How Are Panic Attacks Caused

Imagine this: You’re calmly going about your day when suddenly, out of nowhere, your heart starts racing, your chest feels tight, and your thoughts spiral into a whirlwind of fear and panic. This bewildering experience is known as a panic attack, and it can be utterly overwhelming. But have you ever wondered what causes these intense episodes that seemingly come out of the blue? In this article, we will explore the underlying factors behind panic attacks, shedding light on the intricate web of physiological, psychological, and environmental triggers that can set off this distressing phenomenon. Prepare to gain a deeper understanding of the causes and empower yourself with knowledge on how to navigate through the storm.

What Is a Panic Attack?

Definition of a Panic Attack

A panic attack is a sudden episode of intense fear or discomfort that is accompanied by a variety of physical and psychological symptoms. During a panic attack, you may experience a rapid heartbeat, chest pain, shortness of breath, sweating, dizziness, trembling, and a sense of impending doom or a fear of losing control. These attacks can occur unexpectedly and often reach their peak within minutes, causing extreme distress and a feeling of being out of control.

Symptoms of a Panic Attack

The symptoms of a panic attack can vary from person to person, but common physical symptoms include a rapid or pounding heartbeat, shallow breathing or difficulty breathing, chest pain or discomfort, sweating, trembling or shaking, feeling dizzy or lightheaded, and experiencing hot or cold flashes. Additionally, you may also experience psychological symptoms such as a fear of losing control or going crazy, a sense of impending doom, feeling detached from reality, and an intense urge to escape the situation. It is important to note that panic attacks can be very debilitating and may occur in various situations, impacting your daily life and overall well-being.

Psychological Factors

Generalized Anxiety Disorder

Generalized Anxiety Disorder (GAD) is a common psychological condition that involves excessive worry and anxiety about a wide range of everyday situations. People with GAD often experience chronic and persistent anxiety that can trigger panic attacks. The constant worry and fear associated with GAD can amplify the body’s stress response, leading to the onset of panic symptoms.

Specific Phobias

Specific phobias are intense and irrational fears of specific objects, places, or situations. When confronted with the feared object or situation, individuals with specific phobias may experience overwhelming panic symptoms. The anticipation and fear of encountering the phobic stimulus can be enough to trigger a panic attack.

Post-Traumatic Stress Disorder

Post-Traumatic Stress Disorder (PTSD) is a mental health condition that can develop after experiencing or witnessing a traumatic event. People with PTSD may suffer from flashbacks, nightmares, and overwhelming anxiety. These symptoms can be accompanied by panic attacks, especially when triggered by reminders of the traumatic event.

Panic Disorder

Panic Disorder is a specific anxiety disorder in which individuals experience recurrent and unexpected panic attacks. Unlike other anxiety disorders, panic disorder is characterized by the fear of having future panic attacks, often resulting in avoidance behaviors and significant impairment in daily life. Panic disorder can be debilitating and may require professional intervention for effective management.

Obsessive-Compulsive Disorder

Obsessive-Compulsive Disorder (OCD) is a chronic condition characterized by unwanted, intrusive thoughts (obsessions) and repetitive behaviors or mental acts (compulsions). People with OCD may become overwhelmed by obsessive thoughts or irrational fears, leading to heightened levels of anxiety and the possibility of experiencing panic attacks.

How Are Panic Attacks Caused

Biological Factors


Genetic factors can play a significant role in the development of panic attacks and anxiety disorders. Research suggests that individuals with a family history of panic disorder or other anxiety disorders may have a higher risk of experiencing panic attacks themselves. However, genetics alone are not the sole cause of panic attacks, as other environmental and psychological factors also contribute to their onset.

Neurotransmitter Imbalances

Neurotransmitters are chemical messengers in the brain that help regulate various bodily functions, including mood and anxiety. Imbalances in neurotransmitters such as serotonin, norepinephrine, and gamma-aminobutyric acid (GABA) have been linked to panic attacks. Low levels of serotonin and GABA, as well as high levels of norepinephrine, can contribute to the development and severity of panic symptoms.

