Panic Attacks

Learn about the effects of panic attacks and what can be done to help treat someone who is having a panic attack.

Panic attacks are episodes of severe fear that can be unexpected and debilitating. Many people who have a panic attack will have one or two in their life and never experience any more panic attacks. However, some people may have recurring panic attacks; these are often due to underlying mental health conditions and may require treatment by health care professionals.

What Is a Panic Attack?

Panic attacks are sudden episodes of intense and debilitating fear that occur without an obvious cause. During a panic attack, several physical and psychological symptoms may be experienced. The symptoms of a panic attack are often similar to those that would be experienced as a result of severe fright, and it is thought that panic attacks may be an overactivation of the fight-or-flight response. Sometimes panic attacks may have triggers that could relate to previous traumatic situations or be caused by certain phobias. Panic attacks are common among individuals with certain mental health conditions, such as post-traumatic stress disorder (PTSD).

Panic Disorder Overview

People who have had panic attacks often wonder, “What is panic disorder, and does having panic attacks mean that I have panic disorder?” Panic disorder is a condition in which panic attacks occur with no underlying reason. These attacks can occur at any time and are unpredictable. Panic disorder also involves either a persistent worry that panic attacks will occur or changes in lifestyle in an effort to prevent panic attacks from occurring.

Panic Attack vs. Anxiety Attack

Many people tend to use the terms panic attack and anxiety attack interchangeably. In reality, these terms have very different meanings. “Panic attack” is a medical term used to describe a certain set of symptoms that are experienced. Panic attacks involve intense, debilitating symptoms. The term “anxiety attack” does not have a medical definition and is subject to interpretation. Generally, the term is used to describe a state of anxiety that is temporary and may or may not have a cause. The symptoms of anxiety are not normally debilitating or as intense as a true panic attack.

Panic Attack Symptoms

People who think they may have had a panic attack will often ask, “What does a panic attack feel like?” The signs of a panic attack are typically symptoms that occur with severe fright and may include both physical and psychological symptoms. Panic attack symptoms typically last for several minutes but persist for longer than an hour.

Physical Symptoms

There are several panic attack physical symptoms that may be experienced during a panic attack. These include:

• Shortness of breath
• Rapid breathing
• Heart palpitations
• Chest pain or chest pressure
• Trembling
• A feeling of choking or inability to breathe
• Sweating
• Nausea
• Dizziness or lightheadedness
• Numbness or tingling sensations, especially around the fingers or mouth
• Hot or cold flashes

These physical symptoms are all part of the body’s normal fight-or-flight response and are healthy and sometimes necessary in dangerous situations. Unfortunately, in the case of panic attacks, these symptoms may occur without any good reason.

It is important to note that many of these symptoms may also occur during medical emergencies such as a heart attack. If you are having these symptoms and are not certain that it is a panic attack or are experiencing these symptoms for the first time, you should seek immediate medical attention.

Psychological Symptoms

There are several psychological symptoms that may also be experienced during a panic attack. These may include:

• Feeling detached from your surroundings
• Feeling that everything around you is not real
• Fear of dying
• Fear of going crazy
• Fear that you are about to lose control of yourself

Fear and anxiety occur for everyone at some point in their lives. The differences between fear, anxiety and panic attacks are related to the severity of the emotional distress. Panic attacks will also illicit severe physical symptoms, while fear and anxiety typically cause more minor physical symptoms.

Diagnosing Panic Attacks

People who think they may have had a panic attack often wonder exactly how to diagnose a panic attack. A panic attack must be diagnosed by a physician who is trained to recognize and diagnose panic attacks. Physicians will use the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) to diagnose panic attacks, and a diagnosis will be based on the presence of at least four of the following symptoms:

• Palpitations, pounding heart or accelerated heart rate
• Sweating
• Trembling or shaking
• Sensations of shortness of breath or smothering
• A feeling of choking
• Chest pain or discomfort
• Nausea or abdominal distress
• Feeling dizzy, unsteady, lightheaded or faint
• Feelings of unreality (derealization) or being detached from oneself (depersonalization)
• Fear of losing control or going crazy
• Fear of dying
• Numbness or tingling sensations (paresthesias)
• Chills or hot flashes

This diagnosis must be made by a physician, as some people may believe the symptoms they have meet some of these criteria, while in the strict medical definition they do not. People may also incorrectly dismiss symptoms that may actually fit into one of these categories. Undergoing a medical assessment by a licensed health care professional is absolutely necessary to be diagnosed with a panic attack.

How Long Do Panic Attacks Last?

