How long does a panic attack last?

According to the NHS, most panic attacks last between 5 and 20 minutes, and some have been reported to last up to an hour. The fear itself peaks within minutes.

Can a panic attack come out of nowhere?

Yes. A panic attack can start from a calm state as well as an anxious one, and some have no clear trigger. Repeated unexpected panic attacks, followed by a month or more of worry about the next one, are the main feature of panic disorder, which is treatable with therapy, medication or both.

Can a panic attack hurt you?

The NHS says panic attacks are frightening but not dangerous, and an attack will not cause you physical harm. A first episode is still worth a check with a doctor, because some heart, thyroid and breathing problems cause similar symptoms. New, severe or crushing chest pain is an emergency: call 911.

Panic attack vs anxiety attack: how to tell the difference

Q: Is an anxiety attack the same as a panic attack?

Not always. A panic attack has a formal definition: a sudden surge of intense fear that peaks within minutes, with four or more physical or mental symptoms. "Anxiety attack" has no medical definition. People use it either for a panic attack or for worry and tension that build up more slowly around a specific concern.

A panic attack is a sudden surge of intense fear that peaks within minutes and brings at least four physical or mental symptoms. "Anxiety attack" has no medical definition. People use it for a panic attack, or for anxiety that builds more slowly around a worry.

Below, a table compares the two, followed by how to tell them apart and what to do about each.

If you have new, severe or crushing chest pain, especially pain that spreads to your arm, jaw, neck or back, or comes with sweating or breathlessness, call 911 even if you are not sure it is your heart. If you are in crisis or thinking about suicide, call or text 988, the Suicide & Crisis Lifeline.

1)What is the difference between a panic attack and an anxiety attack?

The DSM-5 is the diagnostic manual published by the American Psychiatric Association. It defines a panic attack as "an abrupt surge of intense fear or intense discomfort that reaches a peak within minutes", with four or more of 13 listed symptoms during that surge. A US family medicine review and the Canadian anxiety guidelines both quote this wording.

"Anxiety attack" does not appear in the DSM-5, and it is not used in the clinical guidelines this page is based on. Because nothing defines it, the phrase gets used for two different things. Some people mean a panic attack described in everyday words. Others mean a stretch of rising worry, tension and restlessness that builds over a longer period, usually around something specific, such as a deadline or a health scare. That second meaning is closer to the symptoms of generalized anxiety, where worry is hard to control and shows up on most days.

Panic attack compared with what people usually mean by an anxiety attack
	Panic attack	"Anxiety attack" (the slow-build meaning)
Official definition	Yes, in the DSM-5	No, it is an everyday phrase
How it starts	An abrupt surge, from a calm or an anxious state	Worry and tension that build up
Peak	Within minutes	No set peak
How long it lasts	Most last 5 to 20 minutes	No set length
Trigger	Can come with no clear trigger	Usually tied to a worry you can name
Main symptoms	Four or more of 13, such as a pounding heart, breathlessness, dizziness, fear of dying	Worry that is hard to control, restlessness, irritability, poor concentration, tension
Related diagnosis	Panic disorder, when attacks repeat and you fear the next one	Generalized anxiety disorder, when worry is present most days
What helps in the moment	Stay where you are, breathe slowly, let it pass	Slow breathing, movement, talking to someone, less caffeine

2)What are the symptoms of a panic attack?

The DSM-5 lists 13 symptoms. A panic attack includes four or more of them:

Palpitations, a pounding heart or a fast heart rate
Sweating
Trembling or shaking
Feeling short of breath or smothered
Feeling of choking
Chest pain or discomfort
Nausea or stomach upset
Feeling dizzy, unsteady, light-headed or faint
Chills or feeling hot
Numbness or tingling
Feeling unreal, or detached from yourself
Fear of losing control or going crazy
Fear of dying

The surge can start from a calm state or from an anxious one. This explains a lot of the confusion between the two terms. If you were already worried about something when the panic hit, it can feel as if the worry turned into an attack, and many people then call the whole thing an anxiety attack.

