What Is A Panic Attack? Exploring The Definition, Symptoms, And Treatments

Panic attacks, sometimes called anxiety attacks, can stop you in your tracks with overwhelming fear, anxiety, and debilitating physical symptoms. They’re associated with anxiety and panic disorder and symptoms of a panic attack can be so intense that some may fear they’re “losing control” or are in mortal danger when they occur. 

Your body's nervous system is impacted by anxiety, which can cause physical symptoms during panic attacks to keep you alert and aware of potential dangers when threats are perceived. However, when you struggle to process emotions effectively, those effects can linger and worsen over time. If you think you might be experiencing panic attacks, knowing what criteria is involved in panic disorder, common symptoms of panic attacks, how to find relief, and mental health treatment options may be helpful.

What is a panic attack?

According to the American Psychological Association (APA), panic attacks are sudden and overwhelming surges of fear, often without an apparent cause, that far exceed typical stress reactions and may make you feel like you're dying. One panic attack may mean nothing serious, but if you experience intense anxiety and frequent attacks, it may be a sign of an underlying mental health condition, such as general anxiety disorder, panic disorder, or PTSD.

Panic attacks often happen without warning and severely interfere with your ability to function at home, school, work, or anywhere else until the episode passes. Experiencing a panic attack can cause intense fear and anxiety about future occurrences. You may notice that you avoid places where you've had an episode or situations that may incite your panic. Staying home where it's "safe" may feel more manageable and desirable over time, causing you to socially withdraw to prevent incidents. 

Panic attacks may be expected or unexpected. Unexpected attacks can involve intense and sudden feelings of fear, extreme nervousness, or panic without warning. Reactions to the perceived threat are often disproportionate to actual danger. Expected panic attacks occur in response to a real threat or known inciting event – for example, people with panic disorder often begin to recognize events or situations that commonly cause panic attacks, allowing them to anticipate the symptoms. 

When do panic attacks signify panic disorder? 

A panic attack is a single instance of debilitating and overwhelming fear or anxiety interfering with the ability to function. While many experience one or two panic attacks throughout their lives, often related to stressful situations or drastic, unexpected life changes, some people develop a panic disorder characterized by recurring episodes and constant fear of another incident.  

How does a panic attack feel? Recognizing unexpected panic attack symptoms

Unexpected panic attacks and sudden episodes of intense panic can be frightening. However, recognizing that you’re experiencing an unexpected panic attack can help you return to a calm state. So, how does a panic attack feel, and how do you know if you’re experiencing one? 

While panic attacks can present in many variations, symptoms are usually short-lived. Most panic attacks peak and fade away within less than half an hour, but some may last for longer periods, depending on the severity. People often feel extreme fatigue after an episode. Symptoms of these attacks can include the following: 

• An irregular, pounding, or racing heartbeat

• The sense that one is having a heart attack

• Chest pain 

• Sweating

• Shaking

• Shortness of breath or difficulty breathing 

• Choking feeling

• Nausea or abdominal distress

• Dizziness, unsteadiness, lightheadedness, or faintness 

• Hot flashes or alternating hot and cold physical sensations

• Numbness or tingling

• Feelings of dissociation or detachment

• Fear of losing control, "going crazy," or dying

• A sense of impending doom 

• Fear that one is in real danger

If you have never had a panic attack or are experiencing different sensations than the symptoms of a panic attack that you have come to recognize for yourself, seek medical help. Chest pain can be a sign of a heart attack, blood clot, or another medical condition that requires treatment. 

Panic attacks in children and adolescents

Children and adolescents often don't have the ability to understand or express their emotional reactions, so panic attacks may present more as physical symptoms like head and stomach pain. However, they may also have many of the typical adult symptoms. As they experience more panic attacks, children and teens may become anxious most of the time, constantly fearing another episode.

Those in early adulthood who develop panic disorder may also struggle to recognize their symptoms. 

What causes panic disorder?

