Signs of a panic attack: What to watch for and when to seek help

Medically reviewed by Laura Angers Maddox
Updated March 18, 2024by BetterHelp Editorial Team
Content warning: Please be advised, the below article might mention trauma-related topics that include abuse which could be triggering to the reader. If you or someone you love is experiencing abuse, contact the Domestic Violence Hotline at 1-800-799-SAFE (7233). Support is available 24/7. Please also see our Get Help Now page for more immediate resources.

Panic attacks are often a symptom of panic disorder but can also happen unprompted, without warning. These attacks can cause real and distressing physical symptoms that may cause further fear and panic. One step you can take toward understanding panic attacks is learning about why they occur, what they look like, and how to seek support.

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What is a panic attack?

Panic attacks are sudden episodes of dread, fear, and physical symptoms that can feel terrifying. When a panic attack occurs, you might feel that your body is in a state of “fight-flight-freeze,” which might inhibit your judgment and cause you to run, act defensively, or freeze up, struggling to speak. A few physical symptoms that may occur during a panic attack can include the following: 

  • Rapid heart rate
  • Increased blood pressure
  • Heavy or shallow breathing 
  • Shortness of breath 
  • Tingling sensations 
  • Numbness
  • Fatigue 
  • A feeling of being “out of your body” 
  • Headaches
  • Gastrointestinal difficulties
  • Chest pain 

Anyone can experience panic attacks, and they aren’t only associated with a mental illness. However, you might be living with panic disorder if you have frequent and severe panic attacks that decrease your functioning in one or more areas of life. 

Many people with panic disorder feel fear between panic attacks due to the symptoms they cause. For some people, agoraphobia may form due to the fear of panic attacks in certain situations, which can cause difficulty leaving home or going to specific public locations. 

What causes a panic attack?

Stressors, sensory overload, trauma responses, panic disorder, and anxiety can cause panic attacks. In some cases, panic attacks occur for no assumed reason. If you have panic attacks and aren’t sure why, consider contacting a licensed therapist for support. Although panic attacks can be significantly uncomfortable, there may be ways to reduce the chances of them occurring. 

Are panic attacks serious? 

If you experience a panic attack with no other symptoms, it might not be a sign of a mental illness or long-term concern. However, a panic attack might be considered severe if it significantly impacts your functioning and well-being. In addition, it may be possible to have a panic attack during a medical emergency, such as a heart attack. Researchers are studying the connection between coronary disease and panic disorder to understand this phenomenon further. 

However, panic attacks are not fatal and often end after ten to 30 minutes. If your panic attack lasts longer than 30 minutes, calling a nurse helpline for medical advice or talking to a therapist for mental health guidance might be beneficial. 

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Causes of panic disorder

There are a few potential causes of panic disorder, including the following. 

Genetics

Genes may play a role in whether you develop panic disorder. If you think you are living with this mental health condition, you might ask your parents or others in your family if they have also lived with panic attacks and how they’ve coped with these symptoms. 

Stress

Chronic stress can have adverse physical and mental health impacts. However, many people face daily stressors that are challenging to avoid. When left untreated, chronic stress can lead to panic attacks, mental burnout, and other mental health challenges. 

Environmental factors 

Panic disorder may sometimes co-occur with other mental health conditions, like post-traumatic stress disorder (PTSD), which forms from environmental factors (traumatic events). If you have experienced a traumatic or adverse event, especially during childhood, you might experience panic attacks when triggered or reminded of the event. 

Risk factors for panic attacks 

You might choose to limit certain risk factors in your life to lessen your chances of a panic attack. The following are common risk factors associated with panic disorder and panic attacks:
  • Traumatic events
  • Medical trauma 
  • Adverse childhood experiences 
  • Chronic stress 
  • Smoking 
  • Substance use 
  • A history of abuse 
  • Significant life changes, like moving, having a child, or getting married 
  • Phobias 
  • A mental illness like depression, anxiety, or PTSD 
  • Panic disorder 
  • A current unhealthy or abusive relationship
  • Attachment anxiety

If you are struggling with substance use, contact the SAMHSA National Helpline at (800) 662-4357 to receive support and resources.

