What Causes Panic Attacks?

Panic attacks can happen to anyone – up to 40% of the Australian population have experienced a panic attack at some point in their lifetime, although not all go on to develop a panic disorder.

Panic attacks refer to sudden onset of intense fear or discomfort. They are sometimes referred to as “anxiety attacks” in everyday conversation, although the term “anxiety attack” is not a clinical term in the DSM-5.

Panic attacks can come on suddenly, without any obvious trigger. There is no single cause, but they have been linked to a range of contributing factors, including genetics, trauma, chronic stress and certain mental health conditions.

Panic attacks can be disabling and can deeply affect a person’s well-being. However, with the right treatment, strategies, and management, panic attacks can be prevented and managed.

What is a panic attack?

A panic attack is a sudden surge of intense fear or discomfort that typically peaks within minutes. It is often accompanied by physical sensations, including chest pain, heart palpitations, shortness of breath, dizziness, trembling, or muscle tension. While panic attacks typically last between 5 to 20 minutes, the residual physical and emotional impacts can linger for hours.

Panic attacks are common, with up to 40% of the Australian population experiencing a panic attack once or twice in their lives. Panic attacks and anxiety are very closely related, but they are not the same. Anxiety tends to be ongoing and builds gradually, whereas panic attacks are sudden, intense episodes that peak quickly.

Panic disorders

Having one panic attack is not the same as having a panic disorder. While many people experience panic attacks, panic disorders only affect about 5% of the Australian population. Panic disorders occur when an individual experiences recurrent, unexpected panic attacks and is in constant fear of another attack. A panic disorder is a type of anxiety disorder, which is when an individual experiences excessive and irrational fears, causing persistent worry and distress. Panic disorder often begins in the mid-teenage years to early adulthood, although it can develop at any age.

Symptoms of a panic attack

A panic attack is often said to trigger the ‘fight-or-flight’ response when there is no danger. When the body perceives an event as stressful or frightening, the brain activates the ‘fight-or-flight’, flooding the body with adrenaline and physical reactions to protect itself. This response activates symptoms common with panic attacks.

Panic attack symptoms can vary, but generally include:

Rapid heart rate
Sweating
Trembling or shaking
Muscle tension
Lightheaded and dizziness
Shortness of breath or tightness in the throat
Fear of losing control or dying
Sense of impending doom or danger
Abdominal cramping
Feelings of detachment from the environment

These symptoms often peak within 10 minutes, and while they can mimic serious medical conditions like a heart attack or asthma attack, panic attacks are generally not physically harmful.

What causes a panic attack to occur?

The exact cause of a panic attack is not fully understood. However, we do know that the brain and nervous system play key roles in how fear and anxiety are recognised. Panic attacks are linked to the ‘fight-or-flight’ response, which prepares the body for danger even when there are no threats present.

Other factors that have been linked to causing a panic attack include:

Genetics: If your siblings or parents have an anxiety disorder, the risk of developing an anxiety disorder, including a panic disorder, increases by 40%.
Major stress: Long periods of major stress on the body, both physically and mentally, can trigger a panic attack. This can include intense exercise, burnout, sleep deprivation, sudden change of environment, or major life changes.
Traumatic life experience: Negative events that happen in a person’s life can live as trauma in the brain. Trauma such as abuse, serious accidents, or sudden loss of loved ones, can make the nervous system more sensitive and increase vulnerability to panic attacks.
Mental health conditions: Conditions such as generalised anxiety disorder, social anxiety disorder, depression and post-traumatic stress disorder can increase the likelihood of panic attacks.
Substance use or withdrawals: Substances like alcohol, caffeine, recreational drugs, certain medications can also increase the likelihood of panic attacks.
Biological factors: Imbalances in brain chemicals that regulate mood and stress may also play a role in panic attacks.

How to prevent and treat panic attacks

Recurrent and disabling panic attacks are treatable with help from a psychologist. A psychologist can help to manage panic attacks through evidence-based approaches such as cognitive behavioural therapy (CBT) or exposure therapy to identify and change unhealthy emotions, thoughts, and behaviours.

Psychologists can also work together with you to develop personalised strategies and techniques to reduce the likelihood of future panic attacks. While your psychologist will find the best preventative measures specific to your unique circumstance, common ways to prevent and stop panic attacks include:

Breathwork: Regularly practising breathing exercises, even if you don’t feel anxious, can help regulate your nervous system. An example of a breathing exercise: Inhale deeply and slowly through your nose and exhale through your mouth, repeating 5 to 10 times. Increase the length of time you inhale and exhale as you go. If it is safe to do so, close your eyes while doing this to enhance focus and relaxation.
Avoid excessive alcohol: Alcohol is a depressant, which affects brain and nervous system functioning. In the short term, this can make a person feel more relaxed. However, over time, the body can become more sensitive to its effects, and withdrawal can lead to increased anxiety or panic symptoms.
Exercise regularly: Going for daily walks, attending a gym or pilates class a few times a week, or even just doing light stretches every other day at home can go a long way in preventing panic attacks. Physical activity can improve sleep, reduce tension, and produce endorphins, which can make you feel calmer and better equipped to manage negative thoughts.
Positive self-talk: Research shows that positive self-talk can improve self-esteem, stress management, wellbeing, and reduce symptoms of anxiety. Being mindful of how you talk to yourself and replacing negative thoughts with positive or constructive ones can help you feel more grounded and in control during anxious moments.

When to Seek Professional Help

If you’re experiencing frequent panic attacks that are interfering with your daily life, it’s important to seek help from a professional.

Some signs include:

You’re avoiding places or situations for fear of having a panic attack
You’re constantly worried about when the next attack will happen
Your symptoms are affecting your relationships, work, sleep, or wellbeing
You’re feeling overwhelmed, isolated, or unsure how to cope

You don’t have to face panic attacks or panic disorder alone. With the right support, treatment, and tools, it’s possible to overcome this condition and lead a fulfilling and empowered life.