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Panic attacks
Category: Mind, Mood & Sleep · All mind & sleep symptoms
What it can feel like
A panic attack is a sudden surge of intense fear peaking within minutes: racing or pounding heart, breathlessness or choking feelings, chest tightness, trembling, sweating, nausea, dizziness, tingling, and a sense of dread or unreality. Attacks feel catastrophic but are the alarm system firing at full volume — they peak and pass, usually within 10–20 minutes.
Possible causes
A symptom can have many causes, and most are not serious. The lists below group conditions this symptom can be associated with — common causes first. They are possibilities to discuss with a clinician, not a diagnosis.
Common causes
Panic attacks can be associated with anxiety disorders, stress, caffeine and stimulants, and they commonly begin to pair with places or situations where attacks happened before (leading to avoidance).
Other possible causes
A first 'panic attack' can also be a physical event — heart rhythm disturbance, asthma flare, low blood sugar, thyroid overactivity, or rarely a heart attack — which is why first attacks, and attacks with atypical features, get a physical workup before the panic label.
Red flags — when to seek help promptly
- A first-ever attack with chest pain, severe breathlessness or fainting — urgent assessment to exclude physical causes
- Attacks with palpitations that start and stop abruptly like a switch (possible rhythm problem)
- Panic with thoughts of self-harm — seek support the same day (US 988, UK Samaritans 116 123)
- Avoidance that is shrinking your life — work, travel, leaving home
- Attacks with fever, confusion or neurological symptoms
What a clinician may do
A clinician will reconstruct an attack minute by minute — onset, peak, duration, triggers — check pulse, heart and thyroid status, and examine for mimics. Treatment is effective: CBT specifically for panic retrains the fear of sensations themselves, supported by medicines where needed and by cutting caffeine and alcohol triggers.
Watch: related videos
Examination and clinical videos from the MedicalVideos.com library relevant to this symptom. Some clinical footage is graphic — that is the nature of a medical video library.
Related guides on MedicalVideos.com
Frequently asked questions
Can a panic attack damage my heart?
In a structurally normal heart, the adrenaline surge of panic is uncomfortable but not dangerous — the heart is built for exactly this response during exercise and danger. The harm of panic is the avoidance and dread it trains, which is what treatment targets.
Why do attacks make me tingle and feel unreal?
Rapid breathing during panic blows off carbon dioxide, which changes blood acidity and produces tingling in fingers and around the mouth, light-headedness and unreality. Slow breathing — longer out than in — directly reverses the chemistry, which is why it works when 'calm down' does not.
Related symptoms — Mind, Mood & Sleep
Browse the P section of the A–Z list or return to the Symptoms A–Z hub.