Panic Disorder What Causes Panic Attacks? By Elizabeth Plumptre Elizabeth Plumptre LinkedIn Elizabeth is a freelance health and wellness writer. She helps brands craft factual, yet relatable content that resonates with diverse audiences. Learn about our editorial process Published on November 22, 2021 Medically reviewed Verywell Mind articles are reviewed by board-certified physicians and mental healthcare professionals. Medical Reviewers confirm the content is thorough and accurate, reflecting the latest evidence-based research. Content is reviewed before publication and upon substantial updates. Learn more. by Steven Gans, MD Medically reviewed by Steven Gans, MD Steven Gans, MD is board-certified in psychiatry and is an active supervisor, teacher, and mentor at Massachusetts General Hospital. Learn about our Medical Review Board Print Peter Dazeley / Getty Images Table of Contents View All Table of Contents Symptoms of Panic Attacks Causes of Panic Attacks Treatment Anyone who has experienced a panic attack knows firsthand the intense feelings of fear and discomfort this process can produce. It doesn't help that panic attacks may sometimes appear without any warning or trigger in what is known as an 'unexpected panic attack.' Other times, cases of panic attacks may be anticipated, otherwise known as an 'expected panic attack.' These attacks commonly occur during triggering situations like proximity to a feared animal or a dreaded work emergency. Regardless of the circumstances from which panic attacks emerge, it is widely accepted that these encounters can seriously disrupt daily, social, and even work life. In this guide, we'll be examining what may be responsible for panic attacks, ways to recognize symptoms of this disorder, as well as possible treatment methods for the condition. Symptoms of Panic Attacks Despite being valid fears—the panic you feel at missing the bus to school, or realizing that your wallet is back home while dining out, does not automatically translate into a panic attack. A panic attack is described as an intense feeling of fear or discomfort, which may occur without any known cause of danger. These attacks can affect anyone from children and teenagers to grown adults. Regardless of who is going through the crippling fear of an attack, however, these feelings typically do not last longer than a few minutes. Within that timeframe, the Diagnostic and Statistical Manual of Mental Health Disorders (DSM) notes that the following symptoms may be observed: Heart palpitations or a quickened heart rate Sweating Quivering or trembling Feelings of getting choked Shortness of breath Chest pain Nausea Lightheadedness or dizziness Feeling detached from oneself Fear of "going crazy" Chills or hot flashes Fear of dying Despite feeling intense and worrying, the symptoms of a panic attack will usually peter out after minutes. However, there are instances where panic attacks may occur several times a day, or as infrequently as a few attacks a year. Understandably, these symptoms—especially when unexpected, can cause a persistent fear of repeat attacks, leading to a panic disorder. Panic attacks are also commonly experienced with conditions such as obsessive-compulsive disorder, social phobia, depression, and anxiety. Did You Know There Are Different Types of Panic Attacks? Causes of Panic Attacks Despite being a relatively common occurrence—an estimated 4.7% of US adults will experience a panic attack at some point in their lives—the exact cause of panic attacks remains unknown. The following are however suspected causes of these attacks: Family History When a person experiences panic attacks, there’s a chance they inherited the condition from earlier family members. First-degree family members are at a 40% risk of developing a panic disorder if someone in the family lives with it. This person may have a sensitive central nervous system centered in the amygdala. The amygdala is a portion of the brain responsible for processing fear and threatening interactions. Other sections of the brain may also contribute to this condition, as well as certain temperamental and environmental factors. A Chemical Imbalance A lot happens in the midst of a panic attack—the hands tremble, sweat breaks out, and extreme fear takes over. While this occurs, the body is experiencing chemical changes that are leading to that reaction. There is a suggestion that abnormalities in the following could lead to the development of a panic disorder: gamma-aminobutyric acid, cortisol, otherwise known as one of the body’s stress hormones, and serotonin. Childhood Trauma When a child experiences a distressing situation such as an accident, bullying, physical abuse, or a natural disaster, this can have negative consequences for well-being. In addition to conditions like PTSD, a child may also be at an increased risk of developing a panic disorder in adulthood. Hypervigilance In some cases, experiencing a panic attack may have the domino effect of producing even more panic symptoms. This is because the sensations associated with a panic attack: chest pain, shortness of breath, a pounding heart can cause the sufferer to think something more dire is at stake. When a person begins to experience panic symptoms, this leads to heightened attention to bodily sensations, increasing arousal of the fight and flight system. The fight and flight system then further heightens anxiety that may lead to a panic attack. Treatment As anyone who has experienced a panic attack will confirm, panic attacks are too disruptive to the well-being to be simply ignored or endured. To get these attacks under control, there are trusted psychological and pharmaceutical measures that are able to treat and manage this condition. They include: Therapy Cognitive-behavioral therapy (CBT) is a highly recommended course of action to control panic attacks. One of the techniques commonly used in this process is exposure therapy. This measure may be used when there is a specific trigger for the panic. Exposure therapy may also manage the internal responses to panic attacks, such as increased heart rates and dizziness. CBT is also recommended to manage some of the co-occurring conditions that may accompany panic attacks like depression and OCD. Breathing Training Breathing exercises are also sometimes utilized to manage the symptoms of panic attacks. These exercises teach patients how to breathe slower, more deeply, and at a regular pace in an effort to manage panic attacks. Breathing training is intended to curb hyperventilation caused by panic attacks. However, while it is popularly used, its effectiveness remains under study. Medication Two commonly prescribed medications to treat panic attacks are antidepressants and benzodiazepines. While benzodiazepines are rapidly effective tranquilizers in panic, prescribers advise caution as a dependency, drowsiness, and affected cognition may occur following use. More commonly, selective serotonin reuptake inhibitors—a type of antidepressant—are usually the first line of treatment to manage panic attacks. SSRIs help to improve the mood and are useful for improving the levels of serotonin in the brain. A Treatment Plan of SSRI Antidepressants Can Help Panic Disorder A Word From Verywell Panic attacks are high ranking on the list of unpleasant bodily sensations. In addition to trembling, sweating, and palpitations, this condition can be so distressing as to lead to a fear of imminent death. While the origins of this condition remain unclear, management for panic attacks is more certain. Reach out to a professional on the appropriate steps and treatment measures to take to treat these attacks. 6 Sources Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. Wehry AM, Beesdo-Baum K, Hennelly MM, Connolly SD, Strawn JR. Assessment and treatment of anxiety disorders in children and adolescents. Curr Psychiatry Rep. 2015;17(7):52. doi:10.1007/s11920-015-0591-z Taylor CB. Panic disorder. BMJ. 2006;332(7547):951-955. doi:10.1136/bmj.332.7547.951 Cackovic C, Nazir S, Marwaha R. Panic disorder. In: StatPearls. StatPearls Publishing; 2021. National Institute of Mental Health. Panic Disorder. Cackovic C, Nazir S, Marwaha R. Panic Disorder. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan. De Bellis MD, Zisk A. The biological effects of childhood trauma. Child Adolesc Psychiatr Clin N Am. 2014;23(2):185-vii. doi:10.1016/j.chc.2014.01.002 By Elizabeth Plumptre Elizabeth is a freelance health and wellness writer. She helps brands craft factual, yet relatable content that resonates with diverse audiences. See Our Editorial Process Meet Our Review Board Share Feedback Was this page helpful? Thanks for your feedback! What is your feedback? 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