% chance of developing the condition (Cackovic, 2020). 

Some people have one or two panic attacks in their life, while others experience recurrent ones. Recurrent panic attacks, worries over having more panic attacks, and avoiding situations because of the risk of having one are all features of panic disorder (Chand, 2021). 

As with many mental health conditions, there are no lab tests to diagnose panic disorder. To diagnose it, a mental health professional will ask you a series of questions about your experiences with panic attacks, how frequently you have them, and whether they affect your ability to function on a daily basis.

They will likely perform a physical examination and perform tests to rule out any other underlying condition that might contribute. 

Since the symptoms of a panic attack often feel like a heart attack, visits to the emergency room are common. In fact, one of every 100 emergency room visits in the United States is someone in the throes of a panic attack.  

If you’ve had panic attacks before and can identify what’s happening in the middle of one, here are some tips and tricks you can use to stop attacks at home. 

1. Deep breathing. Regulating your breathing can be an effective way to slow your heart rate, catch your breath, and stop an attack. Slow, deep breaths can stimulate your parasympathetic nervous system, which is responsible for keeping your body relaxed (as opposed to the flight-or-fight response that's in high gear during a panic attack). It can lower blood pressure, slow your heart rate, and help stop an attack. 

2. Cognitive behavioral therapy (CBT). Treatment for panic disorder can include psychotherapy and medication. A specific type of therapy known as CBT is often recommended, as well as coping tools like deep breathing techniques. 

3. Antidepressants. Medication, specifically SSRIs (selective serotonin reuptake inhibitors), are commonly prescribed for panic disorder. These drugs take as long as six weeks to start working efficiently––for some people, this means anxiety gets worse before it gets better (Quagliato, 2018). 

4. Benzodiazepines. Sometimes an additional medication is added at the start of treatment until the other medication starts working (Cackovic, 2020). Benzodiazepines (like Xanax) work quickly to bring about feelings of calm and relax your muscles. However, these aren't for long-term use since they can be habit-forming and the effects dissipate with continued use (Chand, 2021). 

Panic attacks may be an occasional occurrence or a significant disruption in your life––even if they don’t happen often. If you’re experiencing panic attacks and are looking for ways to manage them, speak with a  healthcare provider about your symptoms. 

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Current version

July 29, 2021

Written by

Danielle Oaks

Fact checked by

Caitlin Knudsen, RN, BSN

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About the medical reviewer

Caitlin Knudsen, RN, BSN