Hormonal Changes

Hormonal fluctuations can impact emotional well-being and may contribute to the occurrence of panic attacks, particularly in women. Women may experience panic attacks during specific phases of their menstrual cycle, pregnancy, or menopause due to changes in hormone levels. These hormonal fluctuations can affect neurotransmitter activity and increase vulnerability to panic symptoms.

Chronic Medical Conditions

Certain chronic medical conditions, such as cardiovascular disorders, respiratory disorders, and thyroid disorders, have been associated with an increased likelihood of experiencing panic attacks. These physical conditions can cause physiological changes and sensations that mimic the symptoms of a panic attack, leading to heightened anxiety and panic.

Environmental Factors

Stressful Life Events

Experiencing significant life stressors, such as a divorce, job loss, or the death of a loved one, can trigger or exacerbate panic attacks. High levels of stress overload the body’s stress response system, increasing the likelihood of panic symptoms. It is important to manage stress effectively and seek support during challenging life events to reduce the risk of panic attacks.

Childhood Trauma

Childhood trauma, including physical, emotional, or sexual abuse, can have long-lasting effects on mental health. Individuals who have experienced trauma during childhood are more susceptible to developing anxiety disorders, including panic attacks, later in life. Traumatic events can disrupt the brain’s stress response system, making an individual more vulnerable to anxiety-related symptoms.

Substance Abuse

The use and abuse of substances such as alcohol, drugs, and certain medications can contribute to the development of panic attacks. Substance intoxication and withdrawal can trigger anxiety symptoms and panic attacks. Additionally, individuals with a history of substance abuse may experience higher levels of stress and anxiety, increasing their susceptibility to panic attacks.

How Are Panic Attacks Caused

Cognitive Factors

Catastrophic Thinking

Catastrophic thinking refers to the tendency to anticipate the worst possible outcome in any given situation. Those who engage in catastrophic thinking often perceive events or situations as extremely threatening, which can trigger intense anxiety and panic symptoms.

Heightened Sensitivity to Bodily Sensations

Some individuals may be more acutely aware of their bodily sensations, leading to a heightened sensitivity that can trigger panic attacks. The perception of normal bodily sensations as dangerous or threatening can result in heightened anxiety and the onset of panic symptoms.

Irrational Beliefs

Holding irrational beliefs or distorted thinking patterns can contribute to the development of panic attacks. Believing that something terrible will happen or that one is incapable of coping with challenging situations can create a perpetual state of anxiety and increase the likelihood of experiencing panic attacks.

Negative Self-Talk

Negative self-talk involves engaging in self-deprecating or self-critical thoughts and beliefs. This negative inner dialogue can fuel feelings of anxiety and heighten the risk of panic attacks. Challenging and replacing negative self-talk with more positive and realistic thoughts can help reduce the occurrence of panic symptoms.

Neurological Factors

Amygdala Dysfunction

The amygdala, a key brain structure involved in processing emotions, is thought to play a significant role in the development of panic attacks. Dysfunction or hyperactivity in the amygdala can lead to an exaggerated fear response, triggering panic symptoms even in non-threatening situations.

Hippocampus Abnormalities

The hippocampus, another crucial brain structure involved in memory and emotions, may also contribute to the occurrence of panic attacks. Abnormalities in the hippocampus, such as structural changes or impaired functioning, have been associated with panic disorder and heightened anxiety.

Prefrontal Cortex Dysregulation

The prefrontal cortex, responsible for decision-making, impulse control, and emotional regulation, can become dysregulated in individuals prone to panic attacks. Reduced activity or impaired functioning of the prefrontal cortex can diminish the ability to regulate fear and anxiety, increasing the likelihood of panic symptoms.

How Are Panic Attacks Caused

Stimulant Use


Caffeine is a stimulant found in coffee, tea, energy drinks, and some medications. Consumption of caffeine can increase heart rate, blood pressure, and anxiety levels, potentially triggering or worsening panic attacks in susceptible individuals. Limiting or avoiding caffeine intake is advisable for those prone to panic symptoms.


Nicotine, found in tobacco products, is a powerful stimulant that can increase heart rate and blood pressure. Smoking or using nicotine-containing products can heighten anxiety levels, making individuals more vulnerable to panic attacks. Quitting smoking and avoiding nicotine products can significantly reduce the risk of panic symptoms.

