Panic Attacks Explained: Symptoms, Causes, and What To Do
From racing hearts to dizzy spells, panic attacks are scary—knowing how to respond can make all the difference
May 18, 2026
We, as humans, need anxiety. Why? Anxiety is information.
It tells us when we must freeze, flee, or fight and mobilizes our body to respond quickly, without thinking. Without anxiety, we would not be able to avoid real threats to our well-being.
However, we also feel anxiety about imagined threats that may or may not be meaningful or real.
Anxiety can be our friend
In a sense, our minds have evolved to be extra careful about threat detection. They are more likely to evaluate things as threats than not. This way we do not miss anything that might harm us.
Also, our minds do not have an “off button.” This means that sometimes anxiety becomes a problem because it doesn’t give us useful information and contributes to our distress and avoidance.
All humans experience anxiety when they experience stressful events, such as receiving an upsetting medical diagnosis. Public speaking, social events, relationship problems, stress on the job, and financial worries are also common triggers that make people feel anxious.
However, sometimes life events can trigger anxiety disorders or panic disorder.
So, what’s the difference?
Keep Reading To Learn
- How to tell the difference between panic and anxiety
- How to recognize and de-escalate a panic attack
- The treatment of anxiety and panic disorders
Panic Disorders: What You Need To Know
People often joke that they are having a “panic attack” without actually knowing what a panic attack is. Such talk only contributes to the stigma that surrounds panic disorder and around those who experience panic attacks.
A panic attack is a sudden episode of intense fear, often triggering physical reactions even when there is no real threat. Unlike anxiety, which often has clear triggers, panic attacks occur suddenly and unexpectedly and typically only last for a few minutes.
When a person has a panic attack, their heart starts pounding and they have trouble breathing. Some say they feel like they were being choked or suffocated. Others say an attack made them feel “detached from reality.” People have also reported lightheadedness, chest pain, hot flashes, chills, and stomach discomfort.
Occasional panic attacks can happen to anyone, although for some individuals, they occur more frequently and cause significant distress and impairment. Some people only have a single panic attack, while others may experience repeat episodes. For those who have recurring episodes, mental health professionals can work to help identify the cause and triggers.
Overall, the exact cause of panic disorder and panic attacks is unclear. However, panic attacks do appear to run in families. In some situations, a major life shift can bring on a panic attack—in others, a person may not know the cause of the attack.
Panic vs. Anxiety
Panic attacks and anxiety are often confused for each other. McLean’s Michelle Silverman, PhD, helps us understand the difference between panic and anxiety especially when either is affecting a child or teen.
Is it Panic or Anxiety?
Understanding the differences between naturally occurring anxiety, worry, and panic can help people take steps to address their feelings. Knowledge of these conditions can also help individuals recognize if their condition is serious enough to require treatment.
Example 1: A Normal Level of Anxiety
Imagine this: Your social media feed is full of divisive political talk, there are risks of layoffs due to the decimated economy, and there seems to be no clear end in sight.
In the meantime, you have a project deadline tomorrow.
You feel stressed, squeezed, and overwhelmed. You feel tired and worried, unsure about what the future holds, whether you will get done what you need to do, whether you will help your child cope with it all.
This example describes an individual experiencing very natural, understandable anxiety around a challenging situation. Fear of an uncertain future, memories of a difficult past, threats (both real and perceived), and confusion about the world around us are all triggers for anxiety.
Example 2: A Concerning Level of Anxiety
Now consider this scenario: It is the middle of the night, and you can’t go to sleep. Your thoughts are racing.
What if …? Your mind can’t stay away from the stream of catastrophic worries that keep circling. Your heart pounds. You’re exhausted. You look at the clock—it’s 3:15am.
The second example describes an individual experiencing worry and—depending on the level of distress and functional impairment caused—may indicate that treatment for anxiety might be helpful.
Worry is a mental activity that, somewhat counterintuitively, functions as an anxiety avoidance strategy, though it’s one that doesn’t work very well. It’s hard to simply stop worrying.
Typically, when individuals find themselves stuck in a worry cycle, learning acceptance and mindfulness skills from acceptance-based behavior therapy can be useful.
