What Is a Panic Attack?

Woman having a panic attack

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What Is a Panic Attack?

A panic attack is a sudden and intense feeling of terror, fear, or apprehension, without the presence of actual danger. The symptoms of a panic attack usually happen suddenly, peak within 10 minutes, and then subside. However, some attacks may last longer or may occur in succession, making it difficult to determine when one attack ends and another begins.

Anyone can experience a panic attack. An attack can sometimes be triggered by a specific event, but these attacks can also be a symptom of anxiety disorders like panic disorder or agoraphobia.

Symptoms

Panic attacks usually appear suddenly and lead to intense feelings of fear. They tend to last around 10 to 20 minutes but can last longer in some instances. The experience can vary from one person to the next, but some of the most common symptoms include:

  • Chest pain or discomfort
  • Chills or hot sensations
  • Feeling of choking
  • Feeling dizzy, unsteady, lightheaded, or faint
  • Fear of dying
  • Fear of losing control or going crazy
  • Feelings of unreality (derealization) or being detached from oneself (depersonalization)
  • Nausea or abdominal distress
  • Numbness or tingling sensations (paresthesias)
  • Palpitations, pounding heart, or accelerated heart rate
  • Sensations of shortness of breath or smothering
  • Sweating
  • Trembling or shaking

Diagnosis

According to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), a panic attack is characterized by a “surge of intense fear or intense discomfort that reaches a peak within minutes” and includes four or more of the above symptoms. The presence of fewer than four symptoms may be considered a limited-symptom panic attack.

It is important to note that many people may experience a panic attack once or even a few times during their lives, but not receive a diagnosis of a mental health condition. In order for a diagnosis of panic disorder to be made, for example, a person must experience recurring, unexpected panic attacks that are not caused by the effects of drugs, alcohol, or another medical or psychological condition.

It is possible to have a few isolated panic attacks without recurrence. But, since panic-like symptoms may mimic many other medical and psychological disorders, it is important to review your symptoms with your doctor.

Causes

The exact causes of panic attacks are not known, but there are a number of different factors that are believed to play a role. These include:

  • Brain chemistry
  • Genetics and family history
  • Life stress
  • Personality and temperament

If you tend to be more sensitive to stress or frequently experience negative emotions, you may be more likely to experience panic attacks. People who have family members with anxiety disorders may also be more likely to experience panic attacks, suggesting there is a genetic component. 

Women are also more likely than men to develop anxiety conditions such as panic disorder. As a result, experts recommend that women and girls aged 13 and older be screened for anxiety conditions.

Types

One way that panic attacks have been characterized into different types is as follows:

  • Spontaneous or uncued panic attacks occur without warning or “out of the blue.” No situational or environmental triggers are associated with the attack. These types of panic attacks may even occur during sleep.
  • Situationally bound or cued panic attacks occur upon actual or anticipated exposure to certain situations. These situations become cues or triggers for a panic episode. For example, a person who fears enclosed spaces may experience a panic attack when entering or thinking about entering an elevator.
  • Situationally predisposed panic attacks don’t always occur immediately upon exposure to a feared situation or cue, but the person is more likely to experience an attack in such situations. For example, a person who has a fear of social situations but who does not experience a panic episode in every social situation, or who experiences a delayed attack after being in a social environment for an extended period of time.

Treatment

Treatment for panic attacks can involve psychotherapy, medication, or a combination of both. Treatment options are focused on reducing the frequency and intensity of these attacks. The treatment options that your doctor recommends may depend on a variety of factors including your diagnosis, your history, your preferences, and the severity of your symptoms.

Psychotherapy

There are different types of therapy that may be used, but an approach known as cognitive behavioral therapy (CBT) is often recommended for panic attacks and anxiety disorders. CBT is focused on helping people identify the thoughts that contribute to feelings of fear and anxiety and replace them with more helpful, realistic ones. Through this process, people can learn that the things that trigger these attacks are not as frightening as they previously believed.

Medication

Your doctor may also prescribe certain medications to help treat some symptoms that might be associated with your panic attacks. Some of the medications you might be prescribed include:

  • Antidepressants such as selective serotonin reuptake inhibitors (SSRIs) like Zoloft (sertraline) and Prozac (fluoxetine) if you are also experiencing symptoms of depression
  • Anti-anxiety medications that act as depressants on the central nervous system including benzodiazepines such as Xanax (alprazolam)

Coping

There are also steps that you can take if you are having a panic attack or fear that you might have one. Some helpful strategies you can try include:

  • Deep breathing: This can help prevent the rapid breathing or hyperventilation that often happens during a panic attack
  • Mindfulness: This involves grounding yourself and being more aware of what is happening with your body in the moment
  • Progressive muscle relaxation: This involves tensing and then relaxing muscles throughout the body; when practiced regularly, you can learn how to induce a relaxation response when you are anxious or stress
  • Visualization: This involves thinking of something that you find calming and relaxing; picturing this scene in your mind can help produce a relaxation response to combat your feelings of fear

A Word From Verywell

Panic attacks can be distressing, but help is available. Talk to your doctor about your treatment options and explore some relaxation techniques that you can use to stay calm when you are faced with an anxiety-provoking situation.

If you or a loved one are struggling with panic attacks, contact the Substance Abuse and Mental Health Services Administration (SAMHSA) National Helpline at 1-800-662-4357 for information on support and treatment facilities in your area.

For more mental health resources, see our National Helpline Database.

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Article 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.
  1. Locke AB, Kirst N, Shultz CG. Diagnosis and management of generalized anxiety disorder and panic disorder in adults. Am Fam Physician. 2015;91(9):617-24.

  2. Gregory KD, Chelmow D, Nelson HD, et al. Screening for anxiety in adolescent and adult women: A recommendation from the Women's Preventive Services Initiative. Ann Intern Med. 2020. doi:10.7326/M20-0580

Additional Reading
  • American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 5th ed. Washington D.C.: 2013. doi:10.1176/appi.books.9780890425596