Illegal Drugs

The use of illegal drugs, such as cocaine, amphetamines, and hallucinogens, can result in heightened levels of anxiety and trigger panic attacks. These substances can disrupt neurotransmitter activity and stimulate the body’s stress response system, making panic symptoms more likely to occur. Avoiding the use of illicit drugs is essential for managing and preventing panic attacks.

Medication Withdrawal

Abrupt Cessation of Benzodiazepines

Benzodiazepines, a class of medications commonly prescribed for anxiety and sleep disorders, can lead to physical dependence with long-term use. Abruptly stopping benzodiazepines or rapidly tapering off the medication can induce withdrawal symptoms, including rebound anxiety and panic attacks.

Discontinuation of Antidepressants

Certain antidepressant medications, especially those in the selective serotonin reuptake inhibitor (SSRI) class, are commonly prescribed to manage anxiety disorders and panic attacks. Stopping or missing doses of these medications without medical supervision can lead to discontinuation or withdrawal symptoms, potentially including rebound anxiety and panic symptoms.

Medical Conditions

Cardiovascular Disorders

Cardiovascular disorders, such as heart disease or arrhythmias, can cause sensations similar to those experienced during a panic attack. Chest pain, rapid heartbeat, and shortness of breath associated with these conditions can induce anxiety and panic. Close medical monitoring and effective management of cardiovascular disorders are necessary to differentiate between cardiac symptoms and panic attacks.

Respiratory Disorders

Respiratory disorders, such as asthma or chronic obstructive pulmonary disease (COPD), can cause difficulty breathing, chest tightness, and shortness of breath. These physical sensations are akin to symptoms experienced during a panic attack and may trigger anxiety and panic symptoms in individuals already prone to panic attacks.

Thyroid Disorders

Thyroid disorders, including hyperthyroidism (overactive thyroid) or hypothyroidism (underactive thyroid), can disrupt the body’s hormonal balance and contribute to heightened anxiety and panic symptoms. Proper diagnosis and management of thyroid disorders are crucial in reducing the risk of panic attacks associated with these conditions.

Situational Triggers

Public Speaking

Public speaking or performing in front of others can be a significant trigger for panic attacks. The fear of being judged or humiliated in a public setting can induce intense anxiety and panic symptoms. Developing coping strategies and seeking professional assistance can help individuals manage their panic symptoms in these situations.

Crowded Places

Being in crowded places, such as shopping malls, stadiums, or crowded public transportation, can trigger panic attacks in some individuals. The feeling of being trapped or overwhelmed by the presence of others can intensify anxiety and induce panic symptoms. Avoiding crowded places or implementing relaxation techniques can assist in managing these triggers.


Fear of flying, known as aviophobia, can lead to panic attacks in individuals who are anxious about air travel. The anticipation of being in an airplane and the lack of control can trigger intense fear and panic symptoms. Seeking support and employing relaxation techniques can help individuals overcome their fear and reduce the likelihood of panic attacks while flying.


Driving or being a passenger in a vehicle can be a triggering situation for panic attacks, especially in individuals with driving phobias or a history of motor vehicle accidents. The fear of losing control or being involved in a collision can induce heightened anxiety and panic. Gradual exposure therapy and working with a healthcare professional specializing in anxiety disorders can assist in overcoming these driving-related triggers.

Intense Exercise

Engaging in intense exercise or physical activity can sometimes induce panic attacks in susceptible individuals. The rise in heart rate, shortness of breath, and bodily sensations associated with exertion can mimic the symptoms of a panic attack. Implementing relaxation techniques, pacing oneself during exercise, and gradually increasing intensity can help prevent panic symptoms during physical exertion.

In conclusion, panic attacks can have various causes, ranging from psychological factors such as anxiety disorders and traumatic experiences to biological factors like genetic predisposition and hormonal imbalances. Environmental factors, cognitive factors, neurological factors, stimulant use, medication withdrawal, medical conditions, and situational triggers can also contribute to the onset of panic attacks. It is important to seek professional help if you experience recurrent panic attacks to receive an accurate diagnosis and develop an appropriate treatment plan to manage and reduce their occurrence.