Panic Attack Symptoms: What’s Happening in Your Body and What to Do (Urdu + English)

It often starts out of nowhere. You are in a queue at the bank, in a crowded wedding hall, or lying in bed at 2am, and suddenly your heart is pounding, your chest is tight and you can’t get enough air. Your hands tingle. A voice in your head says, “Something is badly wrong. I’m going to die.” These are classic panic attack symptoms. Ten minutes later they fade, and you are left shaken, embarrassed and afraid it will happen again.

This guide explains those symptoms in plain English, with the Urdu and Roman Urdu words people actually use: ghabrahat, dil ki dhadkan tez, saans phoolna. It covers what is happening in your body, what to do during an attack, how to tell when chest pain needs emergency care, and what treatment looks like. There is a glossary and a Roman Urdu FAQ at the end.

It is written to inform, not to diagnose. Some panic symptoms overlap with heart and other medical problems, so the first section is about safety.

First: when to treat it as an emergency

Panic attacks are frightening, but the NHS says they are not dangerous in themselves (NHS). The problem is that you can’t always tell a panic attack from a heart problem at home. The NHS also warns that most panic symptoms can be symptoms of other conditions too.

Call your local emergency number (in Pakistan, Rescue 1122) or get to the nearest emergency department if (NHS chest pain; NHS heart attack):

• you have sudden chest pain or discomfort that does not go away. It may feel like squeezing, pressure, burning or indigestion
• the pain spreads to your arm, neck, jaw, stomach or back
• you have chest pain and you also feel sweaty, sick, light-headed or short of breath
• you have severe difficulty breathing: gasping, choking or unable to get words out
• your lips or skin look pale, blue or grey (on brown skin, this may be easier to see on the palms)
• someone has collapsed and isn’t responding normally

The NHS advises not to drive yourself to hospital if you think it could be a heart attack. If you’re not sure, treat it as an emergency. Nobody will think less of you for being checked.

Why this matters for desi readers. An American Heart Association scientific statement found that South Asians in the United States (including people with roots in Pakistan, India and Bangladesh) have higher proportional death rates from heart disease than other Asian groups and non-Hispanic white Americans. Most of that extra risk is explained by known risk factors, especially those related to insulin resistance (Volgman et al., 2018). The NHS lists being older, smoking, obesity, high blood pressure, diabetes, high cholesterol and a family history of heart attack or angina before 60 as factors that raise your risk. If any of these apply to you, don’t assume chest pain is “just ghabrahat”.

For repeated attacks: see a doctor even if each attack passes. The NHS says a GP may examine you to rule out other conditions that could be causing your symptoms. Once a doctor has checked you, it becomes much easier to trust that a familiar attack is panic, and that something new or different needs checking again.

Panic attack symptoms: the full list

During a panic attack you get a rush of intense mental and physical symptoms. It can come on very quickly and for no obvious reason. The table groups the symptoms the NHS lists by where you feel them, alongside the Roman Urdu phrases people often use.

How long does it last? Most panic attacks last between 5 and 20 minutes, and some have been reported to last up to an hour (NHS). The US National Institute of Mental Health (NIMH) adds that attacks can happen at any time, sometimes even during sleep, and that the physical symptoms usually resolve with time (NIMH).

What’s happening in your body: a false alarm

Your body has a survival alarm built for real danger. When it fires, many of the sensations in the table above can appear at once. NIMH describes how some researchers think panic attacks are like “false alarms”: the body’s survival instincts fire too often or too strongly, when there is no real threat.

What turns an alarm into a full attack is often the meaning we give it. The psychologist David Clark described panic as a cycle in which normal body sensations are misread as signs of catastrophe (Clark, 1986). NIMH gives the same example: someone feels their heart pounding and assumes they are having a heart attack. It runs like this:

1. A sensation: your heart skips, you feel light-headed after standing up quickly, or the room feels hot.
2. A frightening thought: “Heart attack.” “I’m going to faint in front of everyone.” “I’m losing my mind.”
3. More alarm: the fear itself speeds your heart and breathing further.
4. Stronger sensations: these seem to “prove” the thought, so the fear grows, and the cycle peaks.

