A panic attack causes sudden, temporary feelings of fear and strong physical reactions in response to ordinary, nonthreatening situations. When you’re having a panic attack, you may sweat a lot, have difficulty breathing and feel like your heart’s racing. It may feel like you’re having a heart attack.
Panic attacks are the main feature of panic disorder. But they can happen alongside other conditions, such as:
While panic attacks by themselves aren’t dangerous or harmful to your health, frequent attacks can lead to a decrease in your quality of life and other issues.
What are the symptoms of a panic attack?
A panic attack happens suddenly. Symptoms usually peak within 10 minutes after it starts and then disappear soon after. Physical symptoms of a panic attack include:
Derealization (feelings of unreality) or depersonalization (feeling detached from yourself).
Panic attacks are very unpleasant and can be frightening. If you’ve had symptoms of a panic attack, it’s important to see a healthcare provider. They can give you an official diagnosis and ensure there’s no underlying physical cause.
How long can a panic attack last?
Panic attacks usually last 5 to 20 minutes. But some people have reported attacks lasting up to an hour.
What causes panic attacks?
Experts don’t know exactly why some people experience panic attacks or develop panic disorder. Your brain and nervous system play key roles in how you perceive and handle fear and anxiety. Researchers think that dysfunction of your amygdala — the part of your brain that processes fear and other emotions — may be at the root of these conditions. They also think chemical imbalances in gamma-aminobutyric acid (GABA), cortisol and serotonin may play a large role.
Your risk of having panic disorder increases if you have:
A family history: Anxiety disorders, including panic disorder, often run in families. You have a 40% increased risk of developing panic disorder if one of your first-degree relatives (biological siblings, children or parents) has the condition.
Mental health conditions: People who have anxiety disorders, depression or other mental health conditions are more prone to panic attacks.
Adverse childhood experiences (ACEs): ACEs are negative experiences that happen between the ages of 1 and 17. These experiences are usually traumatic events. ACEs can contribute to the development of panic attacks and panic disorder.
What triggers panic attacks?
There’s often no specific trigger for panic attacks. But people who have a phobia can experience phobia-related triggers that lead to a panic attack. For example, someone with trypanophobia (intense fear of needles) may experience a panic attack if they have to get their blood drawn for a medical test. For some people, the fear of having a panic attack is often enough to trigger one.
It’s important to note that one of the criteria for panic disorder is that the panic attacks don’t have a known trigger.
How are panic attacks diagnosed?
Your healthcare provider will ask about your symptoms and medical history. They may run tests to rule out medical conditions that cause similar symptoms as panic attacks, such as heart disease, thyroid disease and respiratory (breathing) problems.
If there’s no underlying physical cause, your provider may make a diagnosis according to your symptoms and risk factors.
How is panic disorder diagnosed?
Medical or mental health providers can diagnose panic disorder based on criteria in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). Your provider may diagnose panic disorder when you have repeated, unexpected panic attacks as well as one month or more of:
Persistently worrying about having more panic attacks or their consequences.
Changing your behaviors to avoid situations that you think may trigger an attack.
In addition, the attacks can’t be due to the direct effects of a substance or general medical condition. And they can’t be better accounted for by another mental health condition, like a phobia or PTSD.
How are panic attacks and panic disorder treated?
Psychotherapy, medications or a combination of both are very effective in treating panic attacks and panic disorder. How long you’ll need treatment depends on the severity of the condition and how well you respond to treatment.
Psychotherapy
Psychotherapy (talk therapy) is a term for a variety of treatment techniques that aim to help a person identify and change unhealthy emotions, thoughts and behaviors.
Specific types of psychotherapy that can help with panic attacks and panic disorder include:
Cognitive behavioral therapy (CBT): In this type of therapy, you discuss your thoughts and emotions with a mental health professional, such as a licensed counselor or psychologist. This specialist helps identify panic attack triggers so you can change your thinking, behaviors and reactions. As you start to respond differently to triggers, the attacks may decrease and ultimately stop.
Exposure therapy: This involves exposing you gradually and repeatedly — in your imagination and/or in reality — to whatever triggers a panic attack. Over time, you learn to become comfortable with the situation instead of it causing anxiety and panic. You’ll learn relaxation techniques, such as breathing exercises, to manage your anxiety throughout the process.
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