You hear the thud of your heart. Your chest feels like it’s being compressed. Your hands start tingling. The floor tilts slightly. And there’s a small voice somewhere in your head that says this is the exact instant something disastrous is going to happen. This is indeed very frightening, and it is physically draining.
But, what commonly goes missing in the midst of the panic is an obvious disconnect: how scary this moment feels vs. How scary this moment actually is; those two things aren’t the same. Consider a panic attack as the body’s alarm system blaring loudly in a completely empty house. There is no fire; just the siren. Once you realize why that siren sounds so physically intense, it loses a bit of its grip.
Below is a walk-through explanation of what occurs in the body during panic attacks, why their symptoms may mimic a medical crisis, and where the truth lies regarding reassuring patients. No amount of information from articles can replace having conversations with your primary clinician, particularly if your panic symptoms have recently appeared or changed.
The purpose of this article is to provide clarity, not to offer a cure-all.
What a panic attack really does to your body
A panic attack is a rapid onset of fear that builds quickly, typically within a couple of minutes. While it reaches its peak, your nervous system switches into a stress response, referred to as the fight-or-flight response. Adrenaline increases rapidly in your bloodstream. Your heart begins to beat faster (in order to send blood throughout your muscle groups) and your breathing becomes quicker (to take in more oxygen). All of this occurs rapidly.
That’s why the sensation of the episode feels so terrifying. A rapidly beating heart can be mistaken for a cardiac event. Rapid breathing can result in lightheadedness. Tingly fingers, a feeling of compression in your chest, and an unreal quality are typical symptoms and related to that increase in adrenaline, not to organ failure.
Here is another unfortunate aspect. You identify the pounding heart as a sign that something catastrophic is about to occur, and thus amplify the alarm even more. That cycle of feedback, when fear interprets your body and your body reinforces that fear, is a hallmark symptom of panic. Fortunately, however, it’s one of the aspects of panic that can be worked through.
How dizziness and the fear of collapse develop
One of the most disturbing symptoms experienced by people experiencing panic episodes is the sensation of losing consciousness. Dizziness during a panic episode results from the quick changes in blood oxygen levels and Co2 caused by rapid breathing. Those rapid changes can create feelings of dizziness, blurry vision, or a disorienting sense of floating that prompts people to prepare themselves for falling.
Understanding how these sensations occur can provide relief. Actual loss of consciousness during a panic attack is significantly rarer than the fear associated with losing consciousness. Loss of consciousness generally requires a drop in blood pressure. Panic episodes tend to do the opposite; they tend to increase heart rate and blood pressure, which explains why people who feel they are about to lose consciousness almost never do.
A straightforward explanation regarding fainting during panic attacks discusses how to explain why the sensation occurs and how to stabilize yourself if/when it does occur.
However, regardless of whether you faint or experience lightheadedness along with other symptoms that seem inconsistent with your normal panic patterns, this could represent an opportunity for further investigation via a medical examination rather than relying solely upon self-assurance.
Can panic attacks kill you?
In short and carefully worded form: a panic attack itself is not generally regarded as posing a direct physical threat to life for most individuals. Episodes of panic tend to feel like life threatening emergencies due to how close their symptoms are to those representing potential emergencies. However, feeling overwhelmed by fear is not equivalent to physical harm.
There exists considerable overlap in terms of symptoms among panic episodes and serious medical issues. Given that no article can evaluate you medically, determining whether or not an issue is merely psychological versus physiological represents the greatest challenge. Chest pain, extreme difficulty breathing, and a racing heart warrant immediate concern (and action) when they arise for the first time. Moreover, they warrant similar consideration any time they appear differently than you would expect from your previously established experiences with panic. Determining whether or not there exists evidence for a physical cause cannot be viewed as either excessive caution or weakness. Rather, such an assessment represents responsible care.
The reassurance provided in response to the inquiry “can panic attacks kill you?” generally serves as a means to reduce the fear that creates the cycle of panic. The reassurance provided does not serve to dissuade someone from obtaining assistance when they believe something is seriously amiss.
