What Is a Panic Attack?

A panic attack can feel like a heart attack, but it is really an episode of overwhelming anxiety that can cause physical symptoms. Here's what you should know.

Your heart is pounding. You can’t catch your breath. You feel dizzy and nauseated. Your hands are shaking.

Are you having a heart attack?

It might feel that way. Or what you’re experiencing could be a panic attack — an intense episode of fear and worry that strikes without warning and makes you feel like you’re spinning out of control.

When panic attacks happen often enough, you might live in fear of when the next one might arrive.

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What is a panic attack?

Most people have experienced anxiety at one time or another. Panic attacks are a more extreme form of anxiety. They’re episodes of overwhelming fear, worry, and physical symptoms like a racing heart and shortness of breath that come on suddenly during normally harmless situations.

Some people have an occasional panic attack. For the estimated 6 million Americans with panic disorder, the attacks strike more often — sometimes every day.

What causes a panic attack?

Panic attacks are a symptom of panic disorder, a type of anxiety disorder. Experts don’t know for sure what causes the episodes, but genes likely play a role. If one of your parents or siblings has panic disorder, your risk of panic attacks increases by about 40 percent.

Scientists believe the roots of panic disorder lie in the amygdala, an almond-shaped area of your brain that helps process fear and emotion. The amygdala triggers your body’s fight-or-flight response.

During dangerous situations, like a car speeding in your direction, your body releases adrenaline and other chemicals that prepare you to either face the threat or run away. In panic disorder, the fight-or-flight response fires without reason.

Symptoms of a panic attack

A panic attack occurs suddenly and makes you feel like you’re in imminent danger, even though no threat is present. Along with fear that something terrible is about to happen, you may have physical symptoms:

• Chest pain
• Difficulty breathing
• Dizziness or lightheadedness
• Palpitations (the feeling like your heart is racing or beating out of your chest)
• Shaking
• Sweating or chills
• Tingly or numb hands

Those sensations last from a few seconds to 20 minutes, on average.

How to tell the difference between a panic attack and a heart attack

A panic attack can feel like a heart attack, and you never want to ignore a potentially serious heart problem. But there are a few key differences between the two conditions that can help you tell them apart.

If there’s any question about which of these conditions you have, seek medical help immediately. Call 9-1-1 or go to the nearest emergency room for an evaluation.

Getting help for panic disorder

The first step if you’re having panic attacks is to see your primary care provider. A physical exam and blood tests can rule out a heart problem and other conditions with similar symptoms. If those tests don’t reveal a medical cause for the attacks, your doctor can refer you to a psychiatrist, psychologist, or other mental health provider.

A type of talk therapy called cognitive behavioral therapy (CBT) is an effective treatment for panic disorder. During CBT, your therapist helps you identify the fears that trigger your panic attacks and teaches you healthier ways to deal with negative emotions.

CBT is sometimes coupled with exposure therapy to make you more comfortable with the physical sensations of a panic attack and help you understand that those symptoms aren’t dangerous.

Medications that may help treat panic disorders include:

• Selective serotonin reuptake inhibitor (SSRI) and serotonin-norepinephrine inhibitors (SNRI) antidepressants
• Anxiety medications like benzodiazepines
• Beta blockers

What you can do

The occasional panic attack probably isn’t cause for worry, but get help if episodes happen often and disrupt your life. Ask your doctor or mental health provider for advice.

If someone you care about is struggling with panic disorder, encourage them to get professional help.

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