Panic Attacks in Adults: Causes, Risk Factors, and Treatment for Lasting Relief

Emma Loker
Published: 03/07/2024 | Updated: 12/30/2025
Authored by: Emma Loker, BSc, PgDip

Your heart is racing uncontrollably. It feels like you can’t breathe. Chest pain is convincing you that you’re having a heart attack. It almost feels as if you’re dying or losing your mind. 

Then, within minutes, the terror gradually subsides, leaving you shaken and dreading the next episode. 

This describes a panic attack. Millions of adults experience them, triggering your body’s alarm system and fight-or-flight response. 

Panic attacks in adults aren’t actually dangerous, despite feeling life-threatening. But when they become recurrent, it can lead to panic disorder, making the anticipatory anxiety more disabling than the attacks themselves. 

Panic attacks and panic disorder respond very well to treatment, with several levels of care and evidence-based interventions that can help you. If you’re in doubt about the right approach for your needs, a mental health professional can provide support and guidance. 

This page explores: 

  • The mechanisms and symptoms of panic attacks in adults
  • The causes of panic attacks and why they occur
  • The risk factors for anxiety disorders and panic attacks
  • Mental health crisis stabilization for severe cases of panic attacks and panic disorder
  • Adult mental health treatment for lasting recovery
  • Responses to FAQs on panic attacks
Woman biting her nails and trying to manage panic attacks in adults

Understanding Panic Attacks and How They Work

A panic attack involves sudden surges of intense fear and discomfort that reach an apex within minutes, triggering overwhelming physical and psychological symptoms.1 

These attacks can seem to happen out of nowhere and without warning. They can also create such intense distress that many people experiencing a first attack seek out emergency medical care, convinced they’re having a heart attack or stroke.1 

The underlying bodily mechanisms behind panic attacks directly involve your fight-or-flight response activating at an inappropriate time. This set of survival responses evolved to protect you from physical danger – when threatened, your brain triggers physiological changes preparing you to fight or run away.1 

Your heart rate increases to boost blood flow to the muscles, and your breathing accelerates to oxygenate your blood. Adrenaline then floods your body to prepare for action. These responses serve their purpose and can save your life when facing actual danger.1 

However, in a panic attack, this natural alarm system misfires. Your brain perceives a major threat where none exists, but the physical sensations are definitely real and feel very intense. 

The attack usually reaches its peak level of intensity within ten minutes, then gradually subsides over 20 to 30 minutes as your stress hormones metabolize.
The Primary Signs and Symptoms of Panic Attack
The physiological symptoms anxiety produces during a panic attack can affect multiple systems in the body at the same time, creating an overwhelming sense that something serious is wrong. 

The Diagnostic and Statistical Manual of Mental Disorders, (or DSM-5), requires at least four of the following symptoms to classify a panic attack:2 

  • Cardiovascular symptoms    : Including a pounding heart, accelerated heart rate, or palpitations that feel like your heart is beating out of your chest. Chest pain or discomfort can feel like a heart attack, which actually results from adrenaline surges and increased output to prepare for emergency exertion. 
  • Respiratory symptoms: These involve shortness of breath or sensations of choking. You might hyperventilate, which paradoxically reduces carbon dioxide and causes additional symptoms like dizziness or tingling. 
  • Neurological symptoms: Including dizziness, lightheadedness, or feeling faint. Tingling or numbness in your extremities is a result of hyperventilation changing your blood chemistry. 
  • Gastrointestinal symptoms: Such as nausea and upset stomach. 
  • Temperature changes: These might produce chills or hot flashes as your body struggles to manage the situation. For instance, you might sweat profusely, even if you’re cold. 
  • Psychological symptoms: Such as feeling detached from yourself or your body. These dissociative symptoms can feel frightening, but are actually your brain’s attempt to manage the situation at hand. 
The Panic Cycle

Chronic panic episodes can develop into continuing cycles. After experiencing an attack, you might become on guard for bodily sensations that signal another episode. For example, you might constantly monitor your heart rate and physical state, which can actually increase your anxiety. 

When you notice a sensation, you may go on to interpret it as the beginning of an attack. This goes on to trigger fear, which leads to more physiological symptoms, creating an escalating pattern that produces the panic attack you feared. 

The anticipatory anxiety between attacks is often described as more impairing than the attacks themselves. As a result, you might begin avoiding situations where attacks occurred or where escaping might be difficult. 

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Risk Factors for Panic Attacks and Anxiety Disorders

The risk factors for anxiety disorders and panic involve several interactions between your genetics, brain chemistry, temperament, life experiences, and your environment. 

