Panic Attack Symptoms + 10 Unexpected Panic Attack Triggers - Dr. Axe

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Panic Attack Symptoms + 10 Unexpected Triggers


Panic attack symptoms - Dr. Axe

Have you ever experienced panic attack symptoms? If you have, then you know that the sensations are so intense it feels like you could be having a heart attack or other serious health issue. Panic attacks are characterized by a fear of losing control or surviving a disaster, even though there is no real danger in that moment.

There are many possible panic attack triggers, from bacterial infections to low blood sugar levels. Many people who experience a panic attack aren’t expecting it and have never had a panic attack before. According to a survey conducted by Harvard Medical School, the lifetime prevalence of isolated panic attacks for people without panic disorder is estimated to be about 23 percent. (1)

If you aren’t familiar with the most common panic attack symptoms and some possible panic attack causes, a panic attack will certainly take you by surprise and feel like a life-threatening occurrence. Luckily, most panic attacks are harmless and will pass within 10 minutes or so. Plus, there are some natural remedies for anxiety and panic attacks that will help you to control your fear and limit your discomfort.

Deconstructing a Panic Attack + Panic Attack Symptoms

A panic attack is an intense and sudden development of fear or anxiety. You will usually experience a peak in symptoms about 10 minutes into a panic attack and then the feeling will begin to subside. Panic attacks can be scary and confusing, especially if it has never happened to you before. And when you’re in the middle of one, it’s hard to understand how to stop a panic attack because you aren’t necessarily in a rational state of mind. Here’s a quick breakdown of some common questions about panic attacks…

Panic Attack vs Anxiety Attack: How Are They Different?

Ever wonder, “What is an anxiety attack?” And how does it differ from a panic attack? Or are they the same thing? In a Michigan Health blog, Ricks Warren, PhD, a clinical associate professor of psychiatry at the University of Michigan, does a great job discussing some of the main differences between an anxiety “attack” and a true panic attack and panic attack symptoms.

Signs of an anxiety attack vs. panic attack are important to differentiate. Anxiety is more about chronically worrying about the future, such as excessive worry about death, illness or even minor things. Warren says anxiety attack symptoms include:

  • Fatigue
  • Hypervigilance
  • Restlessness
  • Irritability

What is a panic attack? Panic attacks are different than anxiety attacks because they are more like acute, “short bursts of intense fear.” These bouts typically last less than a half hour. Panic attack symptoms include:

  • Faster heart rate
  • Brief chest pain
  • Shortness of breath (2)

How do you know when you have a panic attack?

According to the Anxiety and Depression Association of America, a panic attack typically includes at least four of these panic attack signs and symptoms: (3)

  • Sweating
  • Palpitations or irregular heartbeat
  • Trouble breathing
  • Shaking
  • Dizziness or light-headedness
  • Chills
  • Hot flashes
  • Numbness or tingling sensations
  • Chest pain
  • Nausea
  • Upset stomach
  • Fear of losing control or “going crazy”
  • Feeling detached
  • Fear of dying

What does a panic attack feel like?

There’s a reason why people who have just experienced a panic attack often end up in the emergency room or at a doctor’s office. Some panic attack symptoms feel scarily similar to many life-threatening health issues like heart disease or breathing disorders.

Can you have a panic attack for no reason? 

Yes. Often, a panic attack begins out of the blue, with no warning. Some people even experience panic attack symptoms when they are completely relaxed or sleeping. Many people describe their own experience with a panic attack as an inability to stand up, breathe or function. It’s a state of intense and total panic. And your mind can only think about the fear of what you think is going on and what you think is going to happen. This tunnel vision makes the symptoms even worse, in most cases because the anxiety levels are heightened.

What’s going on inside of your body during a panic attack?

A panic attack has been described as a “fear of fear.” According to research conducted at Stanford University School of Medicine, when someone is experiencing a panic attack, he or she feels the common physical symptoms of anxiety, like dizziness, increased heart rate, shortness of breath and chest pain. These panic attack symptoms stem from the thought that something bigger and more fearful is about to happen — like fainting, having a heart attack or suffocating. Your mind actually has a “catastrophic interpretation of physical symptoms,” according to researchers.

