Panic Attacks

About panic attacks

What it is, why it happens and what helps. Contents:

• What a panic attack is
• What it feels like
• How common panic is
• Why panic is not dangerous
• The panic cycle
• Why panic attacks happen
• Panic attacks and panic disorder
• What to do during an attack
• Breathing that helps
• Grounding yourself
• After an attack
• Fear of the next attack
• Avoidance and getting your life back
• Making friends with sensations
• Everyday habits that help
• Night-time panic
• Helping someone having a panic attack
• How self-help methods fit in
• Tracking your progress
• When to get support
• FAQs

What a panic attack is

A panic attack is a sudden rush of intense fear together with strong physical sensations. It can come on very quickly, sometimes for no obvious reason. It is your body’s alarm system, the fight-or-flight response, switching on at full volume when there is no real danger. You can explore related topics in our Wellness hub, including our guide to anxiety.

What it feels like

The NHS lists symptoms including a racing heartbeat, feeling faint, sweating, nausea, chest pain, shortness of breath, trembling, hot flushes, chills, dizziness, pins and needles, a churning stomach, a fear of dying and a sense of not being connected to your body. [3] Many people describe it as a wave that builds quickly, peaks and then slowly subsides. The NHS notes that most panic attacks last between 5 and 20 minutes. [3]

Because the sensations are so physical, people often fear they are having a heart attack, fainting or “going mad”. These are some of the most common thoughts during panic, and they are a normal part of how panic works, not a sign that something is wrong with you.

How common panic is

Panic attacks are very common. In a large US national survey of more than 9,000 adults, 22.7% reported at least one panic attack in their lifetime without going on to develop panic disorder. [4] Panic disorder itself, where attacks keep coming back and you worry about them, is less common. A Cochrane review puts its lifetime prevalence at between 1% and 4%. [1] If you have had a panic attack, you are far from alone, and most people who have one never develop an ongoing problem.

Why panic is not dangerous

This may be the single most helpful thing to know. The NHS says that although panic attacks are frightening, they are not dangerous: an attack will not cause you any physical harm. [3] The racing heart, fast breathing and tense muscles are your body getting ready to run or fight. They are uncomfortable, but they are the same changes your body makes when you exercise or get a fright. Because some of these symptoms can also have other causes, it is sensible to see your doctor once to check things over, especially if you have chest pain or other new symptoms. Once you know what is going on, you can respond to panic with confidence.

The panic cycle

Psychologist David Clark’s cognitive model of panic, one of the most influential ideas in this field, describes how panic builds in a loop. [5] It goes something like this:

1. A trigger. You notice a body sensation, such as a skipped heartbeat, a wave of dizziness or a tight chest.
2. A frightening interpretation. You think, “I’m having a heart attack” or “I’m going to faint.”
3. More fear. The thought triggers the fight-or-flight response.
4. More sensations. Your heart races faster and your breathing quickens.
5. More frightening thoughts. The stronger sensations seem to confirm the fear, and the loop spins faster.

The hopeful part is that the loop can be broken at any point. When you understand that the sensations are harmless, the frightening interpretation loses its grip, and the cycle winds down much more quickly. This is the heart of CBT for panic.

Why panic attacks happen

There is rarely a single cause. Common contributors include:

• Ongoing stress, which keeps the body on high alert. See our guide to stress management.
• Big life changes or difficult events.
• Poor sleep. Our sleep guide has ideas.
• Caffeine, alcohol and other stimulants, which can bring on panic-like sensations.
• A sensitive nervous system, which some people are simply born with.
• Learning to fear sensations after a first, unexpected attack.

Often the first attack comes out of the blue, during a stressful period. What keeps panic going is usually the fear of having another one.

Panic attacks and panic disorder

Having a panic attack does not mean you have panic disorder. Panic disorder is when attacks keep happening unexpectedly and you spend a lot of time worrying about the next one, or change your life to avoid them. Some people also develop agoraphobia, avoiding places where escape might feel hard, such as shops, public transport or crowds. Whether you have had one attack or many, the same skills help, and panic disorder responds well to treatment.

