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, and has severe symptoms that disrupt whatever the person was doing at that moment.

Symptoms of a panic attack

In addition to experiencing a sudden rush of anxiety or fear, a person having a panic attack will have four or more of the following symptoms:

• shortness of breath or difficulty breathing normally

• heart palpitations or rapid heart rate

• a pounding or tight feeling in their chest

• trembling and shaking

• sweating

• nausea or stomach symptoms

• numbness or tingling

• feeling lightheaded

• feeling very hot or cold

• weakness or disorientation

• difficulty swallowing or a tight feeling in the throat

• belief or fear that they are dying, or are having a medical emergency such as a heart attack

• fear of not being able to calm down or of losing control.

Someone having a panic attack can become caught in a cycle: the fear they experience during a panic attack could increase their anxiety, which might increase the severity or length of their 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?

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

However, everyone experiences panic attacks differently, and some people’s symptoms are more pronounced than others’.

In some cases, or during a particularly severe panic attack, the person may appear to be experiencing 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 have ever had a panic attack. If they can’t respond and you can’t confirm they’re having a panic attack and that it’s not a medical emergency, 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 is no simple 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:

• feeling particularly stressed, either mentally or emotionally

• 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).

You can learn more about what causes panic attacks here.

How to calm down from a panic attack

There are a few common strategies for managing a panic attack, and things you can do immediately to help calm you down during an attack.

• Remind yourself that the symptoms will pass.

• Breathe deeply and slowly to help reduce hyperventilation (which causes the feelings of lightheadedness and chest tightness). Or you could try a breathing exercise like 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 during a panic attack and bring you back to the present moment. While breathing deeply, name three things you can see, 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, then stretch out your fingers.

• Distract yourself in a way that shifts your focus away from the panic attack. For example, read something on your phone, watch TV, scroll through TikTok, or talk to someone. Whatever it is, try to immerse yourself in it so that you completely focus on that thing.

• Some relaxation techniques can help you to 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 practise, the easier it becomes.

You can find more tips to help cope with stress, anxiety and panic attacks here.

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 these types of disorders. 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. Living with a panic disorder may involve worrying about future panic attacks and changing your behaviour as a result.

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: This is common across a number of types of anxiety, but with a panic disorder it specifically relates to a near-constant fear of having a future panic attack. If you experience this, you’ll feel anxious and tense about the idea of having a panic attack, even when you aren’t actually having one.

• Phobic avoidance: This is when someone compulsively avoids specific places or situations and experiences fear and other anxiety symptoms when they think about entering that situation. It can be experienced with several different types of anxiety, but if it’s experienced because of a panic disorder, it’s 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. Phobic avoidance has the potential to develop into agoraphobia.

These symptoms have the ability to severely disrupt your everyday life and can be debilitating and isolating. The best thing to do if you are experiencing these symptoms or suspect that you have a panic disorder is to visit a GP to discuss your concerns.

Panic attack treatment options

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

There are various types of mental health professionals who can help, including psychologists, psychiatrists, counsellors, social workers, peer workers and youth workers.

A mental health professional can work with you to help provide evidence-based treatment to manage panic attacks. They will help you learn 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 taken in combination with psychological treatment and self-help strategies. However, while medication is effective for some people who experience anxiety and panic attacks, not everyone needs it. Your GP or psychiatrist will be able to help you decide if medication is the right choice for you.

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