Panic Attack

Symptoms, Causes & How to Stop One

What Is Happening in Your Body — and How to Take Back Control

You Are Not Dying — But It Feels Like You Are

Thou hast a pounding heart. You are hardly able to breathe. Your chest is tight and your hands tingling. There is an air of sheer terror which overcomes you without any apparent cause. You are sure that something is disastrously amiss.

This is an panic attack. And, if you have ever had one, you already know the feeling that it prepares you never to be prepared of how overwhelming it is, or how truly terrifying it can be to pass through.

This is the crucial fact that you need to remember at this moment: A panic attack is not going to do any harm to you. It is not heart attack. It is not the indication that you are getting crazy. And it will come to an end,–generally in 20 or 30 minutes, often in less. And it is among the most curable mental illnesses.

Panic attacks are much more prevalent than most people may think. One out of every 11% of adults has a panic attack per year. Approximately 6 million Americans are affected with panic disorder – and women are twice as many as men to be affected. You are not the only one and when you are struggling with this you are not a weak person.

This guide will answer precisely what is a panic attack, what causes panic attacks, what to do in case of a panic attack, how to differentiate between panic and heart attack and what drugs actually works in panic disorder.

What is a Panic Attack?

According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), panic attack is characterized by a sudden, intense burst of fear or discomfort, which peaks during several minutes. It does not consist of being anxious or stressed, but a sudden, overwhelming rush of the fight-or-flight response of the body that does not have an appropriate external threat.

What is so disjointing and terrifying about panic attacks is that they may occur at any given moment and at any given time without any reason at all; on the everyday commute, in the dead of night, or even at a totally normal time at home. It does not give any warning, and more than once there is no apparent cause. This is what makes them so awful, as it is unpredictable.

The peak of a panic attack occurs about 10 minutes and ends in 20-30 minutes- although there are cases when people indicate that the attack lasts much longer. What you need to set yourself on is the fact that all panic attacks do come to an end. Without exception. However intense it may be, your body will come back to normal.

Panic Attack vs Anxiety Attack -What is the difference?

These are terms that are at times used interchangeably yet they refer to different experiences. Anxiety attack is usually a cumulative situation and is normally caused by certain situation or worry. A panic attack is not preceded by an obvious cause, is more intense, and it always arrives abruptly. Anxiety attacks are similar to a cumulation of dreadfulness; panic attacks are like explosions.

Panic Attack Symptoms — What You Might Feel

A real physiological change in your body causes the symptoms of a panic attack – adrenaline rushing through your body, your heart racing, your breathing speeding up and your breaths becoming shallow and rapid. Such are the same reactions that your body would react to in case you actually were in physical danger. During a panic attack, they do not happen in the presence of such a threat.

Physical Symptoms

• Racing or pounding heart (palpitations) – is the most common symptom experienced.
• Chest tightness or pain -often confused with a heart attack.
• Shortness of breath, or feeling of being unable to get enough air, is a symptom of PCOS.
• Sweating – usually very heavy and abrupt.
• Trembling or shaking
• Lightheadedness, dizziness or being light headed.
• Stomach or nausea.
• Chills or hot flushes out of the blue.
• Numbing or tingling in hands, feet or face.
• Nausea or feeling of being choked or having a lump in the throat.

Psychological Symptoms

• Violent fear or sheer panic – and without any apparent reason.
• Fear of death- a real belief that there is a medical condition which is not right.
• Fear of loss of control or going crazy.
• Derealization – the world does not seem real, dreamlike or far away.
• Depersonalisation – not feeling part of your own bodies as an observer of your own body.

Important: These Symptoms Are Real

Symptoms of panic attack are not visualized. They are brought about by the real physiological alterations in your body instigated by the fight-or-flight response. It is the reason why they sound so persuasive and so threatening. Yet they are not the symptoms of a physical danger, they are the reaction of your nervous system to the threat which is not really present.

What Causes Panic Attacks?

The biological basis of all panic attacks is the same: the amygdala – the alarm centre of the brain – discharges a complete emergency reaction, when there is not even an emergency. This fills the body with adrenaline and cortisol, and activates all the physical symptoms you experience. The brutal irony of it all is that the perception of such physical symptoms (the racing heart, the inability to breathe) provokes even greater panic, which, in its turn, can cause an even greater reaction – a kind of the feedback that can turn an insignificant case of anxiety into a full-blown panic attack in a couple of seconds.

