What causes panic attacks and how you can prevent them

Panic attacks can be a sign of stress, depression or anxiety. Here’s your guide on what causes panic attacks, how to cope with them and reduce your symptoms.

19-year-old Gen was a model student. As both vice captain and sports captain of her school, she was a self-described high achiever. Yet, halfway through her HSC legal studies exam, panic set in and Gen walked out without finishing.

Sweaty palms, racing heart, shortness of breath and light-headedness. These are symptoms we could all experience when faced with difficult situations. But when all these symptoms happen at once, wrapped up in an ominous feeling of dread or fear, it’s called a panic attack.

For Gen, it seemed to come out of nowhere.

“It [school] was the best time of my life up until this point. I was well-liked by my peers … and teachers, and I literally had no worries aside from just getting things in on time and getting assignments done. I played a lot of sport, I was very active.

“Legal studies was my best subject. And so, coming into that exam, I really had no worry of walking out.”

In hindsight, though, the red flags were there. The night before the exam, Gen went to sleep feeling unprepared and anxious, despite being the top student in her class.

As the exam started the next day, self-doubt began to creep in.

“I started to get the shakes, I started to feel a bit cold, I started to think ‘ok, what happened to my plan of attack? What happened to all the things that I said I was going to do?’

“And it’s in this point that I’m looking at the essay questions and I’m looking back at what I’ve already done, and I go blank.”

Understanding why we experience panic attacks is the first step in being able to lessen their scary effects and stop them altogether.

What is a panic attack?

A panic attack is a sudden and overwhelming period of intense fear, panic or discomfort in a situation where most people wouldn’t feel afraid.

Panic attacks are more common than you’d think. Up to 40% of the population will experience a panic attack at some point in their lives, and 5% of Australians will experience a panic disorder (when the panic attacks are recurrent and disabling) in their lifetime. 

What causes panic attacks?

When faced with danger, real or imagined, your brain kicks into gear with a fight-or-flight response. Chemicals, like adrenaline, flood your body and cause an hormonal reaction, like increased heart rate or heavy breathing.

A panic attack happens when you have the hormonal reaction of fight or flight, but there’s no immediate danger.

Claire, 47, is a teacher and had her first panic attack in her early 30s.

“Twelve years ago, I had a severe panic attack that felt like I was having a heart attack,” she recalls. “That day I had two or three more, and then over that week I had at least one a day and through the night.

“I don’t know what my triggers are. I could be at the shops or sitting at home and one could come on.”

There are different factors thought to play a role in causing panic attacks:

• chronic and ongoing stress
• experiencing a sudden traumatic event
• a change in environment (like walking into a crowded shopping mall)
• too much caffeine
• being a person who’s sensitive to stress or negative emotions
• illness (like inner-ear problems or diabetes)
• genetics i.e. if a close family member has suffered with panic attacks in the past.

What are the signs of a panic attack?

Panic attacks can happen quite quickly and at any time. A panic attack can last anywhere from a few minutes to half an hour. During the attack, people can feel totally overwhelmed and disabled. Symptoms include:

• intense and overwhelming feelings of panic or fear
• increased heart rate
• excessive sweating
• dizziness, light-headedness or numbness in hands, arms or feet
• feeling like you’re dying, choking, or losing control
• feeling detached from your surroundings, or that the world around you isn’t real.

How to recognise a panic disorder

When panic attacks are repeated or persistent, it’s a sign that someone may have a panic disorder. The symptoms of a panic disorder are:

• experiencing at least 4 physical symptoms and
• worrying for at least 1 month about having more attacks or
• worrying about what the attacks mean or
• exhibiting a significant change in behaviour related to the attacks.

How to cope with a panic attack

If you or someone you know is experiencing a panic attack, psychologist Sabina Read suggests:

• using relaxation techniques, like deep breathing, focusing on something outside your body like a tree blowing in the wind, or trying 3 repeats of counting backwards from 100.
• reminding yourself that although the symptoms are uncomfortable, they’re not life-threatening, the panic attack will end, and the feelings will pass.
• avoiding fleeing from the situation and talking yourself out of having the feelings of panic. By allowing the attack to pass on its own, you’ll feel more confident you can handle the symptoms if it happens again.

“Now I know the feelings before they start, I focus on things around me and take really deep breaths,” says Claire. “If that doesn’t work, I’ll find a crunchy food like a biscuit and the motion from my jaw and the noise can help lessen the impact.”

To prevent panic attacks some strategies are:

• doing regular mindfulness or meditation
• exercising regularly
• talking to a friend or loved one about how you’re feeling
• practicing breathing exercises so when you feel panic rising you can ease symptoms before they become severe

“I wish my parents encouraged more conversations,” Gen says. “I wish they suggested going for a walk or for a drive to initiate conversation. I think if we’d had more conversations, I would have known I could be vulnerable with them.”

If you feel like you, or your child, might have had a panic attack, speak to your GP about how to deal with the symptoms when they happen.

Seeking advice from health professionals will help you and your family cope better with treating and preventing panic attacks, and may help the sufferer lead a happier life.  

Want to hear more?

Listen to the full interview with Genevieve in our Navigating Parenthood podcast series.

Getting help in dealing with panic attacks

There’s plenty of help out there if you’re concerned about your panic attacks, or those of someone you know.

We're trying to make it as easy and fast as possible for you to access the mental wellbeing support you need. PSYCH2U mental wellbeing services are unique to HCF, offering eligible HCF members* access to online video support and navigation to other mental health services as needed.

You can also access a range of online programs through This Way Up⁺, a not-for-profit initiative developed by experienced psychiatrists and clinical psychologists, to help you take control of your mental wellbeing. Clinically proven, the programs understand and improve mental challenges like stress, insomnia, worry, anxiety and depression.

If you're struggling with depression or anxiety, and need to speak to someone now, call Lifeline on 13 11 14.

Where to find more mental health help:

• Head to Health
• Headspace
• ReachOut Australia
• SANE Australia

Words by Lindy Alexander
Updated April 2021