Example 3: Panic
Lastly, think of this example: You’re out with your friends at a restaurant, laughing at a joke one has just told.
All of a sudden, there’s a sensation of your blood rushing to your ears, and your heart rate accelerates. Your hands are clammy, and you wonder whether you’re having a heart attack.
Intense fear grips you, and you feel the urge to leave, to escape the situation. You get up without excusing yourself and run for the door.
This example describe an individual experiencing a panic attack. Panic attacks are rarer and more severe than anxiety. They can come out of the blue, without warning or provocation.
People having panic attacks can experience shortness of breath, dizziness, nausea, and numbness. Some shake and sweat.
Individuals struggling with a panic disorder are often very watchful for the physical sensations that might be harbingers of panic and avoid places where panic attacks may have occurred in the past. Sometimes those struggling with panic avoid leaving their homes at all.
The good news is that panic disorder is highly treatable with exposure therapy.
Recognizing Anxiety
Anxiety can be so much more than stress or worry. Learn about it and how to live a happy, healthy life—even if you or a loved one has anxiety.
Can Medical Conditions Cause Panic Attacks?
In addition to specific mental health conditions, medical conditions can cause panic attacks to develop. These include:
- Hyperthyroidism, or an overactive thyroid gland
- Withdrawal from certain medications, particularly those used to treat mental health conditions
- The use of stimulants such as caffeine, cocaine, and amphetamines
- Hyperglycemia, or high blood sugar
- Mitral valve prolapse, a heart condition
Signs and Symptoms of Panic Attacks
As with other conditions, panic attacks can be different from person to person. However, there are a few common symptoms that people experience, including:
- A sudden fear of death
- A sense of impending doom or danger
- A rapidly rising heart rate
- The development of chills and hot flashes
- A feeling like someone is squeezing the throat
- The development of nausea, vomiting, and abdominal cramps
- Dizziness, vertigo, lightheadedness, or feeling faint
Again, these symptoms can vary from person to person. Some people may have all of the symptoms described above while others may have only one or two.
People who experience panic attacks are often embarrassed by a sudden onset of their symptoms. Since they are often inexplicable, it is critical for everyone to understand what to do in the event of a panic attack.
How’s Your Head?
Take an online anxiety screening to get insight into how you’re really doing—and what to do next.
De-Escalation: Treating a Panic Attack
If you are having a panic attack, it is important to remind yourself that your brain’s threat detection system is sounding a false alarm—like a fire alarm going off when there is no fire. It is also important to ride the wave of emotion to shore instead of trying to fight or interrupt it.
By doing this, your brain can learn that it is, in fact, a false alarm and that you can handle the experience, even when it feels incredibly challenging.
First, recognize that you are having a panic attack. Then, practice mindfully observing and describing the sensations that you are experiencing—without judgment or trying to control or change them.
You can do this by starting at the top of your head and gradually moving down to your toes. For example, say to yourself, “I notice that my heart is racing.” You may need to repeat this mindful body scan cycle until the symptoms have subsided.
Finally, remind yourself that all panic attacks are temporary and will eventually pass.
Although it may not feel like it in the moment, staying with the experience and observing it—rather than trying to escape or fix it—helps your brain learn that panic is a false alarm. Over time, the experiences can feel less threatening and become more manageable.
How To Help Someone Who Is Having a Panic Attack
It can be frightening to witness someone having a panic attack, especially if you’re unsure how to help or worried about making things worse. However, there are simple and supportive ways you can respond to help the person feel safer and more in control.
If someone is experiencing a panic attack, be sure to remain calm. If you look frightened, this may make the panic attack worse. Try to be understanding and nonjudgmental.
It’s important to also acknowledge that the person is having a panic attack and let them know that you’ll be right there with them, while encouraging them to nonjudgmentally scan and describe their physical sensations until the symptoms subside.
Keep in mind that sometimes people find it helpful to have prompts, such as, “How would you describe the sensations in your chest? How would you next describe the sensations in your stomach?” Other times, people may want you to be silent company while they ride the panic wave.
If you know of someone who tends to experience recurring panic attacks, it can be helpful to ask ahead of time what would feel helpful from you in the moment.