Key Risk Factors and Triggers

• Chronic stress – chronic stress causes a decrease in the panic threshold due to a decrease in cortisol.
• Caffeine and stimulants – Caffeine is among the most extensively documented panic causing agents; even moderate intake can trigger attacks in those who are vulnerable to such attacks.
• Sleep deprivation – interferes with the nervous system in terms of responding to threats.
• Hyperventilation – rapid breathing reduces the amount of carbon dioxide in the blood and has a direct effect of making one feel dizzy, tingling and tight in the chest.
• Significant life events – bereavement, termination of employment, relationship termination, financial crisis.
• Family history — genetics is an important factor in the vulnerability to panic.
• Trauma and negative childhood experiences – there is a strong association with adult panic disorder.
• Other mood and anxiety disorders – panic often occurs with depression, PTSD, and social anxiety.
• Health issues – thyroid diseases, irregular heartbeats, hormonal imbalances can imitate or cause panic.
• Alcohol and substance withdrawal – may result in severe panic as part of the withdrawal process.

What to Do During a Panic Attack — Step by Step

Fighting a panic attack is the last thing you can do when it hits you, the strongest action you can take is not to fight it. Resistance amplifies panic. Acceptance – not catastrophising, accepting what is happening – is much more constructive. Then apply such evidence-based methods.

Box Breathing — Do This Right Now

Step 1: Breathe in slowly, using your nose, 4 counts.

Step 2: Take 4 counts of breath.

Step 3: Slowly exhale 4 counts through your mouth.

Step 4: Hold 4 counts – repeat 4-6 times.

The rationale behind box breathing: slow, deep breathing increases the amount of carbon dioxide in the blood, stimulates the vagus nerve, and sends an immediate message to the brain that the danger has been overcome. Slow diaphragmatic breathing has been found to be as effective as cognitive behavioural therapy in the reduction of symptoms of panic attacks.

The 5-4-3-2-1 Grounding Technique

When panic turns to derealization, that awful sense that the world is not real, grounding will bring you back into the present. Read aloud or in your mind:

• 5 objects that you can observe.
• 4 items that you can feel.
• 3 sounds that you can hear.
• 2 things to smell.
• Something to taste by 1 thing.

This is a sensory receiving-wakefulness which breaks the loop of the internal alarm and makes one focus his attention on tangible, immediate reality. It lasts approximately 90 seconds and is able to stop the escalation of a panic attack.

Other Techniques That Work

• Cold water on your face – Turns on the dive reflex, reduces a heart rate in a few seconds.
• Stay put, when safe – leaving the situation lets your brain know that it was indeed dangerous.
• Recite a mantra of grounding: This is a panic attack. It will pass. I am safe.’
• Progressive muscle relaxation – tense and relax muscle groups systematically – starting feet up to top.

Panic Attack vs Heart Attack — How to Tell the Difference

This happens to be among the most significant aspects to know about panic attacks – and also among the most searched health queries online all over the world. The symptoms are similar to the extent that emergency rooms often receive panic attack patients who are convinced that they are experiencing a heart attack. The following is the way to differentiate them:

Feature	Panic Attack	Heart Attack
Onset	Sudden, peaks within minutes	Can build gradually with exertion
Chest pain	Tight, pressing — rarely radiates	Can radiate to arm, jaw, back
Duration	Resolves within 20–30 minutes	Persists, does not resolve on its own
Trigger	Often no obvious cause	Often physical exertion or stress
Age/risk	Any age — common in young adults	More common over 50 with risk factors
Reassurance	Often helps symptoms ease	Does not respond to reassurance

In Case of Doubt — call Emergency Services.

You should call 999 (UK) or 911 (US) as soon as you are not sure whether or not you are experiencing a panic attack or heart attack. It is never too late to disrule a heart attack. First responders will not discriminate you – cardiac symptoms and chest pains are never ignored.

Feature	Panic Attack	Heart Attack
Onset	Sudden, peaks within minutes	Can build gradually with exertion
Chest pain	Tight, pressing — rarely radiates	Can radiate to arm, jaw, back
Duration	Resolves within 20–30 minutes	Persists, does not resolve on its own
Trigger	Often no obvious cause	Often physical exertion or stress
Age/risk	Any age — common in young adults	More common over 50 with risk factors
Reassurance	Often helps symptoms ease	Does not respond to reassurance

When Panic Attacks Become Panic Disorder

 One panic attack, even a severe one does not imply that you have panic disorder. Numerous individuals have one or two in their lives and never again. Panic disorder is characterized when the panic attacks are frequent and unpredictable and when you spend a month or more worrying constantly about the attacks or altering your behaviour to prevent things that you relate with panic.

Panic disorder has the most harmful effect- it is avoidance, rather than the attacks. Whenever an individual escapes a circumstance that is linked to panic (a busy supermarket, a journey in a car, a busy workplace) the brain is conditioned to the thought that the avoidance was effective. Safety zone reduces. This avoidance may progress to agoraphobia; an anxiety disorder whereby one cannot leave the house.