What to do during an attack

The NHS suggests that during a panic attack you stay where you are if possible, breathe slowly and deeply, remind yourself that the attack will pass, focus on peaceful images and remember it is not life-threatening. [3] Here is a simple sequence based on that advice:

1. Name it. Say to yourself, “This is panic. It is uncomfortable, but it is not dangerous.”
2. Stay put if you can. Leaving teaches your brain the situation was dangerous. Staying teaches it that panic passes.
3. Slow your breathing. Breathe in gently through your nose for four and out through your mouth for six.
4. Let the wave come. Instead of fighting the sensations, imagine riding them like a wave. Fighting tends to make them stronger.
5. Ground yourself. Feel your feet on the floor and look around you.
6. Wait. Panic peaks and then falls. Notice it beginning to ease.

There are guided walkthroughs of this approach in Videos.

Breathing that helps

During panic, breathing often becomes fast and shallow, which can add to dizziness and tingling. Slowing your breath, especially lengthening the out-breath, helps switch on the body’s calming system. A systematic review found that slow breathing, at fewer than ten breaths a minute, was linked to changes in the nervous system and to greater feelings of relaxation and comfort. [2] Try these:

• 4–6 breathing: in for four, out for six, for two to three minutes.
• Box breathing: in for four, hold for four, out for four, hold for four.
• Hand on belly: breathe so your hand rises and falls rather than your chest.

Practise when you are calm, so the skill is ready when you need it. The NHS has a free breathing exercise for stress. Our relaxation guide has more.

Grounding yourself

Grounding brings your attention out of frightening thoughts and into the present moment. Try the 5-4-3-2-1 exercise: name five things you can see, four you can touch, three you can hear, two you can smell and one you can taste. Other ideas include holding something cold, pressing your feet into the floor, describing your surroundings out loud or counting backwards from 100 in sevens. Grounding works best alongside acceptance: you are not trying to make the panic vanish, just giving your mind something steady to hold while it passes.

After an attack

Many people feel drained, shaky or tearful after a panic attack. This is normal. Be kind to yourself. Have a drink of water, rest if you need to and do something gentle and comforting. Then, when you feel ready, reflect: what was happening beforehand, what did you fear would happen and what actually happened? Each attack you get through is evidence that you can cope, even if it did not feel that way at the time.

Fear of the next attack

For many people, the hardest part is not the attacks themselves but the constant worry about when the next one will come. This “fear of fear” keeps the body on alert, which can make attacks more likely. The way out is to change your relationship with panic. Instead of “I must never have another attack”, try “If it comes, I know what it is and I know it will pass.” Paradoxically, the more willing you are to have a panic attack, the less power it has. Many people find their attacks fade once they stop fearing them.

Avoidance and getting your life back

It is natural to avoid places where you have panicked before. The trouble is that avoidance teaches your brain that those places really are dangerous, so fear spreads and your world shrinks. Gentle, gradual return is one of the most effective ways forward. Make a list of avoided situations, rank them from easiest to hardest and start with the easiest. Stay in each one until your anxiety comes down, then move to the next step when you feel ready. Our guide to fear and phobias has more on this step-by-step approach.

Making friends with body sensations

Because panic is often triggered by fear of body sensations, therapists sometimes use “interoceptive exposure”: deliberately bringing on harmless sensations in a safe setting so they become familiar. Examples include running on the spot to raise your heart rate, spinning gently on a chair to feel a little dizzy or breathing through a straw for a short time. Over time, these sensations stop setting off the alarm. If you have a heart or breathing condition, or any other health problem, check with your doctor before trying these exercises. Some people find practices like the Wim Hof Method or yoga help them feel more at ease with strong sensations too.

Everyday habits that help

• Move your body regularly. Exercise burns off stress hormones and teaches you that a fast heartbeat is safe.
• Cut back on caffeine, especially if you notice it makes you jittery.
• Watch your alcohol. Alcohol can make anxiety worse the next day. See our guide to cutting down on alcohol.
• Protect your sleep.
• Eat regularly to avoid dips in blood sugar that can feel like anxiety.
• Practise calm daily, even five minutes of breathing, mindfulness or meditation.
• Stay connected. Talking to people you trust about how you feel makes panic less lonely.

Night-time panic

Some people wake from sleep in a state of panic. This can feel especially alarming because there is no obvious trigger. The same approach helps: remind yourself it is panic and it will pass, slow your breathing and ground yourself by noticing the room around you. Turn on a soft light if that helps. Keeping a regular sleep routine, reducing caffeine and alcohol and winding down before bed can make night-time attacks less likely.