This fear causes the body to go into a mode of hypervigilance, where you become even more aware of your bodily sensations. Right before a panic attack, as these thoughts have entered your head (whether you are aware of it or not), your body experiences an increased arousal of the sympathetic nervous system and heightened symptoms of anxiety, which spirals into a full-blown panic attack. (4)

How do you feel right before and after a panic attack?

Most people will say that their panic attack symptoms occurred suddenly and out of the blue, but one study suggests that your body actually experiences physiological changes before a panic attack happens. For the study that was published in Biological Psychiatry, 43 panic disorder patients underwent repeated 24-hour monitoring. Researchers were able to evaluate 13 panic attacks, where they found patients experienced significant patterns of autonomic and respiratory instability as early as 47 minutes before the panic attacks began. So although you may not sense these changes occurring, your heart rate and lung volume begin to change before you experience noticeable signs of a panic attack. (5)

How long do panic attacks last? Most last only about 10 minutes or so, but after a panic attack, you will probably feel exhausted and completely drained of energy. The aftermath of a panic attack is different for everyone, but some may feel embarrassed if the attack happened in public, some may grow fearful of having another attack and others experience signs of depression following a panic attack.

10 Panic Attack Triggers

What causes panic attacks? The truth there’s not one concrete cause for every case. But here are some of the top panic attack triggers that could be making your life difficult.

1. Panic Disorder

People with panic disorder experience recurrent panic attacks; in fact, panic attacks can occur as often as several times a day for some, and only a few times per year for others. Researchers suggest that panic disorder stems from an interaction of genetic and environmental factors. It can be caused by a stressful life event, like divorce, abuse or the death of a loved one, a family history or mental and anxiety disorders, elevated cortisol levels or even shyness in childhood. Women are also more likely to experience symptoms of panic disorder than men. (6)

Not all people who get panic attacks have panic disorder. According to researchers, to fall within the criteria of panic disorder, a person must have at least one panic attack, followed by at least one month of persistent concern or fear of having another one. A person with panic disorder will also change their behaviors or activities in order to avoid situations that may bring on another attack, like avoiding social activities or calling out of work. (7)


Panic attack symptoms - Dr. Axe


2. Agoraphobia (fear of certain situations)

Agoraphobia is a type of anxiety disorder that causes feelings of fear that are associated with specific situations or places. Unlike panic disorder, which involves recurrent panic attacks that come on out of the blue, this type of anxiety disorder leads to panic attacks that are specifically triggered by social events. People with agoraphobia may have anxiety about being in crowds, being in public places, traveling away from home or traveling alone. Part of what drives this anxiety is the fear of having a panic attack, which can be both embarrassing and extremely uncomfortable. Because of this fear, people with agoraphobia usually avoid the situation completely, which reduces their ability to live normally. (8)

3. Hyperthyroidism

Research shows that people with thyroid problems score significantly higher on anxiety tests compared to those with normal thyroid function. A Japanese study investigated the correlations between thyroid function and panic attacks in patients with panic disorder. Researchers examined 66 patients with panic disorder and measured their thyroid hormone levels. The results? Patients suffering from the more severe panic attacks also had the highest levels of thyroid-stimulating hormone. (9)

Your thyroid controls your body heat and aspects of energy expenditure, so when you have an overactive thyroid, which is called hyperthyroidism, you may experience an increased heart rate, sweating, nervousness and other symptoms of anxiety.

4. Bartonella Infection

Bartonella is a type of bacteria that cause several diseases in humans, including cat scratch disease and trench fever. Research shows that Bartonella infections can lead to neurologic and psychiatric illnesses, and patients may develop panic attacks, agitation and depression.

Researchers found three specific cases that linked Bartonella to psychiatric symptoms, including panic attacks. In one case, a family member reported a 41-year-old loved one underwent a personality change after a camping trip in North Carolina. When he returned home from the trip, he removed three deer ticks from his leg and shoulder and developed an enlarged lymph node, excessive warmth, irritability, insomnia and feelings of rage five weeks later. In the next two weeks, the patient experienced serious agitation, panic attacks and major depression. A psychiatrist diagnosed him with bipolar disorder and prescribed him anti-anxiety panic medication, but the symptoms didn’t dissipate. After seeing an infectious disease physician and receiving antibiotic treatment for eight weeks, the patient’s symptoms improved significantly. (10)

Bartonella is carried by many animals and insects, including fleas, cats, ticks, lice and biting flies. One of the most common ways to contract Bartonella? Being scratched by a cat with flea feces on its paws. This is no reason to get rid of your cat, but it does mean you should keep your cat indoors only, avoid scratches and wash any scratches out with soap and water quickly.

