A racing heart. Chest tightness. A sudden wave of fear. Many people mistake a panic attack for a heart attack because the symptoms can feel so alarming. Understanding what is happening in your body can make the experience less frightening. Here's why panic attacks occur and what can help.

­­­

A panic attack occurs when the body’s natural fight-or-flight response is activated even though there is no real danger. Within minutes, the body shifts into stress mode. This can cause a pounding heart, rapid or shallow breathing, sweating, trembling, dizziness, chest tightness, or tingling. Some people may also feel detached from themselves or from the world around them.

"The symptoms can be so intense that people may believe they are losing control or dying," says Prof. Dr. Dr. Katharina Domschke, Medical Director of the Department of Psychiatry and Psychotherapy at the Medical Center – University of Freiburg.

Although panic attacks can feel terrifying, they are usually not physically dangerous. They are self-limiting, meaning the body cannot remain in this heightened state indefinitely. Most attacks peak within minutes and gradually subside within 10 to 30 minutes.

Why do panic attacks happen?

There is rarely a single cause. Instead, several factors may increase the risk, including:

• A family history of anxiety disorders
• A heightened sensitivity of the brain's fear response
• Ongoing stress
• Major life changes or emotional challenges
• Hormonal changes, such as during menopause

Panic attack or heart attack?

Because panic attacks and heart attacks share many of the same symptoms, it can be difficult to tell them apart. Both can cause chest pain, shortness of breath, dizziness, nausea, fatigue, and feelings of fear or anxiety.

A panic attack often:

• Starts suddenly and reaches its peak quickly.
• Causes intense fear along with a racing heart.
• May include tingling sensations in the hands or face..
• Usually improves within 10 to 30 minutes.

A heart attack may:

• Cause persistent pressure, heaviness, or pain in the chest.
• Spread pain to the arm, jaw, back, or upper abdomen.
• Be accompanied by cold sweats, nausea, or severe weakness.
• Not improve on its own.

Important: Never try to diagnose yourself. If you have severe chest pain or are unsure whether your symptoms are caused by a panic attack or a heart attack, seek emergency medical care immediately.

Five ways to manage a panic attack

If you know you are experiencing a panic attack, these techniques may help:

1. Slow your breathing
Breathe slowly into your abdomen, pause briefly, then exhale more slowly than you inhale. A longer exhalation can help calm your heart rate.

2. Try a cold sensation
Splash cold water on your face, hold an ice cube, or chew a strongly flavored mint or gum. The sudden sensory input may help interrupt the panic response.

3. Ground yourself using the 5-4-3-2-1 method
Notice:

• 5 things you can see
• 4 things you can feel
• 3 things you can hear
• 2 things you can smell
• 1 thing you can taste

This exercise helps shift your focus away from fear and back to the present moment.

4. Relax your muscles
Clench your fists tightly for a few seconds, then slowly release them. Repeat with other muscle groups if helpful.

5. Accept the experience.
Rather than fighting the panic, remind yourself that it is temporary and allow the sensations to pass. Accepting the experience instead of resisting it can help reduce its intensity.

When should you seek professional help?

About one in five people will experience at least one panic attack during their lifetime. A single panic attack does not necessarily mean you have an anxiety disorder. However, it's time to speak with a healthcare professional if:

• Panic attacks occur repeatedly without an obvious trigger.
• You constantly worry about having another attack.
• You begin avoiding places or situations because of fear.
• Your symptoms interfere with work, school, or everyday life.

Effective treatments are available. Cognitive behavioral therapy (CBT) is one of the most successful approaches, and some people may also benefit from medication. The goal is not to eliminate anxiety completely, but to learn that it can be managed. Remember: A panic attack is not a sign of personal weakness but a stress response that should be taken seriously and is highly treatable.