Panic Attacks Explained: Symptoms, Causes & Therapies That Work
Key Takeaways — Panic Attacks
- Panic attacks can feel overwhelming, with a racing heart, difficulty breathing, dizziness, and fears of losing control or “going crazy.”
- Some people experience dissociation, fogginess, or derealization during and after a panic attack.
- In extreme cases, vomiting and physical collapse may occur.
- Panic attacks are emotionally exhausting and can feel so physical that many people seek emergency hospital care.
- Talk therapies can help manage symptoms, but root-cause therapies offer more lasting relief.
- Internal Family Systems (IFS) and EMDR work to heal the source rather than just teaching coping tools.
- Dr Millia offers therapeutic support and deeper healing for those experiencing panic attacks.
What is a panic attack?
A panic attack is a sudden wave of intense fear or discomfort that peaks within minutes. It feels physical and emotional at the same time. Many people describe it as “coming out of the blue.”
Common signs include a racing heartbeat, shortness of breath, chest tightness, dizziness, shaking or sweating, and a feeling of losing control or impending doom. The episode itself is not dangerous, but it can feel overwhelming.
- Starts suddenly and builds fast (peaks in minutes)
- Strong body sensations (heart, breath, chest, dizziness)
- Scary thoughts (something bad is happening, “I’m losing control”)
- Can be unexpected or triggered by a fear or situation
If panic attacks happen repeatedly and you worry about having more or change your behaviour to avoid them, a clinician may assess for panic disorder.
Sources: American Psychological Association (APA) · National Institute of Mental Health (NIMH)
Symptoms of Panic Attacks (APA)
- Racing heartbeat
- Difficulty breathing, feeling as though you “can’t get enough air”
- Terror that is almost paralyzing
- Dizziness, lightheadedness, or nausea
- Trembling, sweating, shaking
- Choking, chest pains
- Hot flashes or sudden chills
- Tingling in fingers or toes (“pins and needles”)
- Fear that you’re going to go crazy or are about to die
What Is the Difference Between a Panic Attack and Panic Disorder?
A panic attack is a one-time or occasional episode of intense fear accompanied by physical and emotional symptoms. An isolated panic attack does not constitute a mental disorder.
Panic disorder is diagnosed when someone experiences recurrent, unexpected panic attacks along with persistent worry or behavioral changes related to the fear of future attacks—often disrupting daily life.
Panic attacks remains as a traumatic memory
When someone experiences a panic attack—regardless of the cause—the body often encodes the event as a traumatic memory. Because the experience feels unresolved, the nervous system remains alert, anticipating the possibility that it could happen again. This lingering imprint fuels ongoing fear and heightened sensitivity to future episodes.
Panic often leads to avoidance.
Yet the more we avoid, the more possibilities we lose in our lives. As our world becomes smaller, feelings of depression and hopelessness can grow. Panic locks the body into a flight or freeze state, while avoidance gradually pulls us into a posture of submission and giving up.
Fear of the panic attacks returning can be as bad as the panic attacks.
For many people, the fear of a panic attack returning is often more distressing than the attack itself. This anticipatory anxiety can create a cycle where the expectation of panic feels heavier and more limiting than the episode
Frequently Asked Questions About Panic Attacks
How long does a panic attack last for?
Most panic attacks last only a few seconds or minutes, though in some extreme cases they may continue for longer. After-effects such as exhaustion, fogginess, or emotional distress can linger well beyond the episode. For many, the anticipation of another panic attack feels worse than the attack itself.
How to stop a panic attack ASAP?
Trying to “control” a panic attack with certain techniques—like forced breathing—can sometimes make symptoms worse, because panic is often rooted in the fear of losing control. The most effective approach is to remind yourself that a panic attack cannot kill you. Accepting its nature reduces fear, and when fear diminishes, panic loses its power to take over your life.
What actually causes panic attacks?
