Panic attacks: what they are and what helps

What is a panic attack?

A panic attack is a sudden rush of intense fear or anxiety. A single panic attack does not necessarily mean someone has panic disorder, which is when attacks keep coming back.

What does it feel like?

Common physical signs include a pounding heart, fast breathing and shaking. The NHS says a panic attack usually lasts between 5 and 20 minutes. Panic can feel like heart or breathing problems, so the NHS advises speaking to a GP rather than self-diagnosing. The NHS says that although panic attacks are frightening, an attack will not cause physical harm.

What can help during an attack?

The NHS advice is to stay where you are if you can, breathe slowly and deeply, and remind yourself that the attack will pass and is not life threatening. NHS self-help guides describe the feelings as normal bodily reactions that are not harmful, and suggest waiting for them to pass rather than adding frightening thoughts. Grounding techniques, such as focusing on the senses, can also help.

How are repeated attacks treated?

Cognitive behavioural therapy is a recommended psychological treatment, and in England people can refer themselves to a talking therapies service or ask a GP to refer them. Medicines used include SSRI antidepressants, and a tricyclic antidepressant may be used if SSRIs are not suitable. NICE says psychological therapy, medicine and self-help have all been shown to work, and that the benefits of psychological treatment lasted longest.

What causes panic disorder, and when should someone see a GP?

The exact cause of panic disorder is not fully understood, and it is thought to be probably a combination of physical and psychological factors. A GP asks the person to describe their symptoms and may carry out a physical examination to rule out other causes. The NHS says to see a GP if attacks keep happening.

What can people do day to day?

The NHS suggests activities such as yoga and Pilates, breathing exercises for stress, and regular exercise to help ease anxiety. NHS self-help guides note that escaping or avoiding panic can stop an attack in the moment but can also keep the problem going.

Where can someone get urgent help?

Panic attacks are frightening but pass. If a person feels unable to stay safe, urgent help is open at any time. If you or someone else is in immediate danger, or has been physically harmed, call 999 or go to A&E. For urgent help that is not an emergency, NHS 111 has a mental health option (option 2), which trusts describe as available at any time, for yourself or on someone else's behalf. Samaritans listen at any time of day or night, and the number, 116 123, is free to call.