If you have panic attacks it’s likely to have started with one particular situation one day which made you feel panicky, anxious or frightened. You could have been giving an important work presentation, trapped on a crowded bus or stuck in a lift, for example.

It’s not surprising that you may have started to avoid similar situations for fear that they might trigger another attack. And this has helped to increase your sense of fear, helping to keep panic attacks happening. Our case study shows how panic attacks can develop in this way. 

Case study

Suzanne Smith is a single mum of a 14-year-old girl, Jess. Last year Suzanne and Jess were at Leeds Bradford Airport getting ready to board a plane to Spain when Jess collapsed and was taken very ill. Suzanne started to feel very frightened as she waited for emergency help to arrive. Her heart started to race, her breathing got very fast and she felt very dizzy, nauseous and light-headed. A crowd formed around Jess who was lying on the floor in her mother’s arms. Many faces were looking at them as Suzanne got more and more anxious. When help arrived, Jess was transported on a stretcher through the crowded airport.

After a couple of weeks in hospital Jess got better but her mum started to experience anxiety symptoms in crowded places. One busy Saturday afternoon in the supermarket she started to feel sweaty, hot and dizzy. Her heart was racing, and her breathing was very fast. She thought she was about to faint in front of lots of people. This made her anxiety symptoms worse and she had a panic attack. She had to leave the supermarket and sit in her car until the panic was over.

Since that day Suzanne has continued to have panic attacks at random times in public places such as on the bus on her way home from work. During her panic attacks Suzanne is frightened that she will faint although this has never happened. She has started to avoid going to the supermarket at busy times, for fear of having a panic attack and will only go late at night when it’s very quiet. She will only travel on the bus now when with a friend and has stopped going into Leeds city centre. She has also started to carry a bottle of water and a stress remedy around with her at all times.

Suzanne and Jess want to go on holiday this year, but Suzanne is too scared to go back to Leeds Bradford Airport. She is frightened about having a panic attack in front of lots of people and is worried that, if she does, she wouldn’t be able to take care of her daughter if she was taken ill again.

This could happen to anyone at any time. Some stressors or factors can reduce someone’s resilience or ability to cope, however, and make them more likely to experience panic attacks. These can include:

  • difficult life events – such as bereavement, a relationship break-down, unemployment, ill health or debt
  • a period of change – experiencing lots of difficult or challenging events such as uncertainty at work, health worries, money issues, moving house, having a baby or leaving home to go to University
  • a stressful lifestyle – working or living in a pressurised or hostile place
  • difficult or traumatic life experiences such as being in a fire or a car crash, witnessing an upsetting event or experiencing harassment, a violent attack or domestic abuse. This can include a single one-off event or experiences which happened over time. 
  • early experiences – panic attacks can sometimes connected to experiences in your childhood or teenage years such as bullying, neglect, emotional or sexual abuse.

So while experiencing a panic attack can seem like a ‘false alarm’ as there may not be any immediate danger, right now – they can be linked to very real emotional problems or difficult events (including experiences that have happened a long time ago).

If you think that your panic attacks may be connected to an unresolved trauma – you may need to talk to your GP or another professional about your concerns. It’s possible for the memory of a traumatic event that happened in the past to remain unprocessed and be re-lived by the mind as if it’s happening in the present.

While emotional factors are more common – it’s also possible for some physical health issues to cause panic-type symptoms as well, such as:

  • asthma
  • drinking too much caffeine or alcohol
  • medication issues or using certain illegal drugs
  • poor sleep
  • heart problems
  • hormonal or thyroid problems
  • low blood sugar

Speak to your GP if you are concerned that some physical factors may be behind your panic attacks.