Symptoms of a Panic Attack
- Racing or pounding heart (palpitations)
- Chest tightness or pain
- Shortness of breath or hyperventilation
- Dizziness or feeling faint
- Tingling in hands, feet, or face
- Sweating and trembling
- Nausea or stomach churning
- Feeling of unreality (derealisation)
- Fear of dying or 'going mad'
Ruling Out Heart AttackPanic attacks and heart attacks share symptoms. Seek emergency care if: chest pain is central and crushing, spreads to arm or jaw, persists more than 20 minutes, comes on with exertion, or you are over 40 with risk factors. Don't assume it's 'just anxiety'.
Blood Tests Your Doctor May Order
| Test | Rules Out |
|---|---|
| Thyroid (TSH / T4) | Hyperthyroidism causes panic-like symptoms |
| Blood glucose | Hypoglycaemia causes tremor, anxiety, palpitations |
| FBC | Anaemia causes breathlessness and palpitations |
| ECG | Arrhythmias (SVT) can mimic panic attacks |
| Cortisol (24h urine) | Phaeochromocytoma (rare tumour) causes episodes of panic + high BP |
| Electrolytes | Low magnesium or potassium causes palpitations |
The 5-4-3-2-1 TechniqueDuring a panic attack: name 5 things you can see, 4 you can touch, 3 you can hear, 2 you can smell, 1 you can taste. This grounds you in the present and interrupts the fight-or-flight cycle.
Evidence-Based Treatments
| Treatment | Effectiveness | Notes |
|---|---|---|
| CBT (Cognitive Behavioural Therapy) | Highly effective (80%) | Treatment of choice — especially exposure therapy |
| SSRI antidepressants | Very effective | Takes 4–6 weeks to work |
| Benzodiazepines | Fast relief but not long-term | Risk of dependence — short-term only |
| Beta-blockers (propranolol) | Reduces physical symptoms | Useful for specific situations |
| Breathing retraining | Moderately effective | Reduces hyperventilation cycle |
Can panic attacks cause physical harm?
No. Despite feeling terrifying, panic attacks do not cause heart attacks, fainting (blood pressure actually rises), or brain damage. Understanding this is central to recovery.
Will I always have panic attacks?
With treatment (especially CBT), most people recover fully. Even without treatment, panic disorder often reduces naturally over time.
What triggers panic attacks?
Common triggers include stress, caffeine, alcohol withdrawal, certain medications (e.g. stimulants), medical conditions, and learned fear responses from a previous attack.
Medical Disclaimer: This page is for general education only and does not replace professional medical advice. Always consult a qualified healthcare provider.