Panic attacks vary in length but typically last about 30 minutes on average. They may be shorter — as short as ten minutes or even less — and may be as long as an hour. Panic attacks rarely last longer than an hour. While panic attacks may be relatively short, it is possible to experience more than one panic attack in a single day.

Causes of Panic Attacks

People who have experienced a panic attack often wonder what causes panic attacks. There are several things that can cause panic attacks, including:

• Phobias
• Underlying mental health conditions, such as PTSD
• Stress, including the death of a loved one, divorce or loss of a job
• Panic disorder

Many times the reason for a panic attack may not be discovered, and it will often not happen more than once. There some panic attack risk factors that may make people more likely to experience a panic attack. These risk factors include genetic predisposition, anxious trends during childhood and increased stress.

How to Stop a Panic Attack

There are several techniques for coping with panic attacks, and different individuals will find that some techniques may work better than others. Potential coping techniques include:

• Grounding: Find things in your environment such as smells, sounds, sights or tastes and focus on them. Focusing on objects or stimuli in your environment can help ground you and help you to avoid the feeling of panic and disconnect that accompanies a panic attack.
• Distraction: Trying to distract yourself as a panic attack is starting may be helpful. Techniques such as counting backward from 100 by threes or any similar distraction can help to reduce symptoms.
• Deep breathing: One of the most common physical symptoms of panic attacks is rapid breathing that, in turn, causes other symptoms such as tingling, dizziness or lightheadedness. Controlling your breathing can help control the entire panic attack. Focus on taking slow, deep and controlled breaths, timing your breathing if necessary.
• Exercise: Exercise reduces anxiety and may help prevent panic attacks or provide an outlet during a panic attack that reduces its severity or length.
• Avoid triggers: While not an intervention that will necessarily help during a panic attack, avoiding triggers can help prevent panic attacks from developing. The one caveat to this is that if your trigger is other people. Avoiding others can lead to a condition called agoraphobia. If interacting with others is a trigger, then you should consult a medical professional.

Panic Attack Treatment

Potential treatments for panic attacks involve medications and therapy and are focused on reducing the frequency and severity of panic attacks. The most commonly used therapy is a type of therapy called cognitive behavioral therapy. Panic attack medication can also be used to decrease anxiety and the likelihood or severity of panic attacks that do occur. Medications used to prevent panic attacks or lessen their effects include:

• Benzodiazepines
• Beta-blockers
• Selective serotonin reuptake inhibitors (SSRIs)
• Serotonin-norepinephrine reuptake inhibitors (SNRIs)

All of these medications can be helpful in treating panic attacks or panic disorder, but they must be prescribed by a physician. Never take any of these medications without a doctor’s approval and without a doctor monitoring the effects of these medications, as in some cases they can make panic attacks more likely or severe.

How to Help Someone Having a Panic Attack

People who are around those with frequent panic attacks may wonder how to help someone with a panic attack. Some people will not respond well to others attempting to help and may need to be left alone to work through their panic attacks. Others may benefit from the help of others. When someone seems to be having a panic attack, you should first make sure that it is not a medical emergency. There are emergency conditions that can mimic panic attacks, and panic attacks should be assumed to be a medical emergency until proven otherwise.

If you are certain that the person is having a panic attack, a good approach to help them is to first attempt to engage in conversation with them using short, simple sentences. Always remain calm. Panic can be contagious, and if you allow their panic to prevent you from being calm, engaging with them can worsen the situation. If the person having a panic attack responds to you and the conversation is not making their symptoms worse, then try to get them to slow their breathing, breathing with them at a normal rate, if necessary. If they are around any obvious triggers, attempt to remove those triggers. If they are in a setting with other people, try to get them somewhere away from others. Reduce noise and lighting, and create as calm an environment as possible. Recognize that the panic attack may take several minutes to resolve, and support them throughout the attack.

After the panic attack, ask if they have any medications that they take to help prevent another attack. Also try to find out if the person who had the attack has ever received treatment for their panic attacks, and encourage them to seek medical help if they are not already doing so.

If you or a loved one struggle with panic attacks and addiction, help is available. The Recovery Village specializes in treatment for addiction and co-occurring mental health conditions. Call a representative today for more information.

Editor – Megan Hull

Megan Hull is a content specialist who edits, writes and ideates content to help people find recovery. Read more

Medically Reviewed By – Benjamin Caleb Williams, RN

Benjamin Caleb Williams is a board-certified Emergency Nurse with several years of clinical experience, including supervisory roles within the ICU and ER settings. Read more