A panic attack is a sudden surge of intense fear with strong body sensations. It peaks within about 10 minutes and then settles.
Although it feels dangerous, a panic attack itself does not harm the heart or cause madness.
Key concepts
- The body's alarm system fires without real danger
- Fighting or fleeing the feelings makes them stronger
- Repeated attacks with fear of the next one suggest panic disorder
Symptoms and signs
- Pounding heart, chest tightness, sweating, trembling
- Breathlessness, choking feeling, dizziness
- Numbness or tingling, feeling unreal
- Fear of dying, fainting or losing control
Causes
- Overactive fear response in the brain
- Stress, poor sleep, caffeine or stimulant use
- Misreading normal body sensations as danger
Risk factors
- Family history of anxiety
- Recent stressful events or illness
- Alcohol or cannabis withdrawal
Evidence-based management
- Name it: 'This is a panic attack; it will pass in minutes'
- Slow breathing: in for 4, out for 6, for 2–3 minutes
- Ground yourself: notice 5 things you see, 4 you can touch
- Long-term: CBT for panic and, if needed, antidepressant medicines
When to seek professional help
- First-ever chest pain or breathlessness — get a medical check to rule out heart or lung problems
- Repeated attacks or avoiding places for fear of an attack
- Using alcohol or tablets to control attacks
Frequently asked questions
Can a panic attack cause a heart attack?
In healthy people, no. But new chest pain should always be checked by a doctor first.
Should I breathe into a paper bag?
This is not recommended. Slow, steady breathing is safer and effective.
Medical references
Guidelines and official sources used for this article.
- Generalised anxiety disorder and panic disorder in adults: management (CG113). NICE, UK, 2011.
- Anxiety disorders — fact sheet. World Health Organization.
- Author
- Dr. Kuldeep Budania, MBBS, MD Psychiatry
- Medical reviewer
- Dr. Kuldeep Budania, MD Psychiatry
- Last reviewed
This article is for general information and is not a substitute for personal medical advice.
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