Panic Attack

Panic attacks are an extreme anxiety response. They can come on quickly, often with no clear reason, and they can be really scary. Whether you rarely experience them or have frequent panic attacks, they can leave you shaken and feeling out of sorts. 

In this article, we'll break down all aspects of panic attacks, including the symptoms, what tends to trigger them, and ways to help if you (or someone close to you) are in the middle of one.

What is a panic attack?

The clinical definition of a panic attack is a sudden surge of intense fear or discomfort that reaches its peak within minutes. It's your body's alarm system going off at full volume, even when there's no actual danger nearby. That's part of what makes them so disorienting: your nervous system reacts as though something life-threatening is happening, but on the outside, life is carrying on as normal.

Panic attack duration

Panic attacks usually last between five and twenty minutes, although the after-effects can linger much longer. The duration is short, but the experience is so intense that it can feel much longer.

Panic attacks are normal in the sense that they're a recognised, well-understood response, and a huge number of people experience them at some point in their lives. They're not a sign that something is fundamentally wrong with you.

What can cause a panic attack?

Unfortunately, this isn't a clear-cut answer. Sometimes panic attacks come from nowhere. For other people, they might be brought on by certain situations, like crowded spaces, public speaking, or a particular memory resurfacing.

From a psychological perspective, panic attacks often sit at the meeting point of stored stress and a nervous system that's been running on high alert for some time. You might be coping perfectly well on the surface, but underneath, your body has been holding onto pressure, grief, overwork, or unresolved emotion. A panic attack can happen when that pressure finds its way out.

Common triggers for panic attacks include major life changes, ongoing stress, sleep deprivation, caffeine or alcohol, hormonal shifts, and reminders of past trauma. 

Some people experience random panic attacks with no identifiable trigger, which can feel especially confusing. If you find yourself wondering "why do I keep having panic attacks for no reason," it's often because the cause sits below the surface of conscious awareness, woven into patterns your body remembers even when your mind doesn't.

Constant panic attacks, or attacks happening regularly, are a sign your nervous system is asking for some real attention and care, not something to push through alone.

What does a panic attack feel like

People often ask what a panic attack feels like. The honest answer is that it varies a lot from person to person, but there are some common physical symptoms and emotional symptoms. Here are some of the signs of a panic attack to look out for:

• A racing or pounding heart

• Shortness of breath, or feeling like you can't get a full breath in

• Tightness or pain in the chest

• Dizziness or feeling lightheaded

• Trembling or shaking

• Sweating or chills

• Tingling or numbness, often in the hands or face

• Nausea or stomach discomfort

• A sudden, overwhelming sense of fear or dread

• Feeling detached from your body or surroundings

• A fear of losing control, fainting, or, in more severe cases, a fear of dying

In more severe panic attacks, people can feel like they might be dying, or that they're having a heart attack. This is one of the most frightening parts of the experience, and one of the most common. 

What are the symptoms of a panic attack?

The physical symptoms of a panic attack and a heart attack can overlap (chest pain, racing heart, shortness of breath), which is part of why it feels so alarming. But to answer a question many people think: no, you can't die from panic attacks. 

You might also hear people talk about a mini panic attack. This usually refers to a milder version, where you notice some of the symptoms (a tight chest, a racing heart, a wave of dread) but the experience doesn't escalate. These can be your body letting you know something needs care.

Panic attack or panic disorder: what is the difference?

Whilst the terms are often used interchangeably, a panic attack and panic disorder are two distinct things. The simplest way to understand the difference is that a panic attack is a single event, whereas panic disorder is an ongoing condition.

Common symptoms include:

• A racing or pounding heart (palpitations)

• Shortness of breath or feeling smothered

• Sweating, trembling, or shaking

• Dizziness, light-headedness, or feeling faint

• Numbness or tingling sensations (pins and needles)

• A terrifying feeling of losing control, going mad, or even dying (many people mistake a panic attack for a heart attack and end up at A&E).

What is Panic Disorder?

