A Survivor’s Guide to Panic Attacks: Understanding PTSD, Anxiety and Trauma-Related Panic Responses
- Jul 18, 2018
- 6 min read
Updated: Jun 24
A panic attack is a sudden and intense episode of anxiety that triggers strong physical sensations of fear when the body’s fight–flight response is activated.
While this response is a normal survival mechanism designed to protect us from danger, panic attacks can often occur unexpectedly, without an obvious trigger or immediate physical threat.
In some cases, panic attacks may also be predictable when linked to specific fears or phobias (for example, fear of flying or enclosed spaces).
From a trauma-informed perspective, panic attacks are often understood as part of a broader pattern of PTSD panic attacks, anxiety dysregulation, and trauma-related nervous system activation. These responses are closely connected to how the nervous system reacts under perceived threat, particularly in people with trauma histories. You can learn more about this in Why Do I Freeze, Shut Down or Go Numb During Stress?
What is a Panic Attack?
A panic attack can feel overwhelming and frightening, particularly when the person does not understand what is happening.
During a panic attack, you may experience at least four of the following symptoms:
Shortness of breath or difficulty breathing
Feelings of choking
Palpitations, pounding heart, or racing heart rate
Dizziness, light-headedness, or faintness
Sweating
Trembling or shaking
Chest pain or pressure
Nausea or stomach distress
Hot flushes or chills
Fear of losing control or “going crazy”
Numbness or tingling sensations
Fear of dying
Feelings of unreality (derealisation) or disconnection from self (depersonalisation)
These symptoms can be extremely intense, and it is common for individuals to seek
medical attention during an episode due to the physical nature of the experience.
How Long Do Panic Attacks Last?
Panic attacks typically peak within 10 minutes and then begin to subside. Most resolve within 20–30 minutes, although they can occasionally last up to an hour.
Some people experience multiple panic attacks in close succession, making it difficult to identify where one ends and another begins.
Afterwards, it is common to experience:
heightened anxiety
fatigue
rapid heart rate
confusion
concentration difficulties
ongoing fear of another panic attack
This post-panic state can contribute to ongoing anxiety and trauma-related panic cycles.
What Can Cause Panic Attacks?
Panic attacks can occur at any time — even when a person feels calm. The exact causes are not always clear, but may include:
Ongoing stress leading to increased stress hormone activation
Trauma or acute stress overwhelming the nervous system
Physical illness or hormonal changes
Habitual hyperventilation affecting carbon dioxide balance
Stimulants such as caffeine, amphetamines, or cocaine
Sudden environmental changes (e.g. crowded or overstimulating spaces)
Fear of experiencing panic attacks (fear-conditioning cycle)
From a trauma-informed lens, these experiences are often linked to PTSD panic attacks and heightened nervous system sensitivity. This sensitivity is often shaped by earlier experiences that affect how the brain detects and responds to threat. You can read more about this in Trauma Triggers Meaning: Why Am I So Easily Triggered?
PTSD Panic Attacks and the Nervous System
Panic attacks are closely linked to the autonomic nervous system, which controls the body’s fight–flight response.
When activated, stress chemicals such as adrenaline and epinephrine flood the body, preparing it for perceived danger. In trauma survivors, this system can become more easily triggered, leading to trauma-related panic attacks that may feel sudden or unprovoked. Panic attacks are often part of a broader pattern of trauma-related symptoms, including anxiety, dissociation, hypervigilance, and emotional overwhelm. You can explore these experiences further in PTSD & Trauma Symptoms.
This can also contribute to:
hypervigilance
increased body scanning
sensitivity to triggers
fear of bodily sensations
These patterns such as hypervigilance and increased body awareness are common in trauma-related panic responses and reflect how the nervous system stays in a protective state after overwhelming experiences. When the body becomes highly sensitised to threat, it can also shift into states such as freeze or shutdown during periods of overwhelm. You can read more about these responses in Why Do I Freeze, Shut Down or Go Numb During Stress?
How to Cope During a Panic Attack?
Deep breathing
Panic attacks often involve hyperventilation, which can intensify symptoms. Slow, deep abdominal breathing can help regulate the nervous system and reduce the intensity of the panic response.
Acknowledge what is happening
Catastrophic thoughts (e.g. “I’m having a heart attack”) can increase fear. Recognising that you are experiencing a panic attack, and that it will pass, can reduce symptom escalation.
Grounding strategies
Grounding techniques help bring attention back to the present moment, especially when symptoms such as dizziness, dissociation, or unreality are present during a panic attack. These strategies support nervous system regulation by helping the body reconnect with safety cues in the environment. You can learn more grounding strategies in Using Grounding in Trauma Recovery.
