Panic Attacks: What Are They Exactly?

By Lynne Harris

What would you think was happening to you if out of nowhere your heart started to race, you were drenched in sweat, you found yourself trembling uncontrollably, short of breath, with chest pain and feeling nauseated, dizzy and lightheaded as though you might faint?

You might also be feeling very cold or very hot, with tingling sensations in your fingers and toes. You might feel removed from the world around you – as though it wasn’t real – and be worried that you might lose control or that you are going insane. You might try to work out what is happening and conclude you are having a heart attack or dying.

A panic attack is a sudden, intense feeling of fear or discomfort with at least four of the signs described above.

For some people, a panic attack can come out of nowhere, like a sudden thunderstorm from a clear blue sky. For other people, the panic attack may be more predictable, such as an abrupt escalation of a milder anxiety about giving a speech or speaking to someone in authority.

Just as a panic attack can follow an experience of relative calm or of mild anxiety, panic can resolve to a relatively calm state or to ongoing, but less intense symptoms. But the symptoms of the panic attack itself are experienced as severe and frightening, leading many people to believe they are seriously ill and seek urgent medical help.

What is happening to the body?

Often one of the first symptoms of a panic attack is hyperventilating (rapidly breathing in and out), which upsets the natural balance of oxygen and carbon dioxide in our system. It is believed that a low level of carbon dioxide in the blood directly triggers the symptoms of panic, such as feeling lightheaded and dizzy. When we breathe quickly we also build up oxygen in our blood. Paradoxically, too much oxygen is also associated with feeling short of breath.

Hyperventilation causes many of the other symptoms of a panic attack too, such as dizziness, blurred vision, tingling, muscle tension, chest pain, heart rate increases, nausea and temperature changes.

People who experience panic misinterpret the bodily signs of hyperventilation as indicating immediate physical danger and believe they have little control over the symptoms. When we then say things to ourselves such as “I might be having a heart attack” and “I can’t cope with this”, the anxiety gets worse.

It’s important to remember the symptoms of a panic attack are “just” caused by anxiety and are not life-threatening

In a 2013 study, researchers showed when people with no history of panic inhaled air containing increased levels of carbon dioxide, they reported fear, discomfort and panic symptoms. The same study also showed that people with a history of panic attack experienced these symptoms at lower concentrations of carbon dioxide, suggesting they are hypersensitive to this internal signal for danger.

Panic attacks can occur with a range of diagnosed psychological conditions, including anxiety disorders, depressive disorders and substance use disorders, as well as physical illnesses, especially illnesses that affect heart function, breathing, balance and digestion.

It is very important to understand and deal with panic attacks so they don’t lead to a more serious condition known as panic disorder.

Panic disorder is where people begin to repeatedly experience panic attacks and worry that they will have further panic attacks in future. They change the way they live to try and ensure they do not have another panic attack. They avoid activities like exercise that cause feelings similar to panic attack (shortness of breath, sweating) and avoid situations where they fear another panic attack may occur. This avoidance brings many additional problems, as social, family and occupational worlds shrink due to fear of panic.

What should you do if you have a panic attack?

Panic attacks are common, with almost 23% of a people from a large US study of the general population reporting at least one panic attack during their lives. Panic attacks are more common in females than males. They are also more common in family members of people with panic disorder.

Panic attacks are more common among people who believe symptoms of anxiety are dangerous and harmful, rather than annoying and uncomfortable. They are also more likely if you are under emotional pressure, have been ill, are tired, are hungover or smoke.

As many of the symptoms of panic attack are physical and can be caused by a number of physical conditions, the first thing to do if you have symptoms like the ones described here is to see your doctor to check whether there is a medical reason for the symptoms.

If the symptoms turn out to be due to panic, then there are effective psychological approaches for controlling panic attacks. These include focusing on:

  • monitoring and slowing breathing, so as to limit the overbreathing that can cause many of the panic sensations
  • correcting the interpretations about what the symptoms mean, by looking at the things we say to ourselves before, during and after a panic attack. It is very important to remember the symptoms are “just anxiety” and are not life-threatening.

Exploring Treatment Options

There are also a number of proven, non-medical options to help manage the symptoms of panic attacks and the stress and anxiety disorders that can underlie them.

These include computer-based relaxation, mindfulness and  meditation training programmes – which are particularly helpful for those who find it difficult to achieve a sense of calm under their own steam. In addtion, there are more advanced “future forward” stress-management tools, such as audio-visual entrainment (AVE) and cranio-electrostimulation (CES), which are easy to use and have proven effect in managing the symptoms of stress and anxiety disorders. It’s also important to remember the simply interventions, like massage and ensuring better sleep can be off great help in managing stress levels and so reduce the liklihood of experiencing a panic attack.

Readers who wish to explore relaxation and stress-management options further will find them in the dedicated area on our main website, here

About the authors and source material:

The author of this article is Lynne Harris, who is Professor of Psychological Sciences, School of Psychological Sciences, Australian College of Applied Psychology and Honorary Assoc Prof with the Faculty of Health Sciences, University of Sydney

This article was published in revised form in online academic discussion journal, The Conversation, and is reproduced here under CCL copyright provisions. The original article, which includes active links to all references, may be found here