This is why panic can feel so physical and so real. It is also the pattern that CBT for panic works on: changing how you read the sensations, and learning not to run from them.

What to do during a panic attack

The NHS suggests these steps for the next time you feel an attack coming on (NHS). Once you are sure it isn’t an emergency (see the first section):

1. Stay where you are, if you can. Leaving can strengthen the fear of that place next time (see the section on avoidance below). Sit down if you feel faint.
2. Breathe slowly and gently. The NHS breathing exercise: breathe in through your nose and out through your mouth, gently and regularly. Some people find it helps to count steadily from 1 to 5 on the in-breath and again on the out-breath (NHS breathing exercises). Don’t force it. If you can’t reach 5 at first, that’s fine.
3. Name it. Say to yourself, in whatever language comes naturally: “Yeh panic attack hai. Yeh guzar jayega.” (“This is a panic attack. It will pass.”)
4. Remind yourself it is not life-threatening. This is part of the NHS advice, but only once the emergency signs above have been ruled out.
5. Focus on something calm. The NHS suggests picturing positive, peaceful images. Some people prefer to describe the room around them slowly, out loud.
6. Let it peak and fall. Don’t fight the sensations or check your pulse every few seconds. Most attacks pass within minutes.

If you are with someone having a panic attack: stay with them, speak slowly and calmly, and breathe slowly together. Please don’t say “kuch nahi hua, drama mat karo”. Dismissing it usually adds shame to the fear. If they have any of the emergency signs, call for help.

After the attack: why avoidance keeps panic going

After a bad attack, it is natural to avoid the place where it happened: the mall, the motorway, a crowded bazaar, the office lift. The NHS explains that this avoidance can create a cycle of living “in fear of fear”, which adds to your sense of panic and may lead to more attacks. NIMH notes that many people with panic disorder change their lives significantly to avoid another attack.

What helps instead:

• Write down what happened within a day: where you were, the first sensation, the first thought, and how long it lasted. Patterns you can see are easier to change.
• Keep your routine going as much as you can, rather than shrinking your life around the fear.
• Look at the triggers you can control. The NHS suggests regular exercise and avoiding sugary food and drinks, caffeine and alcohol, and stopping smoking, because they can all make attacks worse. If your day runs on four cups of doodh patti and an energy drink, that’s worth noticing.
• Practise the breathing exercise when you are calm, not only during an attack. The NHS says you get the most benefit if you do it regularly, as part of your daily routine.

My guide on how to handle anxiety at home, at work and at night has more day-to-day techniques for the worry that often sits around panic attacks.

A composite of common situations (not a real client). Sana, 29, works at a bank branch in Lahore. Her first panic attack came during her cousin’s mehndi: a hot, crowded hall, loud music, and suddenly a pounding heart and the certainty she was dying. Her family rushed her to the emergency department. Her ECG and blood tests were normal, and the doctor said it looked like a panic attack. Over the next two months she had four more, two of them at night. She stopped going to weddings and began sitting near the door in every meeting. Her mother worried about her heart, and her husband told her she was overthinking. Sana took a free panic screening test, which showed that her answers were worth a proper assessment. She went back to her doctor, who referred her for CBT. The first thing she learned was the cycle in this article. The second was that the hall wasn’t the danger.

Panic attack or panic disorder?

Having a panic attack doesn’t mean you have panic disorder. NIMH says an isolated panic attack is not a mental disorder. Panic disorder may be diagnosed when someone has recurrent, unexpected attacks along with ongoing worry about more attacks, or changes their behaviour to avoid them, for at least a month.

