Everything you need to know about panic attacks

What is a panic attack?

A panic attack is a sudden, intense episode of fear or anxiety. Panic attacks can be pretty scary, and the symptoms can disrupt you from whatever you’re doing at that moment.

Symptoms of a panic attack

On top of a sudden rush of anxiety or fear, a panic attack will involve four or more of the following symptoms:

• shortness of breath or difficulty breathing normally

• a pounding heart or a tight feeling in their chest, which can be confused with a heart attack

• sweating or shaking

• nausea or stomach symptoms

• numbness or tingling

• feeling lightheaded, weak or disoriented

• feeling very hot or cold

• difficulty swallowing or a tight feeling in the throat.

When you’re having a panic attack, you might also get scared that you won’t calm down. You might lose control or die. It can become a cycle: the extra fear increases your anxiety, which then increases the severity or length of your symptoms. This means it’s important to try to interrupt the cycle of the panic attack to help lessen the symptoms.

What do panic attacks look like?

Everyone experiences panic attacks differently, and some people’s symptoms are more noticeable than others.

Panic attacks are usually recognisable from the sudden physical symptoms that someone begins to experience, often without warning.

But sometimes, it can look like the person is having a medical emergency, such as a heart attack. The best thing to do is to ask them if they know what is happening and if they’ve ever had a panic attack. If they can’t respond and you can’t confirm what’s going on, it’s important to call 000. Other people may have symptoms during a panic attack that feel extreme to them but don’t seem so severe to the people around them. Some people also try to hide the fact that they’re experiencing a panic attack. They may be quiet, look pale or sweaty, or have difficulty answering questions or speaking coherently.

What causes panic attacks?

Panic is our body and brain’s response to a real or perceived fear or threat. During a panic attack, the amygdala (a key part of your brain that processes emotions) may become hyperactive and cause confusion about what is a real threat and what isn’t.

Unfortunately, there’s no one-size-fits-all cause of panic attacks. They can be brought on by increased stress or by distressing thoughts, or there may be no specific trigger or obvious reason at all.

Common causes of a panic attack can include:

• becoming overwhelmed by your current commitments or expectations

• being back in a place where you’ve previously had a panic attack

• remembering or reliving a past traumatic experience.

Other factors may also play a role in causing panic attacks. These include:

• genetics

• lifestyle

• having a diagnosed anxiety or panic disorder, or depression (but having a panic attack doesn’t necessarily mean the person has a mental illness)

• personality traits (e.g. being a very sensitive person or someone who worries all the time).

Read more about what causes panic attacks.

How to calm down from a panic attack

It can be hard when you’re panicking, but remind yourself that your symptoms will pass. These are some things you can do immediately to help you calm down during an attack.

• Breathe deeply and slowly. Or try the 4-7-8 breathing technique: breathe in for 4 seconds, hold your breath for 7 seconds, then exhale for 8 seconds. Repeat this as many times as you need until your anxiety symptoms lessen.

• Use the 3-3-3 technique to interrupt your racing thoughts and bring you back to the present moment. While breathing deeply, name three things you can see and then three sounds you can hear. Then, one by one, move three different parts of your body – for example, touch your nose, roll your neck in a slow circle, and then stretch out your fingers.

• Distract your focus from the panic attack, and try to immerse yourself in something else. For example, read something on your phone, watch TV, or talk to someone.

• Some relaxation techniques can also help you relax during a panic attack. Practising them regularly can also help you to become less prone to panic attacks.

When you first start experiencing panic attacks, it can be tricky to put some of these strategies into place, but the more you practice, the easier it becomes

Find more tips to help cope with stress, anxiety and panic attacks.

What is a panic disorder?

While having a panic attack doesn’t necessarily mean you definitely have a panic disorder, if you experience them regularly, you might develop this type of disorder. So, it’s a good idea to seek advice from a GP for treatment.

Common signs of a panic disorder

A panic disorder is characterised by repeated and unexpected panic attacks that severely disrupt the person’s life.

You could be experiencing a panic disorder if you:

• have frequent, unexpected panic attacks that don’t have an obvious trigger

• worry about having another panic attack

• act differently because of the panic attacks – for example, you avoid places where you’ve previously had a panic attack.

Long-term effects and symptoms of panic disorders

If you have a panic disorder, experiencing recurring panic attacks can take a heavy toll on your mind and body.

Someone with a panic disorder may display some of the following symptoms:

• Anticipatory anxiety: If you experience this, you’ll feel anxious and tense about the idea of having a panic attack, even when you aren’t having one.

• Phobic avoidance: This is when you avoid a place or situation because it caused you to have a panic attack in the past.

It can also extend to avoiding places and situations solely because it would be difficult to get help if you did have a panic attack.

It can be challenging to go about your daily life when you have a panic disorder, and it can leave you feeling isolated. The best thing to do if you are experiencing these symptoms or suspect that you have a panic disorder is to visit a GP. They’ll be able to set you on a path to getting the right support.

Panic attack treatment options

If you experience panic attacks, the best thing to do is seek professional help.

Various types of mental health professionals can help, including psychologists, psychiatrists, counsellors, social workers, peer workers and youth workers. Your GP will help you figure out which one is right for you.

These professionals work with you to provide treatment for panic attacks, which includes learning how to intervene in the panic cycle and manage the symptoms.

Everyone is unique, and different treatments work differently for different people, but cognitive behavioural therapy (CBT) is generally considered the most effective treatment for panic attacks and anxiety disorders.

Medication is also known to be effective when combined with psychological treatment and self-help strategies, though not everyone needs it. Your GP or psychiatrist will help you decide if medication is right for you.

Read more about the treatment options for panic attacks, panic disorders and anxiety.

Want to know more about managing panic attacks? For answers to your questions, Ask ReachOut.