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Anxiety / Panic attacks
I am 20 years old and keep getting panic attacks. During them my heart races my chest feels tight I struggle to breathe my hands shake and I feel like I am having a heart attack or I am going to die. I have had ECG heart scan thyroid vitamin B12 and other blood tests and everything is normal. I have tried breathing exercises grounding techniques and spoken to a psychologist but the attacks still happen. I do not feel very stressed and they seem to come out of nowhere.
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Your symptoms of a racing heart, chest tightness, and a fear of dying resemble a panic disorder. Since medical clearances like normal ECG and blood tests rule out physical issues, these sudden episodes are highly consistent with panic attacks stemming from subconscious anxiety.
Next Steps
Consult Dr. Rupali Mohbe, a licensed clinical psychologist at BIRDY ME. You can book online or offline appointments at 208, CENTRAL, Sangath IPL, Motera, Ahmedabad, Gujarat.
Health Tips
When a panic attack hits, try "box breathing": breathe in for 4 seconds, hold for 4, exhale for 4, and hold for 4.
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Hi, how are you? Thanks for reaching out.
Your symptoms sound very much like panic attacks, and it’s common to feel like you’re having a heart attack even when all the medical tests are normal. Panic attacks can happen suddenly without an obvious trigger. Since breathing exercises and therapy haven’t been enough, it would be a good idea to consult a psychiatrist as well. Sometimes medication, along with therapy, is needed to reduce the frequency and intensity of panic attacks.
Take therapy. You can connect with me on nine two six six seven two six zero six five.
Health Tips
One suggestion: Instead of fighting the panic, remind yourself, “This is a panic attack. It feels scary, but it is not dangerous and it will pass.” This change in response can gradually reduce the fear cycle.
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This is classic panic disorder. Since therapy alone isn't controlling it, you likely need medication alongside. SSRIs like escitalopram or sertraline are the first-line treatment for panic disorder â they reduce frequency and intensity of attacks over time and work best when combined with CBT. The out-of-nowhere feeling is very typical of panic disorder.
Next Steps
See a psychiatrist (not just a psychologist) to discuss starting an SSRI. Give the medication 4-6 weeks to show effect â they don't work immediately. Keep noting any patterns even if attacks feel random â triggers often emerge over time. Consult me on Practo for more support and guidance.
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Your symptoms are consistent with panic attacks, especially since your cardiac and other medical tests are normal. If panic attacks continue despite therapy and breathing techniques, a psychiatrist can assess whether medication along with CBT may help reduce their frequency and severity.
Next Steps
Please consult a psychiatrist for a detailed evaluation and an individualized treatment plan.
Health Tips
If you develop persistent chest pain, fainting, or new neurological symptoms, seek immediate emergency medical care.
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Hi. Medicines can help. Consult online for treatment
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Dr. Mrinal Gautam
Psychiatrist
3 yrs exp
Kolhapur
Your description of sudden, unexpected surges of intense fear that "come out of nowhere," accompanied by physical symptoms like a racing heart, chest tightness, shaking, and an overwhelming feeling that you are going to die, points directly to Panic Disorder.
It is very common for panic attacks to occur without an obvious psychological trigger or stressful event. When your body enters this state, it is essentially a false alarm where your autonomic nervous system misfires, triggering a full "fight-or-flight" response as if you were in immediate physical danger.
Because your ECG, heart scan, thyroid panel, and vitamin levels are all perfectly normal, you can be medically reassured that your heart and physical health are completely fine. The sensation that you are having a heart attack is an illusion caused by the massive adrenaline spike in your chest muscles.
Next Steps
Consult a Psychiatrist for Medication Options: if breathing exercises and therapy alone are not stopping the attacks, it is time to consider medical treatment. A psychiatrist can prescribe first-line daily medications, such as Selective Serotonin Reuptake Inhibitors (SSRIs), which work long-term to lower your brain's baseline panic threshold and prevent the attacks from starting. You can book a session with me.
Discuss Short-Term Rescue Medication: Ask your doctor about a temporary, fast-acting "rescue" anti-anxiety medication (like a low-dose benzodiazepine) to use only when a severe attack begins. Knowing you have a pill that can stop an attack in minutes provides significant psychological comfort and helps break the fear cycle.
Transition to Cognitive Behavioral Therapy (CBT) with Interoceptive Exposure: Continue working with a psychologist, but ensure the focus is specifically on CBT for panic disorder. This involves safely reproducing mild physical sensations (like hyperventilating slightly) in a controlled space to teach your brain that these sensations are not dangerous.
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Disclaimer : The content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding your medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website.