There is no single, known cause of the symptoms associated with a panic attack or panic disorder. The symptoms of panic appear to be connected, however, to a person’s heightened awareness of their bodily sensations, such as their heart pounding or breathing. Most symptoms are caused by an interrelated, complex interaction between one’s inner voice (psychology), the environment one is in (social), and the biology of one’s body (biological). Genetics may also predispose someone to be more likely to get a panic attack, or be diagnosed with panic disorder.

Exactly how these three components interact, and what causes what versus what is a result of something else, is still unknown.

There are several possible reasons why a person could experience the same physical symptoms as a panic attack, such as chest pain and abdominal distress. That is why it is important to have a primary care physician rule out any associated ailments. The “out-of-the-blue” feelings of terror accompanied by alarming physical symptoms are the key features of this particular disorder.

Often a panic attack is confused with a heart attack because of the similarity in physical symptoms, such as pounding heart, clammy skin, chest pain, trembling or shaking, and dizziness. Therefore, frequent visits to emergency rooms and medical specialists are not uncommon for people with panic disorder. However, rarely is direct physical problem or cause found in a person who is experiencing a panic attack — it is not usually a physical problem or heart attack (but it can feel just like one).

It is also common for a person with panic disorder to feel an overwhelming fear of dying, which can heighten the desire to seek medical help. This is because the fear experienced in a panic attack is tantamount to the fear experienced during the “flight for fight” syndrome, when a person’s life is threatened by an outside force.

The causes of panic symptoms are simply largely unknown at this time. As more research is conducted into panic disorder and its symptoms, it’s likely that researchers will better understand exactly how the three components — psychological, social and biological — interact.