Panic attacks

Panic attacks can be very frightening experiences. But there are things you can do to manage them when they happen.

Panic attacks would even occur during sleep, waking me up with a pounding heart. I'd have this all-encompassing dread that would leave me hyperventilating.

What is a panic attack?

Panic attacks are an extreme anxiety response. They can develop quickly, and come with very intense symptoms. These are both physical and mental.

Panic attacks normally aren't dangerous. But it can feel like something is very wrong.

They're sometimes called ‘anxiety attacks’.

Most panic attacks last between 5 to 20 minutes. You might also experience symptoms of a panic attack over a longer period of time. This could be because you're having a second panic attack. Or because you're experiencing other symptoms of anxiety.

You can read more on our page on symptoms of anxiety.

What does a panic attack feel like?

During a panic attack, physical symptoms can build up very quickly. These can include:

• A pounding or racing heartbeat
• Feeling faint, dizzy or light-headed
• Feeling very hot or very cold
• Sweating, trembling or shaking
• Feeling sick (called nausea)
• Pain in your chest or stomach
• Struggling to breathe, or feeling like you're choking
• Breathing in too much or too quickly (called hyperventilation)
• Feeling like your legs are shaky or are turning to jelly
• Feeling disconnected from your mind, body or surroundings (called dissociation)

During a panic attack you might feel very afraid that you're:

• Losing control
• Going to faint
• Having a heart attack
• Going to die
• Losing touch with reality or like you can't manage your thoughts

Talking about panic attacks

Watch Lewis, Polly, Faisal, Shelley and Brian share how panic attacks feel for them, and talk about what helps:

What causes panic attacks?

Panic attacks don't always have a specific cause. But they happen when we become very anxious very quickly.

You might notice that certain places, situations or activities seem to trigger panic attacks. For example, they might happen before a stressful appointment. But some of us find they happen at random times. And we can't always figure out why.

Some of us have one panic attack then don't ever experience another. Or you might find that you have them regularly, or several in a short space of time.

Panic attacks can happen as part of lots of other mental health problems. Like obsessive-compulsive disorder (OCD) and other anxiety disorders. But you don't need to have a mental health problem to have a panic attack. And having a panic attack doesn't always mean you have a mental health problem.

They seem to be triggered mainly at night when I want to go to sleep but cannot stop my mind racing.

What is panic disorder?

If you're having lots of panic attacks you might be given a diagnosis of panic disorder. This is a type of anxiety disorder.

You might know what's causing some of these panic attacks. But they may often seem to happen for no reason.

You might also get this diagnosis if you get very anxious about the idea of having panic attacks. And if this anxiety stops you from living your day-to-day life how you want to.

It's common to experience panic disorder and certain types of phobia together. Particularly agoraphobia. This is a fear related to going outside.

If you have panic disorder, you may have some periods with few or no panic attacks. At other times you might have a lot.

Some people with panic disorder get panic attacks while sleeping. These make you wake up feeling very panicked and anxious.

How to deal with a panic attack

Panic attacks can be frightening, but there are things you can do to help yourself cope.

If you have panic attacks a lot, it could help to save this page. Or print it. Or you could write down the tips and keep them somewhere easy to find.

During a panic attack

You can try to follow these steps:

• Accept that you're having a panic attack. Recognising what's happening can help you feel calmer.
• Focus on your breathing. It can help to concentrate on slowly breathing in and out while counting to 5.
• Stamp on the spot. Some people find this helps control their breathing.
• Focus on your senses. For example, taste mint-flavoured sweets or gum. Or touch or cuddle something soft.
• Try grounding techniques. Grounding techniques can help you feel more in control. They can also be helpful if you experience dissociation during panic attacks. See our page on self-care for dissociation for more information on grounding techniques.

It might help to remember this as an ABC: 

• Accept
• Breathe
• Connect yourself to your senses

If you can't calm yourself during a panic attack, you can ask someone you trust to help you. You can show them this information to help.

If you don't have someone to support you, NHS 111 can help you manage a panic attack. You can call 111 for the 24/7 mental health support line (England and Wales). Or contact NHS 111 online (England).

Some helplines might also be able to help. See our useful contacts for anxiety page for more information.

Breathing into paper bags

You might have seen people breathing into paper bags to help panic attacks in films or on TV. Or a health professional might have recommended this to you. This is a technique called ‘re-breathing’.

It can help balance out the gases in your lungs when you hyperventilate. This is when you breathe too much and too fast. It's also called ‘over-breathing’.

Some people find breathing into a paper bag helpful to manage a panic attack. But it can be dangerous if you have a problem with your lungs. Or if there are other things affecting your breathing. So it isn't recommended as much as it used to be.

You can also cup your hands together over your nose and mouth while you breathe. Or try and breathe slowly in and out. This works too.

You shouldn't breathe into plastic bags. This can be dangerous.

After a panic attack

• Think about self-care. It's important to pay attention to what your body needs after you've had a panic attack. For example, you might need to rest somewhere quietly. Or eat or drink something.
• Tell someone you trust. If you feel able to, it could help to let someone know you've had a panic attack. You might also want to tell people close to you how to notice you're having a panic attack. And how to help you.

I try to tell myself that my brain isn't trying to harm me and take a moment to recompose.

Preventing panic attacks

You might not always be able to stop a panic attack from happening. But there are things you can do to make them less likely. And to help yourself cope.

For ideas that could help, see our pages on:

• How to manage anxiety and worry
• Treatment for anxiety

How to help someone else with a panic attack

If someone else is having a panic attack, there are things you can do to help.

It's understandable to feel frightened when seeing a panic attack. Especially if it seems to happen without warning. But it can help if you:

• Try to stay calm
• Gently let them know that they might be having a panic attack, and that you're there for them
• Encourage them to breathe slowly and deeply
• Do something structured or repetitive for them to focus on, like counting out loud, or gently raising your arm up and down
• Encourage them to stamp their feet on the spot
• Encourage them to sit somewhere quietly where they can focus on their breath until they feel better

Our page on how to help someone who has anxiety explains more ways to be supportive.