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Panic attack

A panic attack is an intense feeling of fear and tension that is often accompanied by various psychological and physical symptoms. It usually begins with a physical sensation, such as a shooting pain or dizziness, that you interpret as something catastrophic. Learn more about panic attacks.
Nine Gramberg
Latest medical review by:
Irene Bakker 5 May 2025

What is a panic attack?

A panic attack is an intense feeling of fear and tension. Often panic feelings are accompanied by several psychological and physical symptoms.
A panic attack often begins with experiencing a physical sensation. This may include, for example, pain or a dizzy feeling. You interpret this physical sensation as something catastrophic: you are having thoughts such as, “I’m going to faint” or “I’m going to have a heart attack”. As a result of these anxious thoughts, you experience tension and restlessness. As a result, you focus yourself even more on the physical feelings, which only increases them. As a result, the anxiety and restlessness also increase: you end up in a vicious circle.

How does a panic attack occur?

Causes of a panic attack can vary and include:
  • Stress: Prolonged stress can lead to panic attacks.
  • Trauma: Previous traumatic experiences.
  • Genetic predisposition: Panic attacks are more common if family members also have anxiety disorders, panic attacks and panic disorder.
  • Medical conditions: Such as heart problems or hormonal imbalance.
  • Drugs & alcohol: Use of caffeine, drugs, or alcohol.
  • Life changes: Major changes such as moving, new job, or loss of a loved one.
  • Personality: The tendency to interpret situations in an overly negative way can contribute to the onset of a panic attack.

Hyperventilation

A telling characteristic of a panic attack is rapid breathing, also called (chronic) hyperventilation. Your breathing literally becomes unbalanced. This often happens because of anxiety or tension. Hyperventilating causes you to take in more oxygen than you need, which causes similar symptoms to a panic attack.
Exactly how a panic attack manifests itself varies from person to person. Have you already had a panic attack? A panic attack involves a variety of symptoms, but that doesn’t mean you experience them all.

Symptoms of panic attacks

If you experience four or more characteristics, then we can speak of a panic attack;
  • Accelerated breathing;
  • An increased heart rate and palpitations;
  • Shortness of breath;
  • Derealization or depersonalization; You experience the world around you as unreal;
  • Feeling of loss of control;
  • Sudden heavy sweating;
  • Dizziness;
  • Fear of death;
  • Feeling of suffocation;
  • An oppressive feeling in your chest;
  • Tingling and/or cramping in your hands or feet;
  • Tremors;
  • Nausea, vomiting, diarrhea and abdominal pain;
  • Losing control of reality and yourself:
  • Feeling like you are going crazy.

Complaints after a panic attack

After the fiercest feelings of anxiety subside, you often need to recover from the panic for a while. It is not strange if you then have to cry, tremble or feel tired. These are all logical reactions appropriate to a panic attack you have gone through.

Multiple panic attacks

Have you experienced multiple panic attacks? Then the fear of having another panic attack often grows. Completely preventing a panic attack is not possible. What does help is being less afraid of a panic attack. When that fear subsides, there is less chance that you will actually have another attack.

Reduce likelihood of panic attacks

The following tips can help reduce your chances of having another panic attack;
  • Take time for yourself when you feel you are tired or stressed.
    Take good care of yourself and allow both your body, and your head the rest to truly relax when needed.
  • Reduce or stop using alcohol and drugs.
    Also, don’t drink coffee and other caffeinated beverages.
  • Talk to your friends or family about your fears.
    It is nice if those around you know what you are going through. This helps you cope better with anxiety. Carrying the anxiety yourself, alone, increases your anxiety.
  • Write down your thoughts.
    This helps you clear your mind of anxiety thoughts for a while.
  • Exercise sufficiently and regularly.
    Exercise is an effective way to reduce stress and bring calmness back to your body.
  • Find distractions the moment you feel the tension and anxiety growing in your body.
    Do you suspect a panic attack is imminent? Focus on your surroundings or count to 100 in your head. Going outside and walking also helps in many cases.
  • Reduce stress.
    It is advisable to reduce stress symptoms.
  • Let your feelings be there as they occur.
    This ensures that your anxiety feelings in your body are kept at an acceptable level as much as possible.

Development into panic disorder

Have you experienced panic attacks one or more times now? And are they increasing? You may be suffering from panic disorder. Do you notice that you exhibit escape and avoidance behaviors? You start avoiding situations or stimuli that you associate with panic.
In the case of panic disorder, you also sometimes have panic attacks without knowing what triggers them. You may then also become anxious about the fear itself. This can affect your life considerably.

Help with panic attacks

Do you have questions about anxiety treatment or how to better cope with anxiety? Or are you unsure about when to see a psychologist?

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Irene Bakker
Irene is working as a Healthcare Psychologist at iPractice. She believes it is important to work together, to create an open and equal environment in which everything can be shared and you feel safe.
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Success Stories

8 February 2024
“I learned in treatment to look at myself with more compassion.”
Emma, 25, felt completely disconnected from her surroundings at times during her graduation. She didn’t know exactly what it was, what it was caused by and how to get rid of it. In her treatment at iPractice, she discovered it was a panic disorder.
Emma
13 February 2024
“Letting things go is easier now and I have more focus”.
Kim, 24, had been suffering from anxiety and ruminating thoughts for some time. These were affecting her daily life. The thoughts and anxiety were taking over and making her irritable. Through her family doctor, she came to iPractice for therapy.
Kim
13 February 2024
“I can feel happy and lucky again. I didn’t expect this was still possible.”
Tessa, 18, came to iPractice for anxiety symptoms that she was experiencing after her final exams in high school. She had previously been in treatment with the POH-GGZ, but after her final exams she suddenly felt unwell. She suffered from depressive symptoms and had regular panic attacks. That’s when she decided to seek more intensive help from iPractice.
Tessa

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