Expected and unexpected panic attacks

The DSM separates panic attacks that have an obvious cue, such as a feared situation, from ones that arrive with no clear cause. Panic disorder is diagnosed when unexpected panic attacks keep happening and at least one of them is followed by a month or more of worry about having another one, or of changing what you do to avoid them. One panic attack, or a few, is not panic disorder.

Some panic attacks happen at night and wake people from sleep. A review in American Family Physician notes that these night-time attacks are not uncommon in panic disorder. If you wake up tense without a full attack, see our guide to morning anxiety.

Panic attacks also happen alongside other conditions, including depression and PTSD, and alongside medical problems such as heart and breathing conditions. The DSM-5 lets clinicians note panic attacks as part of those other diagnoses.

3)How common are panic attacks?

Panic attacks are much more common than panic disorder. In a US survey of more than 9,000 adults, 22.7% had had panic attacks at some point without ever developing panic disorder or agoraphobia.

The National Institute of Mental Health estimates that 2.7% of US adults had panic disorder in the past year, and about 4.7% have it at some point in their lives. Past-year rates were higher in women (3.8%) than in men (1.6%).

Even isolated panic attacks can get in the way of daily life. In the same US survey, people who had panic attacks without panic disorder still reported meaningful problems in their daily roles because of them.

4)What is agoraphobia, and how is it linked to panic?

Agoraphobia is anxiety about having a panic attack, or panic-like symptoms, in places where getting out or getting help could be hard. People with agoraphobia avoid those situations or get through them with a lot of distress. Common examples are public transport, crowds, queues and being out of the house alone.

The DSM-5 lists agoraphobia as its own diagnosis, separate from panic disorder. It requires intense fear of at least two different types of situation. In the US survey above, people with both panic disorder and agoraphobia had the most severe symptoms of any group. If you have started to plan your days around avoiding the next attack, that is a good reason to see someone sooner.

5)How can you tell which one you are having?

These questions help sort it out afterwards:

How fast did it start? A panic attack is abrupt. Worry-driven anxiety tends to creep up.
Did it peak within minutes? A panic attack does. The slower kind has no sharp high point.
How many of the 13 symptoms did you have at once? Four or more in the same surge fits a panic attack.
Was it tied to a worry you can name? The slower kind usually is. A panic attack may not be.
How long did it last? The NHS says most panic attacks last 5 to 20 minutes, with some reported to last up to an hour. Anxiety that simmers all afternoon is more likely the slow-build kind.

Both can happen on the same day, and one can follow the other. The sections below cover what helps with each.

Could it be something physical?

Some medical problems cause symptoms that look like panic, so a first episode is worth a check with a doctor. Clinical guidelines list conditions such as an overactive thyroid, heart rhythm problems, asthma, low blood sugar and seizure disorders. Caffeine, alcohol withdrawal, decongestants, stimulants and some inhalers can also bring on panic-like symptoms. Guidelines suggest a physical exam and, depending on your symptoms, some tests.

6)What should you do during a panic attack?

The NHS says panic attacks are frightening but not dangerous, and an attack will not cause you physical harm. Its advice for the moment itself is short:

Stay where you are if you can.
Breathe slowly and deeply.
Remind yourself that the attack will pass.

One breathing pattern with trial data behind it is the cyclic sigh: breathe in through your nose, take a second short breath in on top of the first, then breathe out slowly and fully through your mouth. In a month-long randomized study at Stanford, five minutes of this a day improved mood and lowered breathing rate more than mindfulness meditation did.

You can follow it step by step with our physiological sigh guide. If your attacks tend to happen at your desk, see what to do about a panic attack at work.

7)What should you do when anxiety builds slowly?

When anxiety creeps up over hours, you have more time to work with, and the NHS self-help advice for ongoing anxiety applies:

Talk to someone you trust about what is on your mind.
Use a breathing exercise, such as slow breathing or the cyclic sigh above.
Get some physical activity. A review in American Family Physician notes that physical activity reduces anxiety symptoms.
Protect your sleep and eat regular meals.
Cut back on caffeine and alcohol, and avoid using either to cope.

In a 2022 meta-analysis of lab studies, a dose of roughly five cups of coffee brought on a panic attack in 51.1% of people with panic disorder, and in none of them after a placebo. The same doses also raised anxiety in healthy adults. Less is known about smaller amounts, but if you are prone to either kind of episode, caffeine is an easy thing to test by cutting back for a week or two.