Medical Evaluation Situations
Determining whether panic episodes represent potential medical crises can be difficult at the moment. Likewise, you are not required to attempt to determine that fact independently. Clearly defined situations that indicate an urgent need for medical evaluation include:
- new or severe Chest discomfort or pressure radiating towards your arm, jaw or back.
- blacking out or nearly blacking out (i.e., Fainting) which appears distinct from your customary lightheadedness.
- severe difficulty breathing that does not dissipate after the panic resolves.
- Symptoms that arise without an emotional precursor you typically associate with panic episodes.
- any episode that simply doesn’t look correct or familiar to you.
If you suffer from an existing heart condition, you are pregnant or otherwise have additional health-related issues, then it should be considered reasonable to err on the side of caution rather than risk delaying medical attention.
Grounding techniques to help manage an episode
After reviewing your history with your clinician and ruling out potential medical causes for your episodes, several grounding techniques may help manage them. Grounding techniques are not curative measures but are practical tools designed to assist patients while receiving treatment under the guidance of a licensed healthcare professional.
Firstly, slow down your breathing. Shallow, rapid breathing produces much of the dizziness experienced during panic episodes. Gradually extending the exhalation portion of each breath by counting slowly (e.g., a 4-count exhalation followed by a shorter inhalation) will help rebalance oxygen levels in your blood.
Secondly, describe what you’re experiencing. Quietly telling yourself that this is an example of a panic response (that this too shall pass), will help break the cycle of fear feeding itself.
Lastly, remain stationary if it is safe to do so. The instinct to flee is part of your alarm system but staying put allows your nervous system to learn that the feared disaster did not occur.
Cognitive behavioral therapy (CBT) is a widely accepted method used to address anxiety disorders. CBT programs are available in various forms (including online versions) that enable more people access to trained therapists who can guide them through this process. Finding the right format for you depends entirely on individual preferences, and this is exactly what clinicians are able to help you decide.
Holding Two truths at the same time
It is possible for two things to exist simultaneously. Panic attacks feel deadly. For most people most of the time, panic attacks are not deadly (or at least not directly deadly).
Living with that dualism is made simpler when you understand why your body responds physiologically to fear and maintain awareness of when medical evaluations are warranted based on what you have learned about your body’s responses.
If you’ve found that your episodes have become more frequent or debilitating or are limiting activities in daily Life then now is definitely a good time to consult with a mental health professional (not because anything inherently incorrect with you) but because there likely exists ways you can better understand and respond to these episodes.
Relief ultimately comes from understanding patterns and developing skills to respond appropriately to patterns rather than waiting for fears to subside on their own.
Safety Disclaimer
If you or someone you love is in crisis, call 911 or go to the nearest emergency room. You can also call or text 988, or chat via 988lifeline.org to reach the Suicide & Crisis Lifeline. Support is free, confidential, and available 24/7.
Author Bio
Earl Wagner is a health content strategist focused on behavioural systems, clinical communication, and data-informed healthcare education.
Sources
• Janine V. Olthuis. (2016). Therapist-supported Internet cognitive behavioural therapy for anxiety disorders in adults . https://doi.org/10.1002/14651858.cd011565.pub2
• Tunnell, N. C., Corner, S. E., Roque, A. D., Kroll, J. L., Ritz, T., & Meuret, A. E. (2024). Biobehavioral approach to distinguishing panic symptoms from medical illness. Frontiers in Psychiatry, 15, 1296569. https://doi.org/10.3389/fpsyt.2024.1296569
• Pompoli, A., Furukawa, T. A., Efthimiou, O., Imai, H., Tajika, A., & Salanti, G. (2018). Dismantling cognitive-behaviour therapy for panic disorder: a systematic review and component network meta-analysis. Psychological Medicine, 48(12), 1945–1953. https://doi.org/10.1017/S0033291717003919
