Panic Attacks: Symptoms, Causes and How to Stop One

Panic Attacks: Symptoms, Causes and How to Stop One

A panic attack is a sudden wave of intense fear that comes with strong physical symptoms, such as a pounding heart, shaking, chest pain and trouble breathing. Most attacks peak within minutes and pass on their own, and they are not dangerous, even though they can feel like a heart attack. If attacks keep coming back and you live in fear of the next one, you may have panic disorder, which responds well to therapy and medicine.

This article is for general information and is not medical advice.

Key takeaways

  • A panic attack is an episode of intense fear with physical symptoms. Most last 5 to 20 minutes, and they are not life-threatening.
  • One panic attack is not a mental disorder. Panic disorder means repeated, unexpected attacks plus at least a month of worry about more.
  • Slow breathing, staying put and reminding yourself the attack will pass can help you ride one out.
  • Cognitive behavioral therapy (CBT) is the first-line talking therapy, and SSRIs or SNRIs are the usual first-choice medicines.
  • New chest pain or breathing trouble should always be checked by a doctor first, because other conditions can look like panic.

What are the symptoms of a panic attack?

A panic attack brings on several physical and emotional symptoms at once, usually without warning. The fear often feels out of proportion to what is happening around you.

The National Institute of Mental Health (NIMH) describes a panic attack as "a one-time or occasional episode of intense fear with physical and emotional symptoms." Common symptoms include:

  • A racing or pounding heart (palpitations)
  • Sweating, chills or hot flushes
  • Trembling or shaking
  • Shortness of breath or a choking feeling
  • Chest pain or tightness
  • Dizziness or weakness
  • Tingling or numbness in the hands
  • Nausea or stomach pain
  • A sense of doom, losing control or fear of dying
  • Feeling detached from your body or surroundings

According to the NHS, most panic attacks last 5 to 20 minutes, though some last up to an hour. MedlinePlus notes that attacks usually peak within 10 to 20 minutes.

Because chest pain is so common, many people go to the emergency room during their first attack. For more on this overlap, read our guide on chest pain caused by strong emotions and its warning signs.

How is a panic attack different from an anxiety attack?

A panic attack is a defined medical term for a sudden, intense surge of fear that peaks quickly. "Anxiety attack" is an everyday phrase people use for a period of heavy worry or stress, which usually builds more slowly and lasts longer.

The American Psychiatric Association (APA) draws a useful line between the two feelings underneath. Anxiety is the anticipation of a future concern, and it is linked to muscle tension and avoidance. Fear is a response to an immediate threat, and it is linked to the "fight-or-flight" response, the body's automatic surge of adrenaline that prepares you to run or defend yourself. A panic attack is fear at full volume, even when there is no real danger.

FeaturePanic attack"Anxiety attack" (heavy anxiety)
OnsetSudden, often out of the blueGradual, often tied to a worry or stressor
PeakWithin minutesNo sharp peak, rises and falls
Typical lengthUsually 5 to 20 minutesCan last hours or days
Main feelingIntense fear, sense of doomWorry, unease, restlessness
Body symptomsStrong: pounding heart, shaking, breathlessnessMilder: muscle tension, fatigue, poor sleep
Clinical term?YesNo, an informal description

If ongoing worry is your main problem, our daily toolkit of stress management techniques may be a good place to start.

What is panic disorder?

Panic disorder is an anxiety disorder in which you have repeated, unexpected panic attacks and then spend at least a month worried about having more or changing your life to avoid them. Having one or two attacks does not mean you have it.

NIMH is clear that an isolated panic attack "is not a mental disorder." For a diagnosis, the attacks must be frequent and unexpected, followed by at least 1 month of worry about future attacks, fear about what they mean, or changes in behavior to avoid them.

Panic disorder is less common than many people assume. NIMH statistics estimate that 2.7% of US adults had it in the past year (3.8% of women and 1.6% of men), and 4.7% will have it at some point in their lives. Among adults with past-year panic disorder, 44.8% had serious impairment in daily life.

Agoraphobia and other complications

Some people start avoiding places where escape might feel hard, such as buses or crowds. This is called agoraphobia, a fear of situations where getting help or getting out seems difficult. MedlinePlus adds that untreated panic disorder raises the risk of substance misuse, job difficulties and social isolation.

Panic disorder often travels with other conditions, including depression, other anxiety disorders and substance misuse. If low mood is part of your picture, see our overview of depression symptoms, risk factors and treatment.

What causes panic attacks?

No single cause has been found. Experts think a mix of genes, brain biology, stress and the way you interpret body sensations all play a part.

Known and suspected factors include:

  • Family history. NIMH notes that panic disorder sometimes runs in families, although it also appears in people with no family history.
  • A "false alarm" system. One theory is that the body's survival response fires too often or too strongly. If you read a racing heart as a heart attack, that fear can trigger more symptoms and start a cycle.
  • Stressful life events. The NHS lists traumatic or very stressful experiences, such as bereavement, as a likely factor.
  • Brain chemistry. An imbalance in neurotransmitters, the chemical messengers that carry signals between nerve cells, is thought to contribute.
  • Sex and age. Panic disorder is about twice as common in women as in men, and it often begins in the late teens or early adulthood, according to MedlinePlus.
  • Stimulants. MedlinePlus advises limiting caffeine, stimulants and certain cold medicines, which can make symptoms worse.

People who are very alert to body sensations often notice this cycle. Our article on health anxiety and when a medical worry is valid covers a related pattern.

How can you get through a panic attack in the moment?

The goal is not to fight the attack but to let it pass while keeping your body as calm as you can. The NHS advises staying where you are, breathing slowly and deeply, and reminding yourself that the attack will pass.