Muscle relaxation techniques
Progressive muscle relaxation can reduce physical
tension and increase awareness of early signs of
anxiety escalation, supporting early intervention
before a panic attack intensifies.
What to do Following a Panic Attack
See your doctor
A medical assessment can help rule out physical causes and provide reassurance that symptoms are consistent with panic attacks rather than medical emergencies.
Use positive self-talk
Helpful statements may include:
“I have survived this before.”
“This will pass.”
“I can manage my anxiety.”
This helps reduce the fear cycle that contributes to recurrent panic attacks.
Re-focus attention
Engaging in calming or grounding activities (e.g. walking, speaking with someone, fresh air) can help shift attention away from internal sensations.
Avoid avoidance
Avoiding feared situations can temporarily reduce
anxiety but often reinforces panic over time. Gradual
exposure can help rebuild confidence.
Reduce stimulants
Caffeine, alcohol, nicotine, and recreational drugs can all increase the likelihood or severity of panic symptoms.
Long-term Management and Treatment Options
If untreated, panic attacks may develop into panic disorder or ongoing anxiety conditions.
Effective treatment options include:
Psychotherapy
Therapy can help reduce fear responses, identify triggers, and support regulation of the nervous system over time. Trauma-informed therapy is particularly helpful for PTSD panic attacks and anxiety linked to past trauma, as it focuses on both emotional processing and nervous system safety. You can learn more about this approach in What is Sexual Trauma Counselling? A Safe Path Toward Healing.
Medication
In some cases, medication may be used short-term under medical supervision to reduce symptom severity.
Self-management strategies
These include:
breathing exercises
grounding techniques
gradual desensitisation
nervous system regulation skills
Frequently Asked Questions
Can PTSD cause panic attacks?
Yes. Panic attacks are common among people experiencing PTSD and trauma-related anxiety. When the nervous system becomes highly sensitive to perceived danger, it can trigger intense fight-or-flight responses even when there is no immediate threat. These experiences are often referred to as PTSD panic attacks.
How long does a panic attack last?
Most panic attacks peak within 10 minutes and begin to subside shortly afterwards. Many resolve within 20 to 30 minutes, although some people may experience lingering symptoms such as fatigue, anxiety, or fear of another panic attack for longer.
Can a panic attack make you feel like you are dying?
Yes. Panic attacks can cause intense physical symptoms such as chest pain, dizziness, shortness of breath, and a racing heart. These sensations can feel frightening and may lead people to believe they are experiencing a medical emergency. Although panic attacks are distressing, they are not usually dangerous.
What should I do during a panic attack?
Focusing on slow abdominal breathing, grounding techniques, and reminding yourself that the symptoms will pass can help reduce the intensity of a panic attack. Bringing attention back to the present moment can support nervous system regulation and reduce fear.
What is the difference between anxiety and a panic attack?
Anxiety often builds gradually and may persist over time, while a panic attack is a sudden surge of intense fear or discomfort that reaches a peak quickly. Panic attacks typically involve strong physical sensations such as a racing heart, dizziness, trembling, or difficulty breathing.
When should I seek help for panic attacks?
If panic attacks are becoming frequent, affecting your quality of life, impacting relationships or work, or leading you to avoid situations because of fear, it may be helpful to seek professional support. Trauma-informed counselling can help identify underlying triggers and develop strategies to manage symptoms safely.
Conclusion
Panic attacks can be deeply distressing and disruptive, particularly when linked to anxiety or trauma histories. However, they are a treatable nervous system response, not a sign of personal weakness or loss of control.
With the right support, strategies, and understanding, it is possible to reduce the intensity and frequency of panic attacks, regain confidence, and restore a sense of safety in the body.
Practice stress management and relaxation techniques – such as yoga, abdominal breathing and progressive muscle relaxation to reduce overall tension and stress levels that can contribute to panic attacks.
If you are exploring how trauma can continue to affect emotional and physical wellbeing over time, you may also find it helpful to read more about the long-term impacts of childhood sexual abuse in adulthood in What
Support for PTSD, Anxiety and Trauma Recovery
If you are experiencing panic attacks, anxiety, PTSD, or trauma-related symptoms, support is available. At Sexual Trauma Counselling Perth, I provide trauma-informed counselling for adolescents and adults experiencing the impacts of trauma, anxiety, dissociation, emotional overwhelm, and nervous system dysregulation.
Sessions are available in Perth and via telehealth across Australia.
If you would like further support, you are welcome to get in touch via my Contact page.
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