5. Lyme Disease

Research published in the Journal of Psychiatric Practices indicates that patients with panic-like episodes turned out to have Lyme disease and other tick-borne illnesses. Several women were evaluated for their cognitive changes, such as panic attacks, mental fogginess, recent memory loss and neurological pain. Because all of these symptoms were not typical of panic disorder, they were tested for other underlying physical illnesses. In all three cases, test results were positive for Lyme disease or other tick-borne diseases. After being treated for Lyme disease, all three women experienced reduced or resolved cognitive symptoms. (11)

6. Poor Gut Health

Gut health affects symptoms of anxiety, depression and other related disorders. Did you know that inflammation in the gut actually contributes to inflammation in the brain and somatic tissues? That’s why the health of your microbiota is linked to a variety of mental health disorders. This gut-brain connection explains why a person with leaky gut syndrome or poor gut health may experience psychological symptoms. These include an increased sense of stress and fear. This doesn’t always lead to panic attacks, but it can certainly occur as part of the neurobiological factors of anxiety. (12)

7. Medication Withdrawal

Although the symptoms of drug withdrawal vary depending on the drug abused, it’s not uncommon for people in a withdrawal phase to experience increased anxiety levels, restlessness, tremors, seizures and panic attacks.

According to research published in Addiction, dependence on benzodiazepines, a drug used to treat anxiety disorders, can cause withdrawal symptoms such as panic attacks, sleep disturbance, palpitations, muscle pain, sweating, irritability and difficulty concentrating. Researchers found that people usually begin feeling more anxious within 1 to 4 days of drug discontinuation, and within 10 to 14 days they experience full-blown withdrawal symptoms. Dependence on alcohol and other sedatives also increases the risk of benzodiazepine dependence, making the withdrawal process even more difficult. (13)

8. Substance Abuse 

Substance abuse can make anxiety or panic disorder symptoms worse, contributing to the occurrence of panic attack symptoms. Excessive use of central nervous system depressants, such as alcohol and benzodiazepines, can impair a person’s mental functioning and lead to increased anxiety and panic attacks. Stimulant drugs are also linked to increased anxiety because they excite the neurotransmitters in the brain. Stimulants include cocaine, ecstasy, amphetamines and even caffeine.

A study conducted at the University of Texas Health Science Center investigated the association between substance abuse and panic states. Researchers found that of the 97 participants with panic episodes, 39 percent had abused at least one substance. In addition to this, 10 percent of the participants reported using alcohol to treat their panic disorder, and six percent reported using illicit drugs for self-treatment. (14)

9. Low Blood Sugar

Research shows that low blood sugar, or hypoglycemia, can cause a number of neurological and cognitive symptoms, including irritability, irrational or uncontrolled behavior, sweating, seizures, confusion, slurred speech and loss of consciousness. When your body isn’t getting enough glucose supply, it may result in functional brain failure. This is why researchers have linked repeated episodes of severe hypoglycemia and long-term cognitive dysfunction. Although there are no studies specifically linking hypoglycemia to the onset of panic attacks, the increased level of anxiety and uncontrolled behavior that is associated with low blood sugar can lead to panic episodes in some people. (15)

10. Hyperventilation

Studies show that hyperventilation symptoms can trigger panic attacks, but researchers suggest that it’s the interpretation of these sensations and not the sensations themselves that lead to an attack. Hyperventilation is deep, rapid breathing that causes a decrease in the amount of carbon dioxide in your blood. This decrease in carbon dioxide leads to shortness of breath, increased heartbeat and lightheadedness.

Stress and anxiety can trigger hyperventilation and, on the flip side, hyperventilation can trigger increased anxiety and panic attacks. People may think that they are going to suffocate, which leads to intense fear and brings on a panic attack. (16)

Hyperventilation can occur while you’re awake and experience psychological symptoms of fear or stress, or it may occur when you’re sleeping. In fact, many people experience panic attacks while they are sleeping, waking up in the midst of intense fear and discomfort. Sometimes this is caused by hyperventilation, and it can also be triggered by other breathing issues due to sleep apnea or GERD.