8)When should you get help?

See a doctor or a mental health professional if any of these apply:

It is your first episode, or the symptoms are new to you. A check rules out a physical cause.
Panic attacks keep coming back and you spend time worrying about the next one, or you have started avoiding places or activities because of them.
Worry is hard to control and has been present on most days for six months or more. That is the time frame used for generalized anxiety disorder.
Anxiety is getting in the way of work, sleep or relationships.

Both panic disorder and generalized anxiety are treatable. Cognitive behavioral therapy (CBT) has the strongest evidence for panic disorder, and talking therapy can work as well as medication for both conditions. Antidepressants in the SSRI and SNRI groups are the first-choice medicines.

For panic, CBT usually includes exposure: facing the situations you have been avoiding, and practising being around the body sensations of panic, such as a racing heart, until they are less frightening. One meta-analysis found that CBT with this kind of exposure to body sensations worked better than relaxation therapy for panic symptoms. CBT works in one-to-one or group sessions, and in studies, self-help books and online CBT programmes have also improved anxiety symptoms.

If you are prescribed an SSRI, the NHS says it can take 2 to 4 weeks before it starts to work.

If you want a starting point before an appointment, our free panic attack test looks at how often panic shows up for you, and the GAD-7 anxiety test screens for ongoing anxiety. Both are screening tools, and a professional makes the diagnosis.

9)Sources

"Anxiety attack" is a common term, not a diagnosis, and the DSM-5-TR does not define it: Cleveland Clinic (2026). Panic attack vs. anxiety attack explained.

DSM-5 panic attack, panic disorder and agoraphobia criteria, the panic attack specifier, medical causes to rule out, CBT with exposure, and self-help formats: Katzman, M. A., Bleau, P., Blier, P., et al. (2014). Canadian clinical practice guidelines for the management of anxiety, posttraumatic stress and obsessive-compulsive disorders. BMC Psychiatry, 14(Suppl 1), S1.

Panic attack definition, calm or anxious onset, generalized anxiety time frame, substances and conditions to rule out, physical activity, and treatment: DeGeorge, K. C., Grover, M., & Streeter, G. S. (2022). Generalized anxiety disorder and panic disorder in adults. American Family Physician, 106(2), 157-164.

Expected and unexpected panic attacks, and panic attacks across other diagnoses: Craske, M. G., Kircanski, K., Epstein, A., et al. (2010). Panic disorder: a review of DSM-IV panic disorder and proposals for DSM-V. Depression and Anxiety, 27(2), 93-112.

Lifetime rate of panic attacks without panic disorder, their effect on daily life, and severity with agoraphobia: Kessler, R. C., Chiu, W. T., Jin, R., et al. (2006). The epidemiology of panic attacks, panic disorder, and agoraphobia in the National Comorbidity Survey Replication. Archives of General Psychiatry, 63(4), 415-424.

Panic disorder rates in US adults: National Institute of Mental Health. Panic Disorder statistics.

Panic disorder diagnosis, treatment, and the 988 Lifeline: National Institute of Mental Health (2025). Panic Disorder: What You Need to Know.

Panic attack duration, safety, and what to do during an attack: NHS. Panic disorder.

Generalized anxiety symptoms and self-help: NHS. Generalised anxiety disorder in adults.

Definitions of panic attacks, panic disorder and generalized anxiety disorder: American Psychiatric Association. What are anxiety disorders?.

Cyclic sighing trial: Balban, M. Y., Neri, E., Kogon, M. M., et al. (2023). Brief structured respiration practices enhance mood and reduce physiological arousal. Cell Reports Medicine, 4(1), 100895.

Caffeine and panic attacks: Klevebrant, L., & Frick, A. (2022). Effects of caffeine on anxiety and panic attacks in patients with panic disorder: a systematic review and meta-analysis. General Hospital Psychiatry, 74, 22-31.

Heart attack warning signs and when to call 911: National Heart, Lung, and Blood Institute. Heart attack symptoms.

Panic attack vs anxiety attack