​Panic Attacks: Explore Causes, Symptoms, and Treatment Options

Intense Fear of a Panic Attack

When panic hits, it can feel uncontrollable — but you are going to be okay. Let me help you understand that.

What Is Panic Disorder?

Panic disorder involves sudden waves of intense fear or discomfort that seem to come out of nowhere. Many people describe these moments as a sense of dread, losing control, or even feeling that something terrible is about to happen. During a panic attack, it’s also common to feel disconnected—visually, physically, or mentally—from yourself or your surroundings. These experiences are called depersonalization (feeling detached from yourself) and derealization (feeling detached from the world around you).

Panic episodes can happen at any time—even during sleep—and they may show up often or only once in a while. No matter how frequently they occur, they can feel overwhelming and frightening.

You can learn more below about what panic attacks look like, why they happen, and what can help in Panic Attacks: Exploring Causes, Symptoms, and Treatment Options.

Impact on Daily Life

Panic disorders can make everyday life feel unpredictable. The intensity of symptoms and the fear of another attack can lead people to avoid certain places, situations, or activities. Over time, this can shrink someone’s world in ways they never intended.

What Causes Panic Attacks?

Panic attacks often begin in the amygdala, the brain region that helps us detect danger. When this system becomes overly sensitive or overactivated, it can trigger a surge of fear even when no real threat is present. This is more common in people who also live with generalized anxiety, depression, or periods of significant stress. Genetics can also increase someone’s likelihood of experiencing panic attacks.

Common Physical Symptoms

• Excessive sweating (diaphoresis)

• A racing or pounding heart (palpitations)

• A fast heartbeat, often above 120 beats per minute (tachycardia)

• Rapid or shallow breathing (tachypnea)

• Nausea

• Dizziness or feeling faint

• Numbness or tingling in the fingers or toes (paresthesias)

• Shortness of breath or the feeling of not being able to get a full breath (dyspnea)

• Chest tightness or chest pain (non‑cardiac chest pain)

• Chills or hot flashes

• Shaking or trembling (tremors)

• A feeling of choking

• A sudden sense of impending doom (one of the hallmark symptoms)

These symptoms resemble those of other conditions like asthma, heart attacks, and pulmonary emboli (blood clots in the lungs), making panic attacks particularly frightening and confusing. The important thing to remember is that panic attacks themselves are not dangerous — and although they feel overwhelming, they are fleeting. They rise, peak, and pass, even when it doesn’t feel that way in the moment.

​How to Check Your Heart Rate During an Episode

During a panic attack, a person often notices their pulse racing, which can understandably worry them. A rapid heartbeat is a normal part of the body’s stress response — it’s the adrenaline surge, not a sign that the heart is failing. The heart is doing exactly what it’s designed to do in moments of intense fear.

These days, a person can check their pulse on an Apple Watch, or it can be checked by gently placing two fingers on the thumb side of the wrist, feeling for pulsations. The beats should be counted for 60 seconds (as seen in the photo below).

Checking a Pulse

In younger individuals — especially teens through their early 30s — panic attacks can appear when anxiety and life’s pressures begin to build. If someone with a history of anxiety starts experiencing the symptoms described above, they often recognize it. It’s often a sign that their stress system has been pushed into overdrive. However, if these sensations are happening for the first time, it’s important not to assume it is a panic attack. New or unfamiliar symptoms should always be approached with care and evaluated when needed.

When to Seek Help and What to Do During a Panic Attack

For those who have never had a panic attack

If someone experiences symptoms like chest pain, a rapid heartbeat, or shortness of breath — and it’s their first time — they shouldn’t assume it’s a panic attack. A medical evaluation is important to rule out other possible causes, including heart or lung conditions. When possible, it’s best to assess symptoms as they happen, since this can give healthcare providers the clearest picture. And if there is any uncertainty, especially when symptoms are intense or unfamiliar, calling 9-1-1 is the safest choice. Occasionally, a fast heart rate can be related to an undiagnosed heart rhythm issue, so new symptoms deserve careful attention.

For those with a history of panic attacks

If hyperventilation occurs — especially with numbness or tingling in the hands or feet — sitting down and slowing your breath can help.

Anyone who experiences panic attacks, whether occasionally or frequently, may benefit from talking with a counselor. Techniques such as guided breathing, grounding exercises, or progressive muscle relaxation can help reduce the intensity of episodes over time. In some cases, medication may also play an important role in treatment (see below).

The reassuring news is this: a panic attack is not fatal. Even though the sensations can be overwhelming, they are temporary. At worst, a person may faint and regain consciousness shortly afterward.

If in doubt, call 9-1-1.

Treatments Approaches to Panic and Anxiety

The goal is to try to calm the anxiety before it rises to the level of panic. Many different approaches can help reduce anxiety and prevent panic attacks, which is a good thing — not everyone responds to the same method, and not everyone feels comfortable with the same approach. In more serious cases, a combination of medication and therapy can be especially effective, though not everyone prefers one or the other. What matters most is finding the tools that feel right and work well for the individual.

What Are the Best Techniques on a Moment's Notice?

Some of the better techniques you can try if panic seems to be coming on quickly include the following-

Slow breathing - One minute of slow breathing can interrupt the panic cycle.

Grounding techniques - Try the 5-4-3-2-1 Grounding technique. This technique uses the five senses to help bring attention back to the present moment. It’s quick and can be done anywhere: Look around your environment. Notice five things you can see (colors, shapes, light etc), four things you can feel (texture, clothing, the floor, etc), three things you can hear, two things you can smell and one thing you can taste. This works because by shifting the brain away from fear and back into the body and the present moment, it is a good reset during rising anxiety or panic.

Reassurance statements - These are positive statements of reassurance that a person repeats over and over again like "I am safe" "can get through the next minute" "it's okay to feel this way, nothing will happen" "my body and mind will handle this" "I trust the process of life" and many others (you can create up your own!).

Mindfulness — a group of gentle, awareness‑based meditation practices — has been shown to help regulate the fronto‑limbic system, including the amygdala, which is a region of the brain involved in fear and threat responses. By helping this area settle, mindfulness can reduce the intensity of anxiety and make panic attacks less likely. These techniques are often a core part of long‑term panic‑management strategies. You can learn more about them here.

Checking your pulse may be helpful. Concentrate on slowing it down.

For an extensive list of long‑term strategies to reduce anxiety, see our Generalized Anxiety Disorder page

*Note: This information is for educational purposes only and isn’t a substitute for professional care. Always consult a healthcare provider if you’re unsure about your symptoms