Helping someone having a panic attack

If someone near you is panicking, stay calm and stay with them. Speak slowly and kindly. Reassure them that it is a panic attack and it will pass. Invite them to breathe slowly with you, counting out loud. Avoid saying “calm down”, and don’t crowd them. Ask what they need. Once it has passed, let them rest. If you are not sure whether it is panic or a medical problem, or this is the first time it has happened, get medical help.

How self-help methods fit in

Panic involves the body, the mind and behaviour, so many people combine approaches. CBT skills help you understand and test fearful thoughts, and a Cochrane review found CBT was the most studied therapy and often the most effective. [1] Relaxation and slow breathing calm the body. [2] EFT tapping and Havening are gentle tools many people use to soothe fear in the moment. The Wim Hof Method helps some people build confidence with strong sensations. Try one or two that appeal to you and practise them regularly when you are calm.

Tracking your progress

Keeping a simple panic diary can be very encouraging. Note the date, where you were, what you felt, what you feared would happen, what you did and how long it lasted. Over weeks you will often see that attacks become shorter, milder and less frequent, and that the feared outcome never happened. Celebrate each step back into your life, however small. Setbacks are normal and do not undo your progress.

When to get support

Panic responds very well to treatment. A Cochrane review found psychological therapies worked better than waiting for treatment, with CBT the most studied. [1] The NHS also suggests self-help books based on CBT principles as a starting point. [3] Consider talking to your doctor if attacks are frequent, if you are avoiding more and more, or if panic is affecting your work, relationships or daily life. A therapist trained in CBT can help, and directories for several countries are in Get help & sources.

Frequently asked questions

Can a panic attack hurt me?

No. Although panic attacks are frightening, the NHS says they are not dangerous and will not cause you physical harm. [3]

How long does a panic attack last?

Most panic attacks last between 5 and 20 minutes, according to the NHS. [3]

What should I do during a panic attack?

Stay where you are if possible, breathe slowly with long out-breaths, remind yourself it is panic and it will pass, and let the sensations rise and fall without fighting them.

Why do panic attacks happen for no reason?

Often a small body sensation is noticed and interpreted as dangerous, which triggers more fear and more sensations. This loop can feel like it came from nowhere. [5]

How common are panic attacks?

Very common. In a large US survey, 22.7% of adults had at least one panic attack in their lifetime without developing panic disorder. [4]

What is the best treatment for panic attacks?

CBT is the most studied therapy for panic disorder and often performs best in reviews. [1] Many people combine it with breathing and relaxation skills.

Can panic attacks go away completely?

Yes. Many people find attacks become rare or stop once they understand panic, stop fearing it and return to the things they had avoided.

The best videos on panic attacks

Hand-picked and checked one by one: psychologists, therapists and practitioners, plus guided breathing, tapping and Havening.

Understanding panic

During an attack

Tapping, Havening and breathwork

Books on panic attacks

Free resources

Experts to follow

Get help

Talk to your doctor if panic attacks are frequent, if you are avoiding more and more, or if you have new physical symptoms you want checked. CBT and other talking therapies help many people.

Find a therapist or counsellor

• US and Canada: Psychology Today (US) and (Canada) directories.
• UK: BACP therapist directory.
• Australia: APS Find a Psychologist, and Relationships Australia for couple and family services.
• Elsewhere, including Europe and India: ask your doctor or local health service for a referral, and check that anyone you see is registered or accredited where you live.

This hub is for information, not a substitute for medical or psychological care.

Sources

1. Pompoli et al. (2016), Psychological therapies for panic disorder with or without agoraphobia in adults: a network meta-analysis, Cochrane Database of Systematic Reviews CD011004
2. Zaccaro et al. (2018), How breath-control can change your life: a systematic review on psycho-physiological correlates of slow breathing, Frontiers in Human Neuroscience 12:353
3. NHS, Panic disorder
4. Kessler et al. (2006), The epidemiology of panic attacks, panic disorder, and agoraphobia in the National Comorbidity Survey Replication, Archives of General Psychiatry 63(4):415-424
5. Clark (1986), A cognitive approach to panic, Behaviour Research and Therapy 24(4):461-470

Written by Saj Ali. Last updated 30 October 2026. Spotted an error? Tell us and we will fix it.