Panic Attack or Panic Disorder? When the Attacks Keep Coming Back

A first panic attack can be one of the most frightening moments a person goes through. On its own, it does not mean you have a disorder. The National Institute of Mental Health (NIMH) says an isolated panic attack is not a mental disorder. The questions that matter are whether the attacks come back, and whether fear of the next one has started to shape your days.

What a panic attack is

NIMH describes a panic attack as a one-time or occasional episode of intense fear with physical and emotional symptoms. In the moment, a person may notice a pounding or racing heart, sweating, chills, trembling, difficulty breathing, weakness or dizziness, tingly or numb hands, chest pain, or stomach pain or nausea. An attack can last from a few minutes to an hour, and sometimes longer.

Chest pain always deserves a check

Chest pain and trouble breathing can come from the heart or lungs, not only from panic. If you are not sure what is happening, call 911 or go to the nearest emergency room. Getting checked is the right call, never an overreaction. NIMH also says a provider may do a physical exam to make sure an unrelated physical problem is not behind the symptoms.

When it becomes panic disorder

NIMH says panic disorder may be diagnosed when a person has panic attacks that are recurrent and unexpected. People with it often worry intensely about when the next attack will happen, or begin to fear or avoid places where attacks have happened before. Agoraphobia can sometimes develop alongside it. Panic disorder and agoraphobia are DSM-5-TR diagnoses made by a qualified clinician.

Who it affects

Panic disorder often begins in the late teens or early adulthood, NIMH says, and women are more likely than men to develop it. It sometimes runs in families, though no one knows for sure why some relatives have it and others do not.

What helps

NIMH says treatment typically involves psychotherapy, medication or both. Cognitive behavioral therapy (CBT) teaches different ways of thinking, behaving and reacting to the feelings that come with an attack, and NIMH notes attacks can become less frequent once a person learns to react differently to the physical sensations. Exposure therapy, a common CBT method, works on confronting the fears and beliefs tied to panic, and one version, interoceptive exposure, involves practicing with the body sensations themselves. Medication when indicated is decided jointly with the patient.

NIMH adds that a healthy lifestyle helps but cannot replace treatment: enough sleep, regular exercise, a healthy diet and support from family and friends you trust.

Care at Hope Behavioral Medicine

We evaluate and treat panic attacks and panic disorder in West Ashley and by secure video anywhere in South Carolina; see our telehealth anxiety care. To understand the physical side, read what happens in your body during a panic attack. Request an appointment.

If anxiety ever comes with thoughts of suicide, call or text 988. In an emergency, call 911 or go to the nearest emergency room.

Sources: NIMH, Panic Disorder: What You Need to Know (revised 2025); American Psychiatric Association, DSM-5-TR (panic disorder, agoraphobia).

This article is general information, not medical advice, and does not create a patient–provider relationship. Every situation is different, so see a provider who can evaluate yours and develop a plan of care. Any medication discussed here may not be right for you: the right choice depends on your diagnoses, other health conditions and current medicines, so take medication only as directed by the provider managing your care. If you are ever in doubt about an emergency, call 911 or go to the nearest emergency room.