Panic attack causes: what to know

A panic attack is an intense alarm response that can build quickly, sometimes with no obvious danger. Stress, grief, conflict, trauma reminders, poor sleep and prolonged worry may lower the threshold for an episode. Caffeine, alcohol, recreational drugs and some medicines can alter heart rate, breathing or alertness and may contribute.

Physical sensations can also become part of a feedback loop: a racing heart or fast breathing feels threatening, fear increases, and the sensations become stronger. Palpitations, chest tightness, feeling anxious, or numbness and tingling can occur in panic, but they do not identify its cause. Thyroid problems, heart or breathing conditions and medicine effects may need consideration.

Keep a brief log of the setting, thoughts, body sensations, sleep, meals, caffeine, alcohol, medicines and recent stress. Note what helped and whether symptoms stopped after you rested. This can reveal patterns without assuming a single explanation.

Arrange a GP Consultation when attacks repeat, begin without a clear trigger, disrupt sleep or lead to avoidance. A clinician can review your health and medicines and decide whether further physical checks or a Mental Health Assessment would help.

Seek emergency help for severe or persistent chest pain, serious breathing difficulty, fainting, new weakness, confusion or thoughts of suicide. Get prompt medical advice when an episode is your first severe event, feels different from previous attacks, follows drug use, or occurs with a serious medical condition.

What triggers or medical causes should we consider? Could my medicines or stimulant use affect these sensations? Which symptoms should I record? Would talking therapy, medication review or another assessment be suitable?