Panic attacks

What is Panic attacks?

A panic attack is a brief episode of intense fear that triggers a strong physical response. The body's fight-or-flight system activates as if facing immediate danger — flooding the body with adrenaline, increasing heart rate, and altering breathing patterns. This produces a cascade of alarming physical sensations.

Panic attacks typically peak within 10 minutes and rarely last longer than 20–30 minutes, though they can feel much longer. They can occur in specific situations or come seemingly "out of the blue", which makes them particularly frightening.

Panic attacks themselves are not dangerous — despite feeling very frightening, they cannot cause a heart attack or cause you to stop breathing. However, the fear of having another panic attack can itself become a significant problem, leading to avoidance behaviour and, in some cases, developing into panic disorder.

Signs and symptoms

During a panic attack, you may experience:

• Racing or pounding heartbeat (palpitations)
• Shortness of breath or feeling unable to breathe
• Chest pain or tightness
• Dizziness, lightheadedness or feeling faint
• Sweating, trembling or shaking
• Nausea or stomach pain
• Numbness or tingling sensations
• Feeling hot or cold flushes
• Feelings of unreality or detachment (derealisation or depersonalisation)
• Intense fear of losing control, "going mad" or dying

The physical symptoms of panic attacks can closely mimic those of serious medical conditions, particularly cardiac events. If you have not had a panic attack before and experience these symptoms, it is sensible to get a medical assessment to rule out physical causes.

How therapy can help

Panic attacks respond very well to therapy, particularly approaches that address both the psychological and physical components.

• Cognitive behavioural therapy (CBT) — the gold standard treatment. CBT helps you understand the panic cycle — how catastrophic interpretations of physical sensations fuel further panic — and break it through cognitive restructuring and gradual exposure
• Breathing retraining — correcting the pattern of over-breathing (hyperventilation) that triggers and worsens panic symptoms
• Interoceptive exposure — a CBT technique that involves deliberately inducing mild panic-like sensations in a safe setting, reducing their power to trigger fear
• Hypnotherapy — can work with the subconscious fear response and promote deeper physiological calm
• Mindfulness-based approaches — building the ability to observe sensations without catastrophising

Panic attacks are one of the most treatable presentations in therapy, and most people see substantial improvement within 8–15 sessions.

Seeking help

If you are experiencing panic attacks regularly, or if the fear of having another attack is affecting your life — causing you to avoid certain places, situations or activities — it is worth seeking support. Untreated panic often escalates into panic disorder or agoraphobia over time.

A GP can rule out any physical causes and refer you to NHS talking therapies. You can also self-refer to IAPT in England. Many people find that private therapy allows faster access and more sessions than the NHS offers for this presentation.

Therapies that may help with Panic attacks