A large World Mental Health survey of 142,949 adults in 25 countries found that 13.2% had had a panic attack at some point in their lives. Among them, only 12.8% met the criteria for panic disorder (de Jonge et al., 2016). In other words, panic attacks are common, and most people who have one do not go on to develop the disorder. Recurrent attacks were, however, linked with a higher chance of later mental health problems, which is one more reason to get help early if attacks keep coming.

Panic attacks at night

Many people search for “panic attack symptoms at night”. Waking suddenly with a racing heart and a sense of dread is very frightening, partly because you weren’t worrying about anything when it started. NIMH confirms that panic attacks can occur during sleep. The steps above still apply: sit up, put your feet on the floor, breathe slowly and name what is happening. If night attacks are new, or come with chest pain or breathlessness that doesn’t settle, get checked by a doctor.

Getting help: what actually works

The World Health Organization says there are highly effective treatments for anxiety disorders, yet only about 1 in 4 people who need treatment receive any (WHO). Stigma and not knowing that it is treatable are among the reasons.

The UK’s National Institute for Health and Care Excellence (NICE) recommends the following for panic disorder (NICE CG113):

• For mild to moderate panic disorder, self-help based on cognitive behavioural therapy (CBT), either on your own or with guidance from a professional.
• For moderate to severe panic disorder, CBT with a trained therapist, usually 7 to 14 hours in total, completed within about four months. An antidepressant is an alternative a doctor may discuss in some situations.
• NICE says benzodiazepines (a group of sedative medicines) should not be prescribed for panic disorder, because they are associated with a less good outcome in the long term.

A word about “ghabrahat ki goli”. Many people search for a tablet that will make ghabrahat stop. Please don’t take tablets from a relative’s strip or buy them over the counter. Decisions about medicine belong with a doctor who has examined you. If you are already taking medicine, don’t start, stop or change it on your own.

Free screening tests. The panic attack test uses the panic section of the Patient Health Questionnaire (Spitzer et al., 1999). The GAD-7 anxiety test checks for ongoing anxiety and worry (Spitzer et al., 2006). Both are screening tools, not a diagnosis. They can show whether your symptoms are worth a proper assessment, and give you words to use with a doctor.

If you would like to talk this through with me, you can book a consultation. Consultations are educational and supportive, and are not a replacement for emergency or in-person medical care.

Sometimes panic comes with despair, or with thoughts of harming yourself. If that is happening to you, please reach out now:

Need help right now? If you might harm yourself or someone else, or you are in danger right now, call your local emergency number or go to the nearest emergency department.

• Pakistan: Umang mental health helpline 0311 7786264; in an emergency, police 15 or Rescue 1122
• Saudi Arabia: emergency 911; counselling line 920033360 (8am–8pm, Saturday 1pm–8pm; not 24 hours)
• India: Tele-MANAS 14416 or 1-800-891-4416 (emergency 112)
• Bangladesh: Kaan Pete Roi +880 9612-119911 (3pm to 3am daily)
• United States: 988 Suicide & Crisis Lifeline, call or text 988 (24/7)
• Canada: 9-8-8 Suicide Crisis Helpline, call or text 988 (24/7)
• UK and Ireland: Samaritans 116 123 (free, 24/7)
• European Union: emergency number 112
• Anywhere else: call your local emergency number, or find a free helpline at findahelpline.com.

Urdu and Roman Urdu glossary

Aksar poochay janay walay sawal (FAQ)

Panic attack ki alamat kya hain?
The most common panic attack symptoms are a racing heart, chest pain or tightness, shortness of breath, dizziness, sweating, trembling, tingling, nausea and an intense fear of dying or losing control. They come on quickly and usually pass within 5 to 20 minutes. Dil ki dhadkan tez, saans phoolna, chakkar, pasina aur maut ka khauf: yeh sab panic attack ki aam alamat hain.

Kya panic attack se maut ho sakti hai?
According to the NHS and NIMH, a panic attack itself is not dangerous or life-threatening. But because the symptoms can overlap with a heart attack, chest pain with the emergency signs listed at the top of this page always needs urgent medical care. Agar shak ho, to emergency mein check karwa lein.

