Panic Attacks

Getting nervous before giving a presentation at school or before a big game is normal – but if you’ve ever felt like you’re going to lose control, have a heart attack, or even “go crazy,” you might have had a panic attack.

What is a panic attack?

A panic attack is a sudden rush of intense fear or discomfort, which reaches a peak within 10 minutes. It’s something many people experience at some point in their life. There are a range of symptoms that may include:

• Racing or pounding heart
• Sweating
• Shaking or trembling
• Shortness of breath or feelings of being smothered
• Feeling of choking
• Chest pain or discomfort
• Chills or hot flashes
• Nausea or upset stomach
• Dizziness or lightheadedness
• A sense of things being unreal or feeling detached from oneself
• Numbness or tingling sensations
• Fear of losing control or “going crazy”
• Fear of dying

Feeling extra anxious in certain situations, to the point of feeling panic, can be very uncomfortable. Panic attacks can happen in any situation in which you find yourself feeling very nervous, afraid, or overly worried, but they can also happen “out of the blue” or unexpectedly. If you have at least four of the symptoms listed above, especially if this happens before or during an activity that you know causes you to panic, such as speaking in front of a group of people (in class or someplace else), being around an animal that makes you nervous, or getting on a plane, for example, you are likely having a panic attack.

Many people learn to manage and control their panic attacks using relaxation techniques and other coping skills that their health care provider suggests. If your panic attacks increase in frequency and you no longer can identify what is causing them, you may be developing a panic disorder. This means that you have severe, unexpected, and repeated panic attacks which feel out of your control. In Panic Disorder, panic attacks can be triggered by the fear of having panic attacks. It’s important to get help from your health care provider for advice and treatment as well as to be sure your panic is not caused by a medical problem or medicine you’re taking.

Without treatment, panic can get in the way of your daily life.

It can cause:

• Low self-esteem
• Poor school performance
• Problems with peer and family relationships
• Social isolation
• Sleep problems
• Eating problems
• Depression
• Drug or alcohol use
• Agoraphobia (fear of visiting crowded places)

Things that may increase your risk of having panic attacks:

• Genetics (family history of panic attacks)
• Stress
• Traumatic events (something that you have experienced that is extremely upsetting)
• Having a mental health condition, such as depression or anxiety

How can I get help for panic disorder?

If you’ve had at least two unexpected panic attacks and have been worried about having more attacks and/or you’re avoiding situations that may trigger them, you may have panic disorder and should seek help. Talk with your primary health care provider about your symptoms and ask for a referral to a mental health professional. A mental health professional can talk with you about different treatment options, including therapy and/or medication.

What treatment can help panic disorder?

Your mental health provider will ask you questions about your symptoms, such as when they started and if you have any idea what might bring them on, and he/she will also ask you if you have any relatives who have panic attacks. Your mental health provider will get to know you so he/she can decide what treatment is best for you. Cognitive behavioral therapy (CBT) is a type of therapy that’s often helpful for dealing with panic. Stress management techniques are also a common treatment for stopping panic before it gets out of control, and lessening how often you have panic attacks. Medication can be helpful as well. The goal of treatment is to help you get rid of your panic attacks and learn ways to cope with both daily and unexpected situations that might trigger stress.

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Our health guides are developed through a systematic, rigorous process to ensure accuracy, reliability, and trustworthiness. Written and reviewed by experienced healthcare clinicians from Boston Children's Hospital, a Harvard Medical School teaching hospital and consistently ranked as a top hospital by Newsweek and U.S. News & World Report, these guides combine clinical expertise, specialized knowledge, and evidence-based medicine. We also incorporate research and best practices from authoritative sources such as the CDC, NIH, PubMed, top medical journals, and UpToDate.com. Clinical specialists and subject matter experts review and edit each guide, reinforcing our commitment to high-quality, factual, scientifically accurate health information for young people.