Panic attack: symptoms, causes, what to do and when to get help
A panic attack is a sudden wave of intense fear that peaks within minutes and brings strong physical symptoms, such as a pounding heart, shortness of breath, shaking or dizziness. It can feel like you are having a heart attack, losing control or dying. It is frightening, but a panic attack is not dangerous in itself, and it passes.
This guide explains what a panic attack is, the symptoms, what causes it, what to do while it is happening and how it is treated. If you already know the Urdu meaning, our guide to anxiety attack meaning in Urdu covers the same ground in Urdu. If you want to talk to someone now, Talk to our admissions team on WhatsApp. Your message is confidential.
What is a panic attack?
A panic attack is a short episode of very strong fear or discomfort that comes on quickly, usually reaches its peak within about ten minutes, and then settles. Some come with an obvious trigger, such as a crowded place. Many come with none at all, which is part of what makes them so unsettling.
Your body is reacting as if there were an emergency, releasing stress hormones and speeding up your heart and breathing, even though nothing dangerous is happening. Many people have one or two panic attacks in their life and never have another. When attacks keep returning, or when fear of the next one starts to control your life, it may be panic disorder. A psychiatrist can tell the difference.
Panic attack symptoms
Symptoms differ from person to person. A panic attack usually includes several of these:
Body symptoms
- Racing or pounding heart
- Chest tightness or chest pain
- Shortness of breath or a feeling of choking
- Sweating, chills or hot flushes
- Trembling or shaking
- Dizziness, light headedness or feeling faint
- Nausea or stomach discomfort
- Numbness or tingling in the hands, feet or face
Mind and feeling symptoms
- Sudden, intense fear
- A feeling of being detached from yourself or your surroundings
- Fear of losing control or going mad
- Fear of dying
Most attacks last between five and twenty minutes. The strongest symptoms are usually over in the first ten, though you may feel tired and shaky for a while afterward.
Please do not assume that chest pain is only panic. If you have chest pain for the first time, pain spreading to the arm or jaw, or you are not sure, get checked at an emergency department. A doctor can rule out a heart problem, and that check is a normal part of understanding panic attacks.
Panic attack or heart attack?
The two can feel very alike, which is why people rush to the hospital. Some differences can help, but they are not a reliable way to decide for yourself:
- A panic attack usually peaks within about ten minutes and then eases. Heart attack pain often lasts longer, may build up with effort and may not ease with rest.
- Panic often comes with tingling in the hands and fast breathing. A heart attack more often brings pain or pressure that spreads to the arm, jaw or back.
If you are in any doubt, seek emergency care. Never ignore chest pain because you think it is only anxiety.
What causes panic attacks?
There is rarely a single cause. These factors often work together:
- Long term stress, including work pressure, money worries, family conflict or a major loss
- A tendency to anxiety, which can run in families
- Other mental health conditions, such as depression, OCD, PTSD or other anxiety disorders
- Medical causes, such as an overactive thyroid, some heart rhythm problems or side effects of certain medicines
- Caffeine, nicotine and energy drinks, which can set off or worsen attacks
- Alcohol, sleeping tablets and other substances, including the rebound anxiety that comes as they wear off
- Poor sleep, which makes the nervous system more reactive
- A frightening experience, or a first attack that left you afraid it will happen again
A first attack with no clear cause deserves a proper medical review, because treating a physical cause is simple and removes the problem.
Panic attack versus anxiety attack
People use these two terms as if they mean the same thing, but they are not the same. “Panic attack” is a recognized medical term with a defined set of symptoms and a rapid peak. “Anxiety attack” is a common phrase, not a formal diagnosis, and usually describes anxiety that builds slowly over hours or days around a worry. A panic attack tends to come on suddenly, even out of the blue, and is more intense and shorter.
In practice, the treatment is similar. What matters more than the label is how often it happens, how much it affects your life and whether another condition sits behind it. Our Anxiety Disorder Treatment page explains how we assess and treat anxiety.
What to do during a panic attack
You cannot stop the first wave, but you can ride it out and make it shorter. The NHS also has its own guidance on panic attacks and panic disorder.
- Tell yourself what it is. Say it clearly: “This is a panic attack. It is uncomfortable, but it will pass.”
- Sit down and stay where you are if it is safe. Do not run from the situation, as that can teach your brain that the place was dangerous.
