What is a panic attack?

A panic attack is a sudden rush of fear accompanied by at least four of the following symptoms, which typically peak within 10 minutes. A severe fight-or-flight response can trigger a panic attack and many people with anxiety experience panic attacks.

If your symptoms are very severe, or if a doctor has not checked your symptoms, you should have an assessment by a qualified health professional. It is important that you ensure that these symptoms are a result of anxiety and not caused by something else.

  • Feeling dizzy or light-headed

  • Breathlessness

  • Feelings of choking

  • Blurred vision

  • Pounding heart or increased heart rate

  • Tight chest or chest pain

  • Nausea

  • Feeling ‘detached’ from yourself

  • Tingling or numbness

  • Chills or hot flushes

  • Tense muscles

  • Sweating

  • Fear of dying

  • Fear of losing control/going crazy

  • Trembling or shaking

The Fight-or-Flight Response

Most people with anxiety experience unpleasant physical symptoms, like sweating, shortness of breath or nausea, which cause them discomfort or distress. These symptoms are often caused by the fight-or-flight response.

The fight-or-flight response is the body’s automatic reaction to perceived threat. This response is designed to help us fight or escape dangerous situations, to keep us safe. In prehistoric times, this threat might have been a bear or tiger, today however, we come across less physical threats. We are more often threatened by things like

financial stress (e.g. debt), social situations (e.g. public speaking), or sickness. Often, we can feel threatened by even thinking of these situations. That means that the fight-or-flight response is often triggered unnecessarily, like an oversensitive car alarm.

When the fight-or-flight response is activated (i.e. when we come across or think about a threat), it triggers many bodily changes which can cause unpleasant physical sensations, for example:

It's important to note that the fight-or-flight response is a normal reaction. It is not harmful. In fact, it’s critical for our survival.

The Panic Cycle

Panic attacks are extremely unpleasant and can be frightening, especially when they occur unexpectedly, with no obvious trigger. Unsurprisingly, many people who experience panic attacks start to worry that they are going to have a heart attack, go crazy, or die. However, misinterpreting these symptoms in this way increases anxiety, worsening the panic attack.

Because panic attacks are so unpleasant, people might start doing behaviours that make them feel safe, like always carrying water or a mobile phone in case they have a panic attack. Although these behaviours and avoidance reduce anxiety in the short-term, they actually reinforce fear of panic attacks, maintaining anxiety in the long-term. Any behaviour that reduces short-term anxiety whilst maintaining long-term anxiety is called a safety behaviour.

People might also start to avoid places or situations where they might experience a panic attack. Commonly avoided situations include:

  • Being outside the home alone

  • Crowded areas

  • Very open spaces

  • Public transport

  • Enclosed spaces

Severe fear and avoidance of at least two of these situations is called agoraphobia. Like safety behaviours, avoidance reduces fear in the short-term, but reinforces the fear of panic attacks in the long-term, resulting in a vicious cycle.

Common Fears in Panic Attacks

  • Going crazy or losing control

    Many people worry that if they experience extreme anxiety, then they will go crazy, collapse, or embarrass themselves.

  • Having a heart attack

    Some panic attack symptoms, like chest pain or shortness of breath, are similar to heart attack symptoms. However, in a panic attack, chest pain settles down as you regulate your breathing. Recurrent or long-lasting chest pain should be medically investigated. Then, if you have the all-clear from the doctor, you can ask, “Did I die or have a heart attack last time I experienced these symptoms?”

  • Being unable to escape or get help

    Many people who have panic attacks worry about not being able to escape or get help. However, even on crowded public transport or small spaces like lifts, there is ample air. The feeling of suffocating is caused by the fight-or-flight response. The remedy is to slow your breathing and know that your symptoms will settle. There is also nothing to be ashamed of by telling people that you are having a panic attack. Generally, people want to help.

  • Having a car accident while panicking

    Rather than worrying about your anxiety symptoms, shift your attention back to your driving. That way, you are less likely to experience panic symptoms. You can also use controlled breathing to settle your symptoms, or you can pull over to settle yourself for a few minutes if you need.

  • Fear of never getting better

    A lot of people worry that they will experience panic attacks for the rest of their lives. However, panic attacks are very treatable. Treatment can help reduce the frequency and intensity of panic attacks, and make you feel more confident about managing panic symptoms, so that you can live an enjoyable life.

If you think you may be suffering from panic attacks, visit your local GP or contact Sonder for support.


If you have any questions or need extra support, we're here to help you anytime in any language.

Article originally published by: This Way Up

Image credit: Nik Shuliahin on Unsplash

All content is created and published for informational purposes only. It is not intended to be a substitute for professional advice. Always seek the guidance of a qualified health professional.

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