The following sections provide a brief overview of the role these factors can play. 

Biological and Genetic Factors
Family history can strongly suggest the potential for panic disorder. For instance, first-degree relatives of people with panic disorder have four to eight times higher risk of developing the condition than the general population.3 

Biological factors, such as neurobiological differences in the brain structures that process fear, appear in those suffering from panic disorder. The amygdala, which helps you detect threats and triggers the fear response, shows heightened reactivity. The prefrontal cortex, which regulates emotional responses, shows reduced activity.4 

Additionally, neurotransmitter irregularities can also contribute to vulnerability. Serotonin, GABA, and norepinephrine systems involved in anxiety regulation can function differently in people prone to panic attacks. 
Personality Factors

For some, behavioral inhibition in childhood can predict later anxiety disorders involving panic. Children who react to novelty and surprise with distress and avoidance may carry this sensitivity into adulthood. 

Life Experiences and Trauma
Childhood adversity, including abuse, neglect, and family dysfunction, can all increase your risk. Early trauma has been shown to affect brain development in areas regulating your stress response, with attachment disruptions producing insecure attachment styles associated with adult anxiety.5 

Furthermore, traumatic experiences can trigger panic disorder, especially traumas involving a loss of control or threat to your life. Some people develop panic attacks as a feature or co-occurring condition to post-traumatic stress disorder (PTSD). 
Medical Conditions

Certain medical conditions could increase your risk for panic attacks. Thyroid disorders (such as hyperthyroidism) can produce symptoms that mimic panic and can also trigger an attack. Cardiac arrhythmias and respiratory conditions could also cause dizziness and increase your vulnerability. 

Gender and Age Factors
Women develop panic disorder at around twice the rate of men, likely due to biological factors and higher rates of childhood trauma and anxiety sensitivity.6 

Further, panic disorder usually emerges by late adolescence or early adulthood, with onset after age 45 being less common. Childhood panic attacks can occur, but are less common. 

Find Panic Attacks Treatment Programs

A Mission For Michael (AMFM) provides treatment for adults experiencing various conditions. Panic Attacks support is a phone call away – call 866-478-4383 to learn about our current treatment options.

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When Panic Disorder Requires Intervention

For some, mental health crisis stabilization becomes necessary when panic attacks and their consequences can’t be managed by outpatient treatment or other interventions. 

Indicators for Stabilization and More Intensive Treatment

Severe anxiety attacks that occur multiple times per day can be a sign that you’d benefit from more intensive services. If you’re experiencing constant panic or near-constant anticipatory anxiety that prevents basic functioning, then outpatient therapy may not be enough. 

Likewise, if agoraphobia has constricted your life to the point that it’s hard to function, you may likely benefit from stabilization. 

Co-occurring disorders, such as depression or generalized anxiety, can also complicate treatment. If you’ve tried multiple therapists and different approaches without improvement, then residential approaches can offer you a higher level of care and provide daily opportunities for growth. 

Anxiety Crisis Intervention Needs

Some situations might need immediate crisis stabilization before long-term treatment, such as if your panic attacks are sending you to the emergency room repeatedly.

Additionally, suicidal thoughts arising from panic disorder or ongoing panic attacks can be unbearable and signal the need to reach out for help. If you’ve lost your job, can’t pay your bills, or struggle to maintain basic self-care, then it’s likely time to reach out for help. 

How Intensive Treatment Can Help

Residential treatment for panic disorder offers you a therapeutic environment where you’ll engage with treatment throughout the day, several days a week, instead of one day per week. Individual therapy, group therapy, holistic interventions, and more, allow for faster progress, all within a structured setting removed from the places in which panic has become a regular occurrence. 

In other words, you’ll be away from the places you’ve learned to fear and the routines built around avoiding your triggers. This can allow you to work on building up new patterns without old avoidance patterns. 

Completing residential treatment also allows you to gradually step down the levels of care and consolidate your new skills. Combined with accessing quality aftercare for continued linkage to the providers and team you’ve worked with, you’re improving your chances of long-term recovery. 

Adult mental health treatment for panic attacks can seem frightening – exposures, challenging catastrophic thinking, and being uncomfortable. But tolerating anxiety without avoidance always seems impossible before you do it. Intensive treatment can provide you with the support you need to push through and start the recovery process. 

How Much Does Psychotic Disorder Treatment Cost With Insurance Coverage?