While the medical community hasn't conclusively named a cause for panic disorders, some common risk factors are often seen in people who experience panic attacks, including the following: 

• A family history of panic disorder or panic attacks

• Major life stressors, like death or illness

• Physical or sexual abuse during childhood

• Traumatic events

• Drastic life changes, like divorce or childbirth

• Smoking

• Excessive caffeine use

Panic disorder comorbidity

Panic attacks often occur alongside, or comorbid to, other mental health conditions. Alcohol and substance use disorders are common, as many people with mental illnesses self-medicate to cope with symptoms. Other anxiety disorders, like agoraphobia or social anxiety disorder, mood disorders like depression, and increased stress frequently develop comorbidly with panic disorder. 

Complications related to untreated panic disorder

Untreated panic attacks may cause significant difficulty in caring for oneself. Fear of a panic attack can lead to new worries, contributing to the constant state of anxiety and difficulty relaxing. Below are a few other potential complications of untreated panic disorder:  

• The development of specific phobias

• A physical health condition

• Intense avoidance of social situations where you may have a panic attack, sometimes to the point of the development of agoraphobia 

• Difficulty at home, work, or school

• Mood disorders, anxiety disorders, or other psychological conditions

• An increased risk of suicidal thoughts or behaviors

• Alcohol or substance use disorders

Treatments for panic disorder

Psychotherapy, also called talk therapy, is often considered the most effective treatment to manage the effect of panic attacks and panic disorder. Your doctor or psychiatrist can determine if medication would be a helpful addition to your treatment plan. 

Cognitive-behavioral therapy (CBT) is the preferred treatment for adults' and children's panic attacks and anxiety disorders. CBT helps clients tolerate the physical symptoms of their attacks as they reshape their thinking patterns to gain a more productive perspective and build healthy ways to cope with symptoms. 

Coping skills for a panic attack may include the following:

• Deep breathing exercises

• Desensitization and building tolerance through controlled exposure

• Progressive muscle relaxation techniques

• Positive visualization of a relaxing setting

• Focusing on panic as a symptom of a medical condition that will pass

• Keeping essential oils handy for their calming effects 

• Getting away from the stressor and finding a peaceful spot

• Focusing your attention on an object to distract your mind

• Repeating a mantra or positive affirmation

• Recentering your mind by going for a walk or getting light exercise

• Talking to someone

• Learning what incites panic and using coping skills when it occurs 

"Treatment for panic disorders is usually quite effective. Treatment will help you learn to recognize that the symptoms are not life-threatening. You will also learn coping skills and ways to relax to decrease the intensity and length of the panic attack." — Johns Hopkins Medicine

How to prevent panic attacks 

In addition to exploring treatment options, research suggests that regular exercise may reduce the frequency of panic attacks and the intensity of anxiety symptoms. Consider a regular exercise routine if you know or suspect that you have a panic disorder. 

How to help someone through a panic attack

If a friend or loved one experiences a panic attack and you want to help, remain calm, guide them to a quiet space, and try the following strategies:

• Speak calmly and soothingly, reminding them they are safe and not alone. 

• Narrate taking deep breaths, breathing in and out for three seconds each. "In, two three. Out, two, three." This strategy can help them focus on their breathing. 

• Remind them that this is a real symptom and will pass soon.  

• Avoid showing or validating negative statements. 

• Try initiating a lighthearted conversation about something positive to offer distraction. 

• Avoid telling them to calm down or devaluing their experience. 

• Stay with them. If they request time alone, retreat but stay in contact or nearby.  

When to reach out for help

If your panic attacks occur frequently or significantly interfere with your functional ability in several aspects of your daily life, it may be beneficial to contact a medical or mental health professional for help. If you face barriers to traditional treatment, like social anxiety, you can also work with a provider online. 

Through an online platform like BetterHelp, you can connect with a therapist through phone, video, or chat sessions. In addition, some platforms offer the option of messaging your therapist throughout the week as needed for advice and support. If you are having a panic attack, contacting your therapist may be quicker online. 

According to a recent study, online therapy offers effective results as a treatment for panic attacks and other anxiety challenges. The study participants reported high satisfaction with virtual treatment, and many participants saw fewer symptoms.