Medically reviewed by Kevin Wandler, MD, Chief Medical Advisor
A panic attack can come out of nowhere. Your heart pounds, your chest tightens, you cannot catch your breath and a wave of terror tells you something is terribly wrong. Many people who have their first panic attack are convinced they are having a heart attack or losing their mind. The fear usually peaks within minutes and then fades, but the memory of it can linger for a long time.
When panic attacks keep happening and the fear of the next one starts shaping your life, it may be panic disorder. This guide covers the symptoms, possible causes and effective treatments. If you have chest pain or trouble breathing and are not sure what is causing it, call 911. If you are in emotional crisis or thinking about suicide, call or text 988.
What a Panic Attack Feels Like
A panic attack is a sudden surge of intense fear or discomfort along with strong physical symptoms, such as:
- A pounding or racing heart
- Sweating, trembling or shaking
- Shortness of breath or a feeling of choking
- Chest pain or pressure
- Nausea or stomach distress
- Dizziness, lightheadedness or feeling faint
- Chills or hot flashes
- Numbness or tingling in the hands or face
- Feeling detached from yourself or like your surroundings are not real
- Fear of losing control, losing your mind or dying
Panic Attack vs. Panic Disorder
Having a panic attack does not automatically mean you have panic disorder. Plenty of people have an isolated panic attack at some point, often during a period of intense stress, and never develop an ongoing problem. Panic disorder involves repeated, unexpected panic attacks along with ongoing worry about having more of them or about what they mean.
That worry often changes behavior. People may avoid exercise because a fast heartbeat feels threatening, stop driving on highways, skip crowded stores or stay close to home. When avoidance grows to the point that leaving familiar places feels impossible, it may point to a related condition called agoraphobia.
Panic or a Medical Emergency?
Panic symptoms can closely resemble heart problems, asthma attacks, thyroid issues and other medical conditions. Never assume chest pain is “just anxiety,” especially if it is new, severe or different from what you have felt before. Call 911 if you are unsure. Once a doctor has ruled out medical causes, you can focus on treating panic with more confidence.
What Causes Panic Disorder?
There is no single cause. Panic disorder tends to run in families, which suggests genetics play a role. Major stress, big life transitions and a history of trauma can also raise the risk. Some people are especially sensitive to bodily sensations and interpret normal changes, like a skipped heartbeat, as a sign of danger. That fear triggers more physical symptoms, which feed more fear.
Substances can play a part too. Caffeine, stimulants and cannabis can set off panic-like symptoms in some people. Withdrawal from alcohol or sedatives can also cause intense anxiety and panic.
Panic Disorder and Substance Use
Because panic feels so unbearable, many people reach for something that makes it stop fast. Alcohol can take the edge off in the moment, but anxiety often rebounds harder as it wears off. Benzodiazepines can calm panic quickly and are sometimes prescribed short term, yet regular use can lead to tolerance, dependence and misuse. Withdrawal from alcohol and benzodiazepines can be life-threatening and should always happen under medical supervision. If sedative use has become hard to control, benzodiazepine addiction treatment can help you stop safely.
How Panic Disorder Is Treated
Panic disorder is treatable. Cognitive behavioral therapy is a first-line approach. It helps you understand the panic cycle, challenge catastrophic thoughts and gradually face the sensations and situations you have been avoiding until they lose their power. Certain antidepressants are also commonly prescribed for panic disorder, and a psychiatric provider can help weigh the benefits and risks of any medication.
Mindfulness-based approaches, regular sleep, physical activity and cutting back on caffeine and alcohol can support that work. At Promises Dallas-Fort Worth, anxiety treatment combines therapy, psychiatric evaluation and medication management, with care for co-occurring substance use when needed.
What to Do in the Middle of a Panic Attack
- Name it. Remind yourself, “This is panic. It is uncomfortable, but it will pass.”
- Slow your breathing. Breathe in gently through your nose and let your exhale be longer than your inhale.
- Ground yourself. Notice what you can see, hear and feel around you right now.
- Let it crest. Fighting the feelings often makes them stronger. Allow the wave to rise and fall.
How to Help Someone Having a Panic Attack
Watching someone you love panic can be frightening. Stay calm and close, speak slowly and use short, reassuring sentences. Ask what helps rather than guessing. Invite them to breathe with you, and avoid telling them to “just relax,” which can make them feel dismissed. If they have chest pain, fainting or symptoms that seem different from past episodes, call 911. Afterward, gently encourage them to talk with a professional about treatment.
Frequently Asked Questions
Can a panic attack hurt me?
Panic attacks feel frightening, but they are not dangerous in themselves. Because the symptoms can mimic serious medical problems, it is important to get checked by a doctor.
Is panic disorder the same as generalized anxiety?
No. Generalized anxiety involves ongoing worry about many things, while panic disorder centers on sudden attacks. Learn more about generalized anxiety disorder.
Will I need medication?
Not always. Many people improve with therapy alone, while others benefit from therapy combined with medication. Your treatment team can help you decide.
Get Help for Panic Attacks
Panic does not have to decide where you go or how you live. To talk about anxiety treatment in Lewisville or virtual care anywhere in Texas, call (469) 546-9303. Our line is answered 24/7. You can also check your insurance or contact us online.