Panic attacks and panic disorder: causes and symptoms

The unwanted side effects of stress can show up in different ways for different people. But figuring out if rapid breathing and chest discomfort is a panic attack can be tricky to tell.

In fact, about one in four patients who visit a doctor for chest pain have panic disorder rather than heart trouble.¹ But any condition that could be a sign of heart trouble should be treated seriously and checked out by your health care provider. Learn what to look out for and what some of the causes might be.

In this article:

What causes panic attacks?

A panic attack is a sudden wave of genuine fear that sets off a chain of physical symptoms. It’s not always clear what triggers a panic attack. It can happen at any time for many reasons, and it may come on without a warning.²

The root cause may be psychological, biological or just a reaction to a moment of distress. Research suggests some people may have an imbalance of certain brain chemicals or have areas of the brain that are more excitable. Others may have had difficult life experiences that make them more sensitive to certain situations. And genetics may play a part, too, as a history of panic attacks sometimes runs in the family. Episodes often begin in the late teens or early adulthood and are more likely to occur in women than in men.³

Panic attack symptoms

The signs of a panic attack are varied. Not everyone experiences a panic attack the same way. People having a panic attack may experience the following symptoms:

• Sudden and repeated instances of overwhelming anxiety and fear
• A feeling of being out of control or a fear of death or impending doom
• Physical symptoms, such as the following:⁴
  • Chest pain
  • Chills
  • Difficulty breathing
  • Pounding or racing heart
  • Stomach pain or nausea
  • Sweating
  • Tingly or numb hands
  • Trembling
  • Weakness or dizziness

People who have previously had panic attacks may also experience an intense worry about when the next panic attack will happen or a fear or avoidance of places where panic attacks have occurred in the past.

Anyone who suffers from repeated panic attacks and is continually afraid of future attacks should speak with a health care professional that specializes in panic or anxiety disorders.⁵

Can a panic attack be stopped?

If someone is having frequent episodes, it’s important to seek treatment. Mental health counseling can offer techniques for handling intense symptoms. Medications prescribed for depression or anxiety can help limit attacks. Talk to a health care provider about which option might be best.

Some panic attack symptoms may be managed until an episode is over. Some suggestions include:

• Focus on breathing slowly, deeply and gently in through the nose and out slowly through the mouth.
• Gentle reminders that it’s only a temporary episode and it will soon pass.
• Look around and name individual items that are within sight.⁶
• Relax one muscle group at a time to reduce tension and stay in the present.

How to help someone who is having a panic attack

In the midst of an attack, a person may not be able to think clearly. Another person can try to help until the episode passes with these best practices:

• Ask them what they need
• Keep calm and stay with them
• Move them to a quiet place
• Speak in short, encouraging sentences, such as "You can get through this”
• Suggest a simple physical task to help them focus — for instance, raising and lowering their arms over the head⁷
• Take long, slow breaths with them or count slowly to 10

When to seek medical help

If someone is having panic attack symptoms, especially chest pain, seek medical help as soon as possible to rule out a heart attack or other conditions. Even if their physical health is otherwise fine, untreated panic attacks can become worse. If attacks start to interfere with their relationships or way of life, they should speak with their health care provider to find strategies that support their mental health.⁸