What Happens During a Panic Attack? Symptoms and What to Do

During a panic attack, your body’s fight-or-flight response switches on even though you may not be in immediate danger. Adrenaline increases your heart rate, breathing changes, muscles tighten and you may feel dizzy, breathless or out of control. The symptoms usually rise quickly and then settle, but new or unfamiliar chest pain should always be medically assessed.

Quick Answer: What Should You Do During a Panic Attack?

If you recognise the episode as a panic attack:

1. Stay where you are, provided the place is safe.
2. Slow your breathing rather than taking large, fast breaths.
3. Remind yourself that the symptoms will pass.
4. Focus on something you can see, hear or physically feel.
5. Let the sensations rise and fall instead of fighting them.

Seek urgent medical help if the symptoms are new, unusually severe or could indicate a medical emergency.

What Does a Panic Attack Feel Like?

A panic attack can begin suddenly, sometimes without an obvious trigger. You might feel completely fine and then notice your heart beating hard, your breathing changing or a strong sense that something terrible is about to happen.

Common panic attack symptoms include:

• a pounding or racing heart
• chest pain or tightness
• shortness of breath
• sweating or chills
• trembling
• dizziness or weakness
• tingling or numbness
• nausea or stomach discomfort
• feeling detached from yourself or your surroundings
• fear of fainting, dying or losing control

A panic attack can last from a few minutes to an hour or occasionally longer, although the most intense part often settles sooner.

What Is Happening in Your Body During a Panic Attack?

The symptoms are real. They are not “all in your head.”

Your body has activated the same survival response it would use if you were facing genuine danger. The difference is that during a panic attack, the alarm has gone off when there may be nothing you need to fight or escape from.

Your alarm system switches on

Your brain detects a threat or misreads a normal sensation as one and activates the fight-or-flight response.

Stress chemicals, such as adrenaline, prepare your body to act quickly. This is useful during real danger, but frightening when you are sitting in a meeting, travelling in the metro or trying to sleep.

Your heart beats faster

Your heart rate increases to move blood towards the muscles. You may notice pounding, fluttering or tightness in your chest.

Feeling your heart race can then create another frightening thought:

“Something is wrong with my heart.”

That thought increases fear, which can make the heartbeat feel even stronger.

Your breathing becomes faster

You may begin breathing more quickly or deeply because your body believes it needs extra oxygen.

Overbreathing can lower the amount of carbon dioxide in the blood. This can contribute to dizziness, tingling, numbness, chest discomfort and the strange feeling that you cannot get enough air—even though you may actually be breathing too much.

Your muscles tense

Your shoulders, chest, jaw and stomach may tighten as your body prepares for action. This can lead to chest discomfort, shaking, nausea, or the sensation of being unable to take a full breath.

Your surroundings may feel unreal

Some people feel detached from themselves or as though the room around them is unreal. This is called depersonalisation or derealisation.

It can be deeply unsettling, but it can occur as part of the panic response and usually settles as the attack passes. This is what happens during a panic attack.

Why Does Panic Get Worse So Quickly?

Panic often builds through a loop:

You notice a body sensation → interpret it as dangerous → become more frightened → the body produces stronger sensations.

For example, you feel your heart beat faster after caffeine, poor sleep or climbing stairs. You think, “What if I am having a heart attack?” That thought triggers more fear, which in turn makes your heart race even faster.

The aim during a panic attack is not to force every symptom to disappear immediately. It is to interrupt the belief that the sensations mean you are in immediate danger.

How to Calm a Panic Attack

1. Stop and stay somewhere safe

If possible, sit or stand where you are instead of immediately running away. Leaving every situation as soon as panic begins can teach your brain that escape was what kept you safe.

If you are driving, near traffic or somewhere physically unsafe, move to a safe location first.

2. Slow the exhale

Avoid repeatedly taking huge breaths, as this can worsen overbreathing.

Try breathing gently through your nose and allowing the exhale to last slightly longer than the inhale. For example:

• breathe in gently for four counts
• breathe out slowly for six counts
• repeat without forcing the breath

The exact numbers are less important than making the breathing slower and more regular.

Do not rely on breathing into a paper bag unless a healthcare professional has specifically advised it. Rapid breathing can also have medical causes, and paper-bag breathing is no longer considered appropriate in every situation.

Use one clear sentence:

“This feels frightening, but my body’s alarm system is active, and the symptoms will pass.”

You do not have to convince yourself that you feel calm. You only need to recognise the pattern.

4. Ground your attention

Choose something outside your body and describe it in detail.

You could notice:

• five things you can see
• the feeling of your feet against the floor
• sounds in the room
• the texture of an object in your hand

Grounding does not “switch off” panic instantly. It gives your attention somewhere to go besides repeatedly checking your heartbeat and breathing.

5. Allow the wave to pass

Trying desperately to stop panic can add another layer of fear: “Why is this not going away?”

Instead, let the sensations rise, peak and gradually settle. The NHS advises staying where you are when possible, breathing slowly and reminding yourself that the attack will pass.

Is It a Panic Attack or a Heart Attack?

Panic attacks and heart problems can share symptoms, including chest pain, sweating, nausea, dizziness and shortness of breath. You cannot always safely distinguish them based on symptoms alone.

Seek urgent medical care when:

• this is your first episode of severe chest pain or breathlessness
• the pain feels like pressure, squeezing or crushing
• pain spreads to the arm, back, neck or jaw
• you have severe difficulty breathing
• you faint or become unresponsive
• the symptoms are different from previously diagnosed panic attacks
• you are uncertain whether it is panic

In India, call 112 for emergency assistance. It is the government’s single emergency-response number for medical, police and fire emergencies across states and union territories.

Getting checked does not mean you have “failed” to manage anxiety. It means you are treating unfamiliar physical symptoms responsibly.

Does One Panic Attack Mean You Have Panic Disorder?

No. Many people experience an isolated panic attack without developing panic disorder.

Panic disorder involves recurring, unexpected panic attacks followed by ongoing worry about another attack or changes in behaviour to prevent one. You may begin avoiding public transport, crowded places, exercise, travelling alone or anywhere an attack previously occurred.

For an overview of how panic differs from other anxiety patterns, read Types of Anxiety Disorders: GAD, Social Anxiety, Panic and OCD Explained.

When Should You Speak to a Therapist?

Consider professional support if:

• panic attacks are happening repeatedly
• you constantly worry about the next one
• you avoid places or activities because of panic
• you repeatedly seek emergency reassurance despite normal evaluations
• the attacks are affecting work, travel, sleep or relationships

Cognitive Behavioural Therapy can help people understand the panic cycle, respond differently to physical sensations and gradually return to situations they have been avoiding. NICE and NIMH list CBT among the main evidence-based treatments for panic disorder; medication may also be considered after an individual assessment.

Learn more in Anxiety: What It Is, Why It Happens, and How to Get Help in India or read How to Find a Therapist for Anxiety.

The Bottom Line

A panic attack is your body reacting as though you are in danger. The racing heart, breathlessness and dizziness are part of that alarm response, not evidence that you are losing control.

Learn the immediate steps, but do not ignore new or unusual physical symptoms. Once medical causes have been ruled out, therapy can help you stop fearing the sensations and prevent panic from controlling where you go or what you do.

Find a therapist for panic attacks and anxiety

Sources

• National Institute of Mental Health: Panic Disorder—What You Need to Know
• National Health Service: Panic Disorder
• National Institute for Health and Care Excellence: Panic Disorder in Adults—Management