Try these steps the next time you feel one starting:

  1. Stay where you are if it is safe. Running from the situation can teach your brain that the place was dangerous. If you are driving, pull over safely first.
  2. Name what is happening. Tell yourself, "This is a panic attack. It is uncomfortable, but it is not dangerous, and it will pass." NIMH confirms that attacks are not life-threatening.
  3. Slow your breathing. Breathe in gently through your nose, then breathe out slowly through your mouth, making the out-breath a little longer than the in-breath. Keep going for a few minutes.
  4. Loosen your body. Drop your shoulders, unclench your jaw and hands, and plant your feet on the floor.
  5. Give your mind somewhere to go. The NHS suggests focusing on calm, peaceful images. Some people prefer to describe objects in the room in detail.
  6. Let the wave peak and fall. Notice that symptoms rise, level off and fade. Watching this happen helps your brain learn that the alarm was false.
  7. Return to what you were doing. When it settles, carry on with your day if you can. This builds confidence for next time.

Body-based grounding can also help. Our guide to somatic exercises for anxiety walks through several techniques you can practise between attacks, so they feel familiar when you need them.

What treatments work for panic attacks and panic disorder?

Panic disorder is very treatable. Talking therapy, especially CBT, and certain medicines are the main options, and MedlinePlus notes that combining them often works best.

Cognitive behavioral therapy

Cognitive behavioral therapy is a structured talking therapy that helps you spot and change the thoughts and behaviors that keep panic going. NIMH calls CBT the "gold standard" psychotherapy for panic disorder, and the APA lists it as a first-line treatment. A key part is exposure therapy, including interoceptive exposure, where you practise bringing on harmless sensations (like a faster heartbeat) in a safe way until they lose their power to scare you. CBT can be done in person or by video. If you are deciding where to start, our guides on choosing a psychologist, psychiatrist or therapist and how online therapy works can help.

Medicines

Medicines do not cure panic disorder, but they can reduce how often attacks happen and how strong they are. Your prescriber will match the choice to your health, other medicines and preferences.

  • SSRIs (selective serotonin reuptake inhibitors). A type of antidepressant and usually the first choice, according to MedlinePlus and the NHS.
  • SNRIs (serotonin and norepinephrine reuptake inhibitors). Another first-line antidepressant option listed by the APA and NIMH.
  • Tricyclic antidepressants. The NHS lists imipramine and clomipramine as options if SSRIs are not suitable.
  • Anti-seizure medicines. The NHS mentions pregabalin as a possible option.
  • Benzodiazepines. Sedatives such as clonazepam can ease symptoms quickly, but NIMH warns about tolerance and dependence, so they are usually prescribed only for short periods.
  • Beta-blockers. These can blunt physical symptoms like a fast heart rate and tremor, though NIMH says they are not commonly prescribed for panic disorder.

Antidepressants take time. The NHS says they can take 2 to 4 weeks to start working and up to 8 weeks to work fully. Do not stop them suddenly without talking to your doctor.

Daily habits that support treatment

Regular exercise, enough sleep, regular meals and cutting back on caffeine and alcohol all help. NIMH adds that healthy habits help but "cannot replace treatment."

Common mistakes

  • Assuming every attack is "just panic." New or different chest pain still needs a medical check. Doctors rule out heart, thyroid and other causes first.
  • Avoiding places after an attack. Avoidance brings short-term relief but tends to shrink your world and can lead to agoraphobia.
  • Breathing fast and deep to "get more air." Rapid breathing can make dizziness and tingling worse. Slow, gentle breathing works better.
  • Stopping medicine as soon as you feel better. Stopping suddenly can bring symptoms back. Plan any change with your prescriber.
  • Relying on alcohol or sedatives to cope. Both carry risks of dependence and can make anxiety worse over time.
  • Waiting years to get help. The NHS notes panic disorder can get worse without treatment, and earlier care usually means faster progress.

When to see a doctor

See a doctor if panic attacks keep happening, if you worry about the next one, or if they affect your work, relationships or confidence. MedlinePlus advises contacting a provider when attacks interfere with daily life.

Get emergency help (call 911 in the US) right away if:

  • You have chest pain, pressure or tightness for the first time, or it feels different from your usual attacks
  • Chest pain spreads to your arm, jaw, neck or back
  • You faint or nearly faint
  • You have severe shortness of breath that does not ease as the attack fades
  • Symptoms last much longer than your usual attacks
  • You have thoughts of harming yourself

If you are thinking about suicide or are in crisis, call or text 988 in the US to reach the Suicide and Crisis Lifeline, available 24 hours a day.

Frequently asked questions

Can a panic attack hurt you?

No. NIMH states that panic attacks are not life-threatening, and the NHS says they rarely lead to hospital admission. The symptoms feel alarming, but they are caused by the body's fear response, not by damage to your heart or lungs.

How long does a panic attack last?

Most panic attacks last 5 to 20 minutes, with symptoms peaking early. Some people have attacks that last up to an hour, and leftover tiredness or shakiness can linger after the fear has faded.

Who is most likely to get panic disorder?

Women are about twice as likely as men to develop it, and it usually starts in the late teens or early adulthood. Having a close relative with panic disorder also raises your risk.

Will panic disorder go away on its own?

It sometimes improves, but it often lasts a long time without treatment. MedlinePlus notes that most people get better with proper treatment, so it is worth seeking help rather than waiting.

What to do next

Book an appointment with your doctor to rule out other causes and ask about CBT and whether medicine makes sense for you. Meanwhile, practise slow breathing daily, log when attacks happen, and cut back on caffeine and alcohol.

Sources

Last reviewed: October 2026.

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