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Use online therapy to manage anxiety and stop the panic

Prevention techniques

You can use a few prevention techniques to control your nervous system before a panic attack, including the options below. 

Deep breathing 

One technique for lowering stress levels is deep breathing. With a deep breathing exercise, you can focus on the sensation of moving air in and out of your lungs instead of on the other sensations in your body. Deep breathing may also send a signal to your nervous system that you are not in danger.

Exercise 

Exercise may help you externalize nervous energy during the day, potentially reducing stressors that could lead to a panic attack. In addition, it has direct links to improved mental health.

Grounding exercises 

Many people use grounding exercises to cope before or during a panic attack. When you feel a panic attack coming, look around you at your environment. Try to notice three items of your favorite color. 

Afterward, look for an item that means a lot to you and consider why it positively impacts you. For example, if you have a stuffed animal given to you by your partner, you might hold it and think about the time your partner gifted it to you and why it made you feel loved. 

Healthy lifestyle choices 

You may prevent panic attacks by making healthy lifestyle choices. For example, you might choose to eat healthy, wake up and sleep at the same times each day, and go to the doctor for a yearly checkup. You can also spend time with people you love and take time in nature to connect with your environment. 

The TIPP skill from dialectical behavior therapy (DBT) 

Dialectical behavior therapy was developed by Marsha Linehan, Ph.D., to help individuals with profound emotional responses. One module of the DBT workbook is distress tolerance, which focuses on coping with extreme distress. The TIPP skill is one skill from this module, which is an acronym standing for the following:

  • T: Temperature
  • I: Intense Exercise
  • P: Paced Breathing
  • P:  Paired Muscle Relaxation

To start, find a way to alter your temperature. Studies show that swimming in cold water stops panic attacks. If you can’t swim, you can put your face in a sink of cold water, hold an ice cube, or take a cold shower. The temperature of a cold shower can reset your nervous system, potentially bringing you out of your panic.

After changing your temperature, partake in a form of exercise. Swimming in cold water is one way you can combine both skills. However, you can also try running, taking a hike, running on a treadmill, or doing yoga. Exercising can increase endorphins in your brain, allowing you a mood boost.

After you have finished the first two skills, sit or lay down in a comfortable location. Start pacing your breathing by counting on your in and out breaths. You might count to five, eight, or ten, depending on what works for you. While breathing, you can practice paired muscle relaxation by thinking of relaxing each muscle as you breathe. Start with the muscles of your feet and move up to the top of your head, relaxing each part of your body. 

Treatment options for panic attacks 

Consider seeking support if panic attacks or panic disorder adversely impact your life. Panic disorder can be treatable or manageable with help, and psychotherapy and medication are often effective treatments for this disorder. 

Medication 

There are multiple medications used for short-term or long-term anxiety relief. To discuss medication options, consult your primary care provider or a psychiatrist for further information on what might work for your situation. 

Counseling 

Counseling or therapy can allow you to talk to a professional about how your panic attacks impact your life. If you are someone whose panic attacks lead to agoraphobia or cause barriers to in-person therapy, you might try an online therapy service like BetterHelp. You can talk to a professional from home through an online therapy platform and choose between phone, video, or live chat sessions. In addition, many online platforms offer unlimited messaging with your therapist, allowing you to reach out to them throughout the week. If you have a panic attack, you can message your therapist and ask for in-the-moment coping skills that may help you control your emotions. 

One study on online cognitive-behavioral therapy (CBT) for panic disorder found that internet-based interventions could effectively treat symptoms, with results similar to in-person studies. In addition, the researchers concluded that online therapy was more cost-effective than face-to-face treatment for many clients. If you’re interested in receiving mental healthcare online, you can get started anytime, often receiving a match with a therapist within 48 hours of signing up. 

Takeaway

Treatment for panic disorder is often associated with a reduction in panic attacks and anxiety. Research indicates that 90% of people can find relief from panic attacks if they seek treatment. This statistic may motivate you if you aren’t sure whether you want to seek help. 

If you’re ready to talk to a professional now, consider sending a message to a therapist online or calling therapists available in your area for a consultation to get started with treatment. You’re not alone, and symptom management is possible.

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