What is a panic attack?

Anxiety and panic are natural reactions to dangerous situations; these reactions act as our internal alarm system, and keep us safe. While these natural responses help us by keeping us safe in the face of real danger, panic attacks can occur when a person’s perception of danger is disproportionate to actual risk – it’s relative, subjective, and often hard to pinpoint, even for the person experiencing the panic attack. 

A panic attack happens when a person experiences a sudden, intense rush of psychological and physical symptoms. They can be extremely scary. Though it may feel as though you are in serious physical danger, panic attacks themselves do not cause any lasting physical damage, and on average will last between 5-20 minutes. This can, of course, feel like a lifetime and the psychological damage of living with panic attacks can be severe and debilitating. 

If you have recurring and/or frequent panic attacks, you may have panic disorder. 


Symptoms

During a panic attack, you may feel scared, anxious, apprehensive and unsafe. It is common for people experiencing a panic attack to feel that they are going to have a heart attack and/or die. A panic attack is usually characterised by physical symptoms, most commonly:

  • nausea
  • difficulty breathing (hyperventilation)
  • sweating
  • shaking
  • dizziness
  • tingling or numbness in fingers and/or toes
  • ringing in your ears
  • chest pains and/or heart palpitations

Certain people may also find that they respond by dissociating from the situation. When this happens, you may feel that you are an outsider, an observer to the panic attack. This is a common response to traumatic experiences. You can read more about dissociation here


Causes

As mentioned above, panic attacks are in part the result of your body kicking into ‘fight or flight’ mode, which in the right doses keeps us safe. When this response is activated in your body, you automatically try to take in more oxygen – which speeds up your breathing – and you also experience a rush of adrenaline, causing your muscles to tense and heart to beat faster. 

What causes a panic attack will be different for each person. For some, panic attacks may be a response to a traumatic life event, such as a bereavement or marriage breakdown. Mental health issues such as anxiety, PTSD and OCD may also predispose someone to panic attacks. 

Genetics may also play a part; it is more likely that you will experience anxiety and panic attacks if someone in your family does. Catastrophizing – when a person focuses on minor symptoms and their thoughts very quickly or automatically progress into harmful territory – can also prompt a full blown panic attack.


What can I do to help myself during a panic attack?

Though understandably the idea of following particular steps might seem impossible during a panic attack, many people with panic disorder are able to learn their triggers, symptoms and how to ensure their panic attacks are as manageable as possible. Here are a few things you can do to help yourself during a panic attack. 

If possible, stay where you are. In certain situations, such as if you are in your car, you will need to ensure your safety by pulling over to the side of the road. Staying where you are means you are not using energy displacing yourself, and you are also responding to your ‘fight or flight’ response in the most helpful way. By facing your fear, you will train yourself to understand that nothing bad is about to happen to you. 

Focus on this truth: nothing bad is going to happen to you.  Remind yourself that the symptoms will pass. It may be helpful to focus on your breathing. Try to breathe slowly and calmly; deeply in through your nose and out through your mouth. Some people find it helpful to count while they breathe in and out. Breathe out for longer than you breathe in, to activate the parasympathetic nervous system - this has a calming effect on the body. 


What can I do to minimise the likelihood of panic attacks in the future?

Identifying any particular sources of stress in your life, and working to relieve this, is a good place to start. Whether this is a relationship, work or financial stress, exams – all of us will react to stress in our own way. Once you have identified the source of undue stress, reach out to relevant people for support or advice, or try to find ways of relieving that stress for yourself, whether this means talking to your partner, your boss, or working out a revision schedule. 

Practising breathing exercises everyday will help you stay calm in daily life, and could prove to be a very helpful habit to help you ride out any panic attacks should they occur in the future.

Exercise helps to relieve stress and muscle tension. It is also proven to boost mood and increase confidence. Eating regularly and healthily, keeping your energy levels plentiful and blood sugar levels steady will also protect you from stress; as will avoiding too much alcohol or other drugs. 


How can counselling or psychotherapy help? 

While a panic attack itself is not likely to cause you lasting physical harm, the psychological impact of living with panic disorder can be huge. You may find you develop other mental health difficulties, such as agoraphobia, as a result of becoming isolated. Underlying mental health issues such as anxiety, post-traumatic stress disorder, obsessive compulsive disorder and depression, all of which may cause panic attacks, can be addressed and relieved with the help of talking therapy.

CBT is often recommended for panic attacks, as it focuses on your thoughts and feelings, so a CBT therapist can help you identify and manage your thoughts. In this way, you can better manage your thoughts in general, and during panic attacks – this improves self-awareness and protects you from catastrophizing or getting stuck in an unhelpful loop of thoughts that may make the symptoms of a panic attack worse or longer-lasting. ​

While CBT is helpful, in order to address the underlying issues that may be causing the panic attacks, longer-term psychotherapy may be beneficial, in particular with a therapist who is trained in body awareness.


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Last updated 19 July 2016