Panic disorder is a specific type of anxiety disorder. Whilst anyone can have an isolated panic attack, a person with panic disorder experiences them frequently and unexpectedly.

To be diagnosed with panic disorder, a person must experience recurrent panic attacks, but the most defining characteristic is what happens between the attacks.

Key signs of panic disorder include:

• The fear of fear. Constantly worrying about when and where the next panic attack will strike.

• Behavioural changes. Changing your daily routine to avoid situations that you believe might trigger an attack. For example, you might stop taking public transport, avoid going to the shops, or refuse to leave the house entirely (which can develop into agoraphobia).

• Unprovoked attacks. The panic attacks often happen completely out of the blue, rather than being tied to a specific phobia or a clearly stressful event.

Anxiety or panic attack: what's the difference?

People often use the terms interchangeably, but there's a useful distinction. An anxiety attack tends to build more slowly, often in response to a specific worry, and can last longer at a lower intensity. An anxiety attack feels more like a rising tide, with tension, restlessness, racing thoughts, and a sense of dread that grows over time.

A panic attack, by contrast, tends to come on suddenly and peak quickly. It's sharper, shorter, and often more physically intense.

What can help if you're experiencing a panic attack

If you're wondering what to do when you have a panic attack, here are some things that can help in the moment:

• Remind yourself what's happening. Naming it ("this is a panic attack, it will pass") can take some of the fear out of the experience.

• Slow your breathing. Try breathing in for four counts, holding for four, and exhaling for six. The longer exhale signals to your nervous system that it's safe.

• Ground yourself in your senses. Notice five things you can see, four you can touch, three you can hear, two you can smell, and one you can taste. This pulls your attention back into the present.

• Find something cool. Holding a cold drink, splashing water on your face, or pressing a cold cloth to the back of your neck can interrupt the panic response.

• Sit somewhere comfortable if you can. You don't need to fight it or run from it. Letting it move through you, knowing it will pass, often shortens the experience.

In terms of how to stop panic attacks more generally, or how to prevent a panic attack from taking hold, the longer-term work tends to involve looking at what's underneath them. Panic attack treatment often includes talking therapy, breathwork, lifestyle adjustments, and sometimes medication, all best explored alongside a professional.

How to spot if someone is having a panic attack

If you're with someone you suspect might be having a panic attack, look for sudden changes: a flushed or pale face, rapid breathing, hands pressed to the chest, trembling, or them becoming very quiet or visibly distressed. They may say they feel like they can't breathe, or that something is very wrong. Knowing how to tell if you're having a panic attack yourself, or spotting it in someone else, often comes down to noticing how suddenly the symptoms appear.

What to do if someone is having a panic attack

The most helpful thing you can do is stay calm and stay with them. Speak gently and slowly. Let them know you're there, that what they're experiencing is a panic attack, and that it will pass. Avoid crowding them or asking lots of questions. If they want to move somewhere quieter, help them get there. If they want to sit still, sit with them.

How does someone feel after a panic attack?

A lot of people don't realise that while the panic attack itself can feel like an intense storm, the aftermath is its own thing entirely. The after-effects of a panic attack can leave you feeling drained, tearful, foggy, or strangely detached from the world around you. Some people describe feeling "out of it" for the rest of the day, or even into the next.

This is partly because a panic attack puts your body through an enormous amount, physiologically speaking. Your stress hormones spike, your muscles tense, your heart works hard. Once it passes, your system needs time to settle. Be gentle with yourself in the hours and days that follow. Rest, eat something nourishing, hydrate, and let the people around you know you need a quieter day.

When to seek help

If you're having frequent or constant panic attacks, if they're starting to shape your decisions (avoiding certain places, situations, or people), or if they're leaving you feeling exhausted and frightened, it's worth reaching out. You don't need to wait until things feel unbearable to ask for support.

Our online therapy team work with people experiencing panic attacks every day, and there's a lot that can be done to help you understand what's happening, ease the intensity, and feel more like yourself again. Panic attacks can feel isolating, but you really aren't on your own with this.