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Panic attacks


Expert reviewer, Dr Rahul Bhattacharya, Consultant Psychiatrist
Next review due September 2020

A panic attack is a period of severe fear and overwhelming physical feelings. Panic attacks usually reach their peak within 10 minutes and can last between 20 and 30 minutes. Around one in every three people experience panic attacks in their lifetime.

Panic attacks can either occur unexpectedly or be triggered by a particular situation. They may happen to you just once, or repeatedly over time. While they are unlikely to cause any lasting physical harm, experiencing panic attacks can be very distressing.

Symptoms of a panic attack

The sensations that occur during a panic attack will vary from person to person and can be both physical and mental. You may feel overwhelmed and unable to control them. Some of the most common symptoms include:

  • being short of breath
  • having a rapid heartbeat
  • feeling faint, lightheaded or dizzy
  • trembling or shaking
  • feeling sick
  • feeling hot or cold
  • feeling numbness or a tingling sensation in your skin
  • sweating
  • feeling like you’re choking or having difficulty swallowing
  • feeling detached from reality
  • feeing afraid that you’re going to die, or that you have no control
  • a feeling of tightness in your chest

You might experience symptoms other than the ones listed here. These symptoms can be so intense that people can think they are having a heart attack.

It’s important to remember that although these symptoms are upsetting, they are unlikely to cause any lasting physical harm.

Diagnosis of panic attacks

Your GP will ask you about your symptoms and how you’ve been feeling.

If your GP believes your symptoms could be caused by a health problem, they will refer you for certain tests. For example, sometimes if you’ve had chest pains, they may arrange an electrocardiogram (ECG) test to rule out any heart problems.

If you’ve had repeated and unexpected panic attacks for a month or more, your GP may diagnose you with panic disorder. This is a type of anxiety. People with panic disorder often feel very worried about having more panic attacks, or very anxious that they may have a physical illness.

While panic attacks are common, panic disorder is not. If you do have panic disorder, your GP will discuss your treatment options with you, which could include taking medicine.

How you can help yourself

Learning to manage the anxiety that causes a panic attack may help you to prevent them from occurring. The following steps may help you to do this.

Talking about it

Simply talking to a friend or family member and voicing worries and concerns could help. But if you’re not comfortable sharing your thoughts with someone close, there are lots of other people ready to listen and help. This could be talking to a counsellor, therapist, an online forum, specialist charity or through joining a support group.

Living a healthy lifestyle

Exercise triggers the release of a set of ‘happy’ hormones known as endorphins which have been shown to improve mood and reduce anxiety. Other aspects of a healthy lifestyle, including eating a healthy diet, and avoiding stimulants such as caffeine, alcohol and nicotine, as well as getting a good night’s sleep, could also help.

Breathing and relaxation techniques

For someone feeling anxious, it’s important to keep stress to a minimum and take time out to relax. Activities such as yoga, Tai chi, meditation, mindfulness and deep breathing may help to relax the mind and body. This can reduce stress and anxiety which could prevent the occurrence of a panic attack. Hyperventilating (breathing shallow and quickly) is common during a panic attack. You can try and manage this through the use of deep breathing techniques, which can be learned through these practices.

Identifying triggers

Keeping a diary of the situations and feelings which may trigger a panic attack can help to identify risks which you can then avoid. It could also be useful to take note of any times when you successfully avoided an attack and the steps you took to do this. Not only does this mean you might be able to try the same technique in the future, but it’s important to make note of the positive side and acknowledge how well you’ve done.

Treatment of panic attacks

Treatment could also include talking therapies or counselling. Cognitive behavioural therapy (CBT) is a type of talking therapy where you focus on the way you think and behave. You learn to challenge negative emotions and develop coping strategies for these. It can be done face-to-face with a professional or through online courses. CBT has been shown to be useful in helping some people deal with anxiety and panic attacks.

If you regularly have panic attacks, your GP may recommend a treatment for the anxiety that causes the attacks. This could include taking antidepressants or another medication to improve your mood.

Causes of panic attacks

Around one in every eight people who have panic attacks say a major negative event has happened in their life. But it’s not always possible to explain exactly why panic attacks happen. For some people panic attacks are triggered in particular situations that make them anxious, while for others they seem to happen for no reason.

People who experience panic attacks may also have anxiety or depression. Panic attacks can also happen after people have had problems with alcohol or illegal drugs.

Preventing panic attacks

If you have panic attacks or become very anxious in a particular situation, avoiding that situation may be one way to prevent future panic attacks. However, depending on what you are avoiding, doing this might not always be possible or good for you.

Another way to prevent future panic attacks could be to have cognitive behavioural therapy (CBT) which can help you to manage anxiety.

Finding ways to feel more relaxed and less anxious in everyday life could help to prevent panic attacks. Some people find that breathing exercises and complementary therapies, such as yoga, meditation or massage, are good ways to feel more calm.


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Related information

    • Anxiety and stress-related disorders. Oxford Handbook of Psychiatry (online). Oxford Medicine Online. oxfordmedicine.com, published March 2013
    • Panic Disorder. PatientPlus. patient.info/patientplus, last checked December 2016
    • Panic disorders. BMJ Best Practice. bestpractice.bmj.com, last updated April 2017
    • Panic attacks and panic disorder. MSD Manual. msdmanuals.com, last full review/revision May 2014
    • Anxiety, Panic and Phobias. Royal College of Psychiatrists. www.rcpsych.ac.uk, last updated September 2015
    • Let's get physical: the impact of physical activity on wellbeing. Mental Health Foundation. 2013. www.mentalhealth.org.uk
    • Anxiety and panic attacks. Mind. www.mind.org.uk, last updated February 2015
    • Manzoni GM, Pagnini F, Castelnuovo G, et al. Relaxation training for anxiety: a ten-years systematic review with meta-analysis. BMC Psychiatry 2008; 8(41). doi:10.1186/1471-244X-8-41
    • Hyperventilation. PatientPlus. patient.info/patientplus, last checked September 2015
    • Livermore N, Sharpe L, McKenzie D. Prevention of panic attacks and panic disorder in COPD. Eur Respir J 2010; 35: 557–63; DOI: 10.1183/09031936.00060309 
  • Reviewed by Graham Pembrey, Lead Health Editor, Bupa Health Content Team, September 2017
    Expert reviewer, Dr Rahul Bhattacharya, Consultant Psychiatrist
    Next review due September 2020



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