Early (before avoidance is established) professional assistance has much better chances of success. Please do not wait.

Treatment for Panic Attacks and Panic Disorder

The Good News

Panic disorder is amongst the most manageable mental health problems. Most individuals can respond to treatment- and lots of them can be cured. Research indicates that CBT helps to lessen panic attacks between 70 and 90 percent. Treatment works. Recovery is real.

1. Cognitive Behavioural Therapy (CBT) — The Gold Standard

CBT is the treatment with the best evidence supporting panic attack and panic disorder. It operates by determining the thought processes and behaviours that sustain panic – especially catastrophic interpretations of bodily sensations (my heart is racing, therefore I am dying) – and methodically disputing and substituting them with more realistic responses.

One CBT method which is specifically effective in panic is interoceptive exposure – this is the deliberate re-creation of the physical symptoms of panic (dizziness, a rapid heartbeat) in a safe environment, and the fear response is desensitised. This is a counterintuitive, yet potent, sound.

2. Exposure Therapy

When avoidance has already been in place exposure therapy is slowly re-introduced to the feared situations or sensations in a safe, supported manner. The brain rewires the threat association, beginning with the least scary scenarios and progressing, as each successful exposure is made. It is difficult – but it is effective.

3. Medication

Selective serotonin reuptake inhibitors (SSRIs) and SNRIs are the drugs of choice of panic disorder. They are just as efficient as benzodiazepines, yet do not cause dependence. The full effect is usually attained in four to six weeks. Short term use of benzodiazepines may be useful in acute attacks but is usually not taken in the long term because of the risks of tolerance and dependence. The best results are obtained when CBT is used in conjunction with medication.

4. Lifestyle Approaches That Reduce Panic

• Aerobic workouts (frequency) – a number of studies have determined that there is an inverse relationship between frequent physical exercise and anxiety and panic attacks.
• Cutting down caffeine- even drinking tea instead of coffee can significantly decrease the number of attacks in susceptible individuals.
• Prioritising sleep Directly, sleep deprivation reduces the panic threshold.
• Mindfulness meditation – this is routinely practised, and it re-trains the nervous system to be baseline reactive.
• Reducing alcohol- alcohol disturbs sleep and may result in revitalizing anxiety the next day.

Frequently Asked Questions

Q: Can you die from a panic attack?

No. A panic attack is not fatal, is not associated with heart failure and permanent physical injury. It seems like life threatening since the body is undergoing a true fight-or-flight reaction – but the symptoms, though highly unpleasant, are not life threatening. None has ever succumbed to panic attack itself.

Q: How long does a panic attack last?

The majority of panic attacks are maximum in 10 minutes and completely dissolve in 20-30 minutes. There are individuals who complain of longer episodes. Breathing techniques and grounding methods used during an attack can greatly reduce the duration of the attack.

Q: What is the fastest way to stop a panic attack?

The best immediate technique with the greatest evidence is box breathing (inhale 4, hold 4, exhale 4, hold 4). Along with the 5-4-3-2-1 grounding technique, and an intentional acknowledgment instead of resistance to the sensations, most individuals can have the intensity and the duration of an attack reduced considerably in a few minutes.

Q: What triggers panic attacks?

Examples of common triggers are chronic stress, caffeine, sleep deprivation, hyperventilation, major life events and some medications or substances. Nonetheless, a significant number of panic attacks have no apparent trigger, as such, which is the source of the disorienting nature of panic disorder. Through therapy or journalling, the personal triggers can be identified so that frequency can be reduced.

Q: Are panic attacks a sign of serious mental illness?

No. Panic attacks are very widespread and the vast majority of their sufferers do not have a severe mental health problem. They may happen in otherwise healthy individuals when they are under a high level of stress. The frequent disruptive panic attacks resulting in avoidance behaviours could be a sign of panic disorder – a known anxiety disorder yet very treatable.

Conclusion — Recovery Is Real and Reachable

Panic attack is the most terrible experience which a person can encounter. However, it can also be considered one of the most treatable and manageable conditions in the whole of mental health.

In the event that you have repeated panic attacks, then you should talk to your GP or a mental health professional. Wait not till avoidance has narrowed your world. The combination of CBT, medication, or both can help the greatest number of individuals with panic disorder to heal completely and continue to live free of fear of the next episode.

Meanwhile: take breath at leisure. Name what is going on. Be sure it will pass. It always does.

In case this article was of assistance to you, pass it to a person who may require it.

Medical Disclaimer

This article is for informational purposes only. If you are experiencing distress, please consult a qualified mental health or medical professional. Always seek emergency care if you suspect a heart attack.