- Slow your breathing. Breathe in through your nose for about four seconds and out through your mouth for about six seconds. Longer breaths out calm the body. Repeat for a few minutes.
- Ground yourself. Name five things you can see, four you can touch, three you can hear, two you can smell and one you can taste.
- Relax your muscles. Drop your shoulders, unclench your jaw and open your hands.
- Let the wave rise and fall. Fighting the sensations usually makes them stronger. Watching them, as if from the side, helps.
If someone is with you, they can sit quietly, speak in a calm voice, remind you to breathe slowly and avoid telling you to “just calm down.”
After the attack
- Drink some water and rest.
- Cut back on caffeine and avoid alcohol for now.
- Write down when it happened, what you were doing and what you felt. A short note helps a doctor.
- Do not avoid the place where it happened. Avoidance makes the fear bigger over time.
How are panic attacks treated?
Panic attacks and panic disorder are treatable, and most people improve with the right care.
Assessment. A psychiatrist asks about your symptoms, sleep, medicines, caffeine and substance use and health history, and may order tests to rule out physical causes such as thyroid problems.
Therapy. Cognitive behavioral therapy (CBT) is a main treatment. It teaches you to understand the cycle of fear, change the thoughts that feed it and face feared situations step by step. Our psychologists offer Counseling and Therapy, including CBT.
Medicine. Some people benefit from antidepressant medicines that are also used for anxiety. A psychiatrist decides whether medicine is needed, which one and for how long. Some tablets sold for anxiety and sleep can cause dependence. See our Xanax and Tramadol Addiction Treatment page. Do not start, change or stop a medicine on your own.
Lifestyle. Regular sleep, daily physical activity, less caffeine and slow breathing practice all lower how often attacks happen.
Treating other conditions. If depression, OCD or substance use sits behind the panic, treating them together gives better results. See our Dual Diagnosis Treatment page.
When to see a psychiatrist
Book an appointment if:
- You have had more than one panic attack
- You are afraid of the next one or avoiding places because of it
- Panic is affecting work, study, sleep or relationships
- You are using alcohol, tablets or other substances to cope
- You have been given medicine and are not sure it is helping
- You are not sure whether your symptoms are panic or something physical
If you or someone near you is in immediate danger or is thinking of self harm, go to the nearest emergency department now. Do not wait for an appointment.
At FCRC, you can see a consultant psychiatrist for a private assessment in Bani Gala, Islamabad. Read about our Psychiatrist in Islamabad service, or take our Free Mental Health Self Check, which uses the GAD-7 questionnaire. It does not give a diagnosis, but it can help you decide whether to book a visit.
Frequently Asked Questions
What is a panic attack in simple words?
It is a sudden surge of strong fear that brings physical symptoms such as a racing heart, trembling and breathlessness. It peaks within minutes and then passes.
How long does a panic attack last?
Most last five to twenty minutes, with the strongest symptoms in the first ten. You may feel drained afterward.
Can a panic attack kill you?
A panic attack itself is not dangerous, although it feels as if it could be. Because chest pain can have other causes, anyone with new or severe chest pain should be examined by a doctor.
What triggers a panic attack?
Stress, a family tendency to anxiety, caffeine, poor sleep, alcohol or tablets wearing off, medical conditions and a frightening experience can all play a part. Sometimes there is no clear trigger.
How do I stop a panic attack quickly?
Name it as a panic attack, sit down, breathe in for four seconds and out for six, ground yourself with your senses and let the wave pass. It will not stop instantly, but the peak usually passes within minutes.
What is the difference between a panic attack and panic disorder?
A panic attack is one episode. Panic disorder is when attacks keep happening, or when fear of the next one begins to limit your life. It needs professional treatment.
Can panic attacks happen at night?
Yes. Some people wake from sleep in a panic with a racing heart. If it happens often, see a doctor.
Are panic attacks curable?
Most people recover or improve a great deal with therapy, and medicine when it is needed. Treatment is usually most effective when it starts early.
Should I go to the hospital for a panic attack?
Go if it is your first attack, you have chest pain, you have a heart condition or you are unsure. For repeat attacks you already know are panic, a psychiatrist is the right person to see.
Talk to someone
You do not have to deal with panic alone. Talk to our admissions team on WhatsApp and we will help you book a private appointment with a consultant psychiatrist.
Federal City Rehab Clinic, Bani Gala, Islamabad.