Those who use insurance typically have lower out-of-pocket expenses compared to those who opt to pay for treatment themselves. The cost of treatment is dependent on the details of your coverage, including your limitations, exclusions, deductibles, and copayments. Additionally, some treatment plans have required prior authorizations.

When you complete our insurance verification form, we will then contact your insurance provider to gather the necessary information to provide you with a personalized quote for treatment. Call us today to get started.

See If Treatment Is Covered

Insurance can be complicated but we are here to help. AMFM has over a decade of experience in the mental health field and is in-network with many large insurance providers.

By using our form, we can quickly determine if you are in-network at one of our facilities. Insurance benefits vary greatly depending on the policy you have, so we obtain a detailed quote of your coverage.

It usually takes between sixty to ninety minutes depending on the time of day.

Our team will check insurance coverage and determine the benefits available to you for mental health services.

We also have private pay options available.

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Discover New Paths Forward at AMFM

The fear of your next panic attack can become far worse than the attacks themselves. Let A Mission For Michael guide you through our inpatient, outpatient, and aftercare programs to help you find your way again. 

We treat panic disorder and other dual diagnosis mental health issues and are in-network with most major insurance providers. But most importantly, we do so with compassion and care for your unique circumstances. Contact our team today to get started. 

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Frequently Asked Questions About Panic Attacks in Adults

If panic attacks are taking over your day-to-day experience, after the information on this page, you may still have some persisting questions and concerns. This is normal. That’s why we’ve provided some answers to FAQs about panic attacks – to provide extra clarity and awareness where needed. 

Can Panic Attacks Be Dangerous?

A panic attack feels life-threatening, but they aren’t medically dangerous despite their terrifying physical symptoms. 

The chest pain, racing heart, and shortness of breath are all a result of your body’s fight-or-flight response activating, not from cardiac issues. 

However, a panic attack can be mistaken for a heart attack, and vice versa. Therefore, new chest pain symptoms always warrant medical attention to rule out any potential heart issues. 

Why Do Panic Attacks Happen Without Any Triggers?

Unexpected panic attacks occurring without an identifiable trigger are a direct result of your brain’s natural threat detection system misfiring. Your brain might respond to internal cues you’re not aware of. Alternatively, sleep deprivation, hormonal fluctuations, or accumulated stress might be to blame. 

The random feeling of attacks can make them feel unbearable, but panic attack therapy can help you recognize more subtle triggers and interrupt the escalation process over time. 

How Long Does Panic Disorder Treatment Take to Work?

Panic disorder treatment usually produces improvement within weeks, especially when combining therapeutic interventions and medication. Some meds can take four to six weeks to reach full effectiveness, with many people noticing reduced frequency of attacks and intensity within the first month. 

Coping strategies for panic attacks taught in therapy provide immediate tools for managing attacks, even before the underlying mechanisms have been successfully treated. 

Overall, many people who engage with evidence-based treatment see major improvements over time – or even become panic-free. 

References

  1. National Institute of Mental Health. (2022). Panic Disorder: When Fear Overwhelms. https://www.nimh.nih.gov/health/publications/panic-disorder-when-fear-overwhelms
  2. Substance Abuse and Mental Health Services Administration. (2016, June). Table 3.10, Panic Disorder and Agoraphobia Criteria Changes from DSM-IV to DSM-5. National Library of Medicine; Substance Abuse and Mental Health Services Administration (US). https://www.ncbi.nlm.nih.gov/books/NBK519704/table/ch3.t10/
  3. Weissman, M. M. (1993). Family genetic studies of panic disorder. Journal of Psychiatric Research, 27, 69–78. https://doi.org/10.1016/0022-3956(93)90018-w
  4. Kenwood, M. M., Kalin, N. H., & Barbas, H. (2021). The prefrontal cortex, pathological anxiety, and anxiety disorders. Neuropsychopharmacology, 47(1). https://doi.org/10.1038/s41386-021-01109-z
  5. Cruz, D., Lichten, M., Berg, K., & George, P. (2022). Developmental trauma: Conceptual framework, associated risks and comorbidities, and evaluation and treatment. Frontiers in Psychiatry, 13(1), 1–14. https://doi.org/10.3389/fpsyt.2022.800687
  6. McLean, C. P., Asnaani, A., Litz, B. T., & Hofmann, S. G. (2011). Gender differences in anxiety disorders: Prevalence, course of illness, comorbidity and burden of illness. Journal of Psychiatric Research, 45(8), 1027–1035. https://doi.org/10.1016/j.jpsychires.2011.03.006 

 

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