Natural Panic Attack Remedies

How do you deal with panic attacks? When it comes to panic attack treatment, there is science to support natural options. And while panic disorder medication is effective for some people, natural therapies used in conjunction or as a stand-alone treatment may work, too.

Panic attack treatment without medication may be a possibility for you and your healthcare provider to consider. Here’s a rundown of some common panic attack home treatment options:

  • Certain essential oils
  • Breathing exercises
  • Relaxation techniques
  • Avoiding stimulants

Cognitive behavioral therapy and support groups can also go a long way in reducing panic attacks.

How do you treat a panic attack?

Essential oils: Lavender, ylang ylang and chamomile are some of the best essential oils for anxiety and panic attacks because they induce feelings of relaxation while combating fear, worry and irritability. An example of research that proves the power of essential oils for anxiety and neurological disorders comes out of Evidence-Based Complementary and Alternative Medicine. In the review, researchers indicate that lavender oil is proven to possess sedative, neuroprotective, anticonvulsive and mood-stabilizing properties. It’s simply to use these gentle oils — you can diffuse about 5 drops at home or at work, inhale the oil directly from the bottle when you feel anxiety building or apply one to two drops topically to your temples, wrists or bottoms of your feet. (17)

Vetiver oil is also used in aromatherapy for relaxation to alleviate:

  • Emotional stress
  • Panic attacks
  • Trauma
  • Anxiety
  • Insomnia
  • Hysteria
  • Depression

To use, diffuse, apply one diluted drop topically to bottom of feet or add it to a warm-water bath. Be sure to dilute with a carrier oil before topical use.

Breathing exercises: Ever wonder how to cure panic attacks fast or how to stop a panic attack now? Breathing is your best friend. You may think that the key to relieving the symptoms of a panic attack is to take deep breaths, but research shows that this isn’t going to help much. It’s actually more helpful to take shallow breaths during a panic attack because these breathing exercises limit the amount of carbon dioxide that can enter the body and cause dizziness. So if you are experiencing hyperventilation or you’re breathing quickly and deeply, taking short breaths (which is known as capnometry-assisted respiratory training or CART by researchers) will help you to gain control over the dysfunctional gas exchange that leads to panic attack symptoms. (18)

Relaxation techniques: Research published in Frontiers in Psychiatry found that people with panic disorder experience significant improvements after practicing yoga weekly for 100 minutes for a two-month period. The participants practicing yoga experienced reduced anxiety levels associated with panic disorder. Yoga is so helpful for people who suffer from recurrent panic disorders because it helps to relax your muscles and lower the overall tension in your body. In fact, yoga changes your brain by suppressing neural activity. Any relaxation technique can work as a panic attack remedy, even practicing meditation or quiet prayer at home.  (19)

Avoid stimulants: Stimulants heighten your senses and can bring on increased feelings of anxiety and fear. A systematic literature review published in Expert Review of Neurotherapeutics found a positive association between caffeine and panic disorder. Researchers indicate that caffeine has anxiogenic effects, which means that it can cause feelings of anxiety when consumed. Any type of stimulant, which also includes drugs like amphetamines, can increase anxiety levels and boost your risk of having a panic attack. Alcohol and sugary foods should also be avoided because the alter your blood sugar levels, which can induce anxiety symptoms. Keep your body clear of any mind-altering foods or drugs and stick to a diet rich in nutrient-dense, whole foods. (20)

Cognitive behavioral therapy: There are many studies that support the efficacy of cognitive behavioral therapy for anxiety disorders, including panic disorders and compulsive disorders that may cause panic attacks. This type of therapy pinpoints thoughts that continuously rise up and cause feelings of fear or anxiety. The goal is to replace these thoughts with more positive and empowering alternatives so that you can better cope with your fears. (21)

Support groups: Group programs can be extremely supportive and beneficial in helping people with panic disorder to cope with their feelings of fear. People who suffer from recurrent panic attacks often live in fear of when their next attack with occur. This only drives their anxiety and can lead to feelings of isolation and behavioral disturbances. Finding support from like-minded people and a group leader can help you to navigate your feelings and adopt coping mechanisms to minimize your anxiety levels. (22)

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