Panic attack aur heart attack mein kya farq hai?
You can’t reliably tell them apart at home. Pain that spreads to the arm, neck, jaw or back, or chest pain with sweating, nausea or breathlessness, needs emergency care. If a doctor has checked you and your attacks follow the same familiar pattern, panic becomes more likely, but anything new or different should be checked again.

Panic attack kitni der rehta hai?
Most last between 5 and 20 minutes, and some up to an hour, according to the NHS.

Kya panic attack raat ko bhi ho sakta hai?
Yes. NIMH says panic attacks can happen during sleep. Use the same steps: sit up, breathe slowly and name what is happening.

Ghabrahat ka ilaj kya hai?
CBT-based self-help and CBT with a trained therapist are the main recommended treatments for panic disorder, according to NICE. A doctor may also discuss medicine in some situations. Start with a doctor’s check-up, and use the screening tests above to put your symptoms into words. You can find more guides in the Mind section.

Last reviewed: October 2026. To see how articles on this site are researched and checked, read the editorial policy.

References

1. NHS. Panic disorder. https://www.nhs.uk/mental-health/conditions/panic-disorder/
2. National Institute of Mental Health. Panic Disorder: What You Need to Know. https://www.nimh.nih.gov/health/publications/panic-disorder-when-fear-overwhelms
3. NHS. Chest pain. https://www.nhs.uk/symptoms/chest-pain/
4. NHS. Heart attack. https://www.nhs.uk/conditions/heart-attack/
5. Volgman AS, Palaniappan LS, Aggarwal NT, et al. Atherosclerotic cardiovascular disease in South Asians in the United States: epidemiology, risk factors, and treatments: a scientific statement from the American Heart Association. Circulation. 2018;138(1):e1-e34. https://doi.org/10.1161/CIR.0000000000000580 (PubMed 29794080)
6. Clark DM. A cognitive approach to panic. Behaviour Research and Therapy. 1986;24(4):461-470. https://doi.org/10.1016/0005-7967(86)90011-2 (PubMed 3741311)
7. NHS. Breathing exercises for stress. https://www.nhs.uk/mental-health/self-help/guides-tools-and-activities/breathing-exercises-for-stress/
8. de Jonge P, Roest AM, Lim CC, et al. Cross-national epidemiology of panic disorder and panic attacks in the world mental health surveys. Depression and Anxiety. 2016;33(12):1155-1177. https://doi.org/10.1002/da.22572 (PubMed 27775828)
9. World Health Organization. Anxiety disorders (fact sheet). https://www.who.int/news-room/fact-sheets/detail/anxiety-disorders
10. National Institute for Health and Care Excellence. Generalised anxiety disorder and panic disorder in adults: management (CG113), Recommendations. https://www.nice.org.uk/guidance/cg113/chapter/Recommendations
11. Spitzer RL, Kroenke K, Williams JBW. Validation and utility of a self-report version of PRIME-MD: the PHQ primary care study. JAMA. 1999;282(18):1737-1744. https://doi.org/10.1001/jama.282.18.1737 (PubMed 10568646)
12. Spitzer RL, Kroenke K, Williams JBW, Löwe B. A brief measure for assessing generalized anxiety disorder: the GAD-7. Archives of Internal Medicine. 2006;166(10):1092-1097. https://doi.org/10.1001/archinte.166.10.1092 (PubMed 16717171)

This article is for education only and is not a diagnosis or a substitute for professional or emergency medical care.

Join Learn With Sherjeel on WhatsApp: free mental health tips and updates →

Dr. Malik Sherjeel Awan

Dr. Malik Sherjeel Awan is a clinical psychologist based in Makkah. PsyD (Clinical Psychology), University of Karachi.
He writes practical, evidence-based psychology for everyday life.

About me · Take the free Self-Check · Editorial policy

Buy Dr. Malik Sherjeel Awan's books (opens in a new tab)