There is no single cause of panic attacks. They are the body’s threat response, triggered when the nervous system perceives danger—whether consciously or unconsciously. Contributing factors may include current stress, unresolved trauma, underlying neurodivergence (such as ADHD), anxiety disorders, unsatisfactory life situations, or withdrawal from substances. Causes are highly individual and cannot be generalized.
Why have my panic attacks gotten worse?
Panic attacks often worsen when we resist or “fight” them. They act as an alarm, signaling that the internal system is under immense pressure. This is similar to an overactive immune system reacting even when there is no real virus. The solution lies in understanding panic with compassion rather than resistance. Approaches like Internal Family Systems (IFS) therapy help resolve panic at its roots, bringing long-term relief.
Therapies That Can Help With Panic Attacks
Several evidence-based therapies are recommended by national mental health authorities for treating panic attacks and panic disorder. Each therapy works differently, and their unique benefits are explained below.
Cognitive Behavioral Therapy (CBT)
Cognitive behavioral therapy (CBT) is a talking therapy where a therapist helps you to change how you think and act. It can treat many different mental health problems (NHS).
The three key elements of CBT for panic attacks involve:
- Questioning unhelpful thoughts and beliefs while exploring alternative perspectives
- Recognizing emotions and physical sensations without reacting
- Adjusting actions, such as engaging in activities you’ve been avoiding
Exposure Therapy
The National Institute of Mental Health (NIMH) states that exposure therapy—including interoceptive exposure, where individuals intentionally evoke physical sensations of panic in a controlled setting—is a part of CBT for panic disorder. This approach helps clients confront and reframe their fears, often alongside relaxation and breathing strategies.
Source: NIMH — Panic Disorder: When Fear Overwhelms
Eye Movement Desensitization and Reprocessing (EMDR)
EMDR is a trauma therapy that targets disturbing memories of panic attacks—often the first-ever memory, the worst one, and the last one. Every panic attack, whether linked to a known reason or not, becomes a traumatic memory. The fear of a panic attack returning is similar to the fear of any traumatic event recurring in life.
Internal Family Systems (IFS) Therapy
IFS therapy views panic as a protective response from parts of the inner system that fear losing control. Instead of fighting panic, IFS helps people connect with and heal these protective parts, bringing compassion and balance. It addresses the root causes of panic, rather than only teaching coping strategies.
Conclusion
Panic attacks are a cluster of symptoms that bring intense fears—during the episode and in the time between them. The anticipatory fear of another panic attack can often feel as distressing as the attack itself.
Because the root causes of panic are unique to each person, a one-size-fits-all approach rarely works. While many therapies provide coping skills and short-term tools, lasting change comes from addressing the underlying source of panic attacks. Therapies such as Internal Family Systems (IFS) and Eye Movement Desensitisation and Reprocessing (EMDR) help resolve panic from the inside out.
Not sure which approach fits you best? Many clients benefit from a blended path of IFS and EMDR. If your panic feels trauma-linked, you may also want to explore:
Book a Consultation to explore a personalised plan for healing panic attacks.
📞 Contact Dr. Millia
If you would like to book a consultation or learn more about services, please get in touch:
- Clinic: First Psychiatry Clinic
- Address: 975 Al Wasl Road, Dubai, UAE
- Phone: +971 55 355 7855
- Email: info@milliabegum.ae
- Website: milliabegum.ae
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- Wednesday: 09:00–18:00
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About Dr. Millia
Dr. Millia Begum is a trained trauma specialist with over 25 years of clinical experience in psychiatry and therapy. She trained in the UK’s NHS system and served the NHS in various senior roles. She is a former EMDR Europe Approved Consultant, EMDR researcher, and board member of the EMDR Association UK. She is now a member of the EMDR International Association (EMDRIA). Dr. Millia is a Certified Internal Family Systems (IFS) Therapist, bringing a compassionate, parts-informed approach to her work with clients in Dubai.