Remember that many people feel embarrassed if they have a panic attack. Once the panic attack finishes, remind the individual that these experiences are quite common. Avoid doing this while the attack is happening so they can stay focused on the present moment and the opportunity to learn that their brain can handle the experience.
You can add that they deserve to receive support that helps them feel more empowered than their anxiety. You can then ask if they already see a mental health clinician to address these experiences or if it would be helpful to try to find one together.
The Best Treatment for Panic? Facing Your Fears
We know that anxiety disorders are maintained by avoidance. For example, if you are afraid of dogs, you may have urges to avoid them. Although avoidance may reduce distress in the moment, it can actually feed your fear in the long run because it takes away opportunities for you to learn that either the experience was not as challenging as expected or that, even if it had been, you were able to handle it.
If you are experiencing anxiety that has been prolonged, causes you significant distress, or impairs your ability to function, it may be time to seek help. The good news is that effective treatment is available in a variety of forms.
Although there are different ways to approach anxiety treatment, we know that cognitive behavior therapy with exposure and response prevention has proven to be incredibly helpful. At the heart of exposure therapy is gradually approaching feared situations and learning that you can experience them.
For panic disorder in particular, interoceptive exposure is often used. In this type of exposure, the body is deliberately and gradually exposed to feared physical sensations in a controlled setting so that the person can learn that they can manage the experiences. In turn, they can then apply what was learned if the sensations occur out of the blue.
Sometimes medications are used to augment exposure-based treatment for anxiety. Selective serotonin reuptake inhibitors (SSRIs) and other antidepressants may be useful here to help individuals better engage in exposure-based work. For panic disorder, beta-blockers, SSRIs, and serotonin-norepinephrine reuptake inhibitors (SNRIs) may be prescribed.
Other treatments, like mindfulness-based cognitive therapy, meditation, and acceptance-based approaches, like acceptance and commitment therapy (ACT), have also been shown to be effective.
Finally, maintaining healthy behaviors—such as regular physical exercise, good sleep hygiene, engaging in pleasurable activities (including social ones), and avoiding the use of alcohol or caffeine—can also be helpful.
If you have had continued panic attacks, you may need to seek professional help. Your doctor will ask about your symptoms and other mental health and medical conditions. Blood tests and a heart examination may also be required.
Both panic and anxiety are treatable and manageable—even when they may feel as if they are out of your control.
If you or someone you love is struggling with panic or anxiety, help is just a phone call away.
Please call 800.333.0338 to talk about how McLean Hospital can support you on the path to recovery.
Stopping Stigma Surrounding Panic Attacks
In addition to helping people who experience panic attacks, it is important to dispel the stigma around them. Unfortunately, the public holds common misconceptions about panic attacks.
Some of the most common of these include:
- Folks who have panic attacks are simply weak-minded
- People who experience panic attacks are “just faking it”
- Panic attacks are not as serious as they appear
- People with panic disorder are doing it to themselves
The only way to stamp out stigma surrounding panic attacks and panic disorder is to educate others about how common they are and how important it is to help people experiencing them.
Panic: It’s More Common Than You Think
The Anxiety and Depression Association of America reports that some 40 million U.S. adults experience significant anxiety each year, with more than 28.8% of adults experiencing clinically meaningful anxiety symptoms.
That’s nearly one in three people.
Anxiety is America’s most common mental health condition and can be treated effectively. However, only around one-third of those with the condition seek professional help.
Anxiety disorders are hereditary, which means that if you have a relative with anxiety, you are more likely to experience it yourself.
Panic disorder, which is a type of anxiety disorder, affects about 4.7% of U.S. adults at some point in their lives, according to the National Institute of Mental Health.
There Is Hope Through Understanding
You can learn more about panic and anxiety and share your knowledge with others. As people realize that panic disorder is real, the stigma will begin to fade.
You can explore coping strategies that encourage staying in the present moment with panic instead of trying to immediately stop or avoid the panic attack. By practicing mindful awareness and acceptance, people learn to understand panic attacks better and can become less reactive to panic sensations over time.
You can also seek guidance from mental health professionals to better understand panic disorder and help others recognize the seriousness of panic attacks.
If we can dispel the stigma surrounding panic attacks, it will be easier for those who struggle with them to get help.
Contributors
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