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A panic attack is a feeling of sudden and intense fear or panic and often comes on without a clear cause. It is associated with a range of physical symptoms, including a sense of losing control and fainting.
Many people feel as though they will faint because they are dizzy and lightheaded, and their legs become weak or start shaking.
Therefore, this article will discuss whether panic attacks and anxiety can cause fainting and what you can do about it.
Can a Panic Attack Cause Fainting?
A panic attack will rarely cause you to faint. Feeling dizzy, faint, and unsteady is, however, quite common. These physical symptoms can make it feel like you may pass out.
But fainting is usually caused by low blood pressure and heart rate and panic attacks increase blood pressure and heart rate, so fainting is unlikely.
Intense emotional stress can lead to fainting, but this differs from panic attacks, which often do not have an apparent external cause.
If you have fainted during a panic attack, it might be caused by something else, and you should speak to a doctor about it.
What Does Anticipating Fainting from Anxiety Feel Like?
Just before people faint, they often feel lightheaded and dizzy. Their vision might get blurry, or they may see black spots or darkness enveloping their visual field.
Panic attacks often come with similar symptoms, and understandably, this causes people to worry that they will pass out.
In a clinical study, participants with a history of panic attacks described feeling faint and unsteady, like their legs were getting weak and their vision was becoming blurry.
One person described the onset of panic and the sense of losing control (such as fainting) as a sudden wave or tsunami.
“It kind of feels like this wave…and I can feel it building up and up and up, until like, it hits.”
Other descriptions include:
“my head’s just spinning out of control” and “your ears kind of like blank out, as in you can’t, you can’t make sense […] you just hear loads of voices just in your ears and it’s very hard to concentrate.”
In another study, participants described the sudden overwhelming physical symptoms preceding a panic attack as confusing and terrifying. One participant commented:
“It normally starts in your fingertips and your toes go all really tingly and then like it just starts spreading up your legs and stuff and then you can’t move at all cus once the tingling starts, after that you can’t feel anything and then um like when the dizziness, you’ll like stand up or something and then you just, it’s like a spinning sensation, also like unsteadiness and you feel like if you don’t hold onto something, you’re just going to fall”
What Causes a Feeling Like Passing Out?
Feeling dizzy and weak is quite common in panic attacks and unfortunately, these sensations are similar to those felt when you are actually about to faint.
However, this feeling in panic attacks is generally caused by changes in breathing and the fight or flight response.
Changes in Breathing
Panic can cause you to hypo- or hyperventilate. As a result, you may feel dizzy and like you are about to faint because the balance between oxygen and carbon dioxide is disturbed.
Hyperventilation means your exhalations are too fast, and you are exhaling more than you are inhaling, which lowers the level of carbon dioxide in the blood.
It can feel like you are not getting enough oxygen (although you are getting too much) and you may try to inhale more, which actually makes it worse. Your blood vessels constrict, and this reduces the blood flow to your brain, making you feel faint.
Hypoventilation is the opposite and means your breathing is too shallow or slow. This lowers the level of oxygen and increases the level of carbon dioxide in the blood.
In a panic, people often “forget” to breathe or take small, shallow breaths, which reduces the blood flow to your brain and makes you feel faint.
Fight or Flight Response
When we sense danger, our body goes into survival mode – known as the fight/flight/freeze response.
It “shuts down” the logical and rational part of your brain and puts the brain regions that are important for survival in charge. This can explain why it’s so difficult to think straight during a panic attack.
It can also explain why a panic attack can make you feel dizzy and lightheaded. The stress response activates the secretion of stress hormones into the bloodstream, which causes a sudden spike in heart rate and blood pressure, and your breathing becomes more rapid.
How to Get Rid of the Feeling Like Passing Out?
There are a few things you can try to get rid of the feeling of passing out when you are experiencing a panic attack or acute anxiety. These techniques can also help manage panic attacks in general.
However, having regular panic attacks could be a sign of panic disorder or another mental health condition. Thus, if you are concerned, you should speak to a health professional and consider engaging in therapeutic interventions.
Self-diagnosis is not recommended, and, in many cases, it is important to establish the underlying cause of the symptoms, which can sometimes be difficult to do on your own. Getting professional help is therefore recommended.
But for the time being, here are some strategies you can try to reduce the feeling of passing out during a panic attack:
Breathing
As mentioned above, feeling like you might faint can come from hyper- or hypoventilation.
Instead of trying to breathe more heavily or deeply, try to bring your breath back to its natural rhythm: slow, regular, and mindful breaths.
It could be helpful to close your eyes for a moment and lie down on your back with your feet up against a wall. If closing your eyes feels like too much, find a focal point but try to avoid your eyes darting as this could increase the feeling of dizziness.
Note that not everyone finds breathing exercises helpful and some even find they make things worse. Listen to your body and do what feels right for you.
Muscle Relaxation
The main cause of fainting is a sudden drop in blood pressure. The Applied Tension Technique (tensing and releasing each muscle in the body) was designed to help prevent fainting as it increases heart rate and blood pressure.
However, when you are experiencing a panic attack/ anxiety, your blood pressure and heart rate are usually high, and your muscles become very tense (fight/flight response). Therefore, this technique is likely not helpful.
Instead, you can try to relax each muscle in the body progressively. You can sit or lie down and close your eyes (or find a focal point) and then mentally move through your body and tell each muscle to relax.
This will allow your body to relax and provide something else for your mind to focus on.
Cognitive Interventions
An important feature of panic attack/ anxiety interventions is building your sense of control (a.k.a. self-efficacy).
It makes a big difference when you know that you are able to deal with panic and the feeling of fainting. It’s often the feared consequence of fainting (e.g., “I am going to hurt or embarrass myself”) that makes anxiety/ panic worse.
Furthermore, it is good to know that although panic attacks are frightening, they are not life-threatening, and they pass.
Building confidence in your ability to cope with panic can take time and practice. However, when you notice the first signs of a panic attack, you can try repeating a phrase, such as
- “I am in control”
- “I can cope with this fear”
- “My fear is not dangerous and it will pass”
3-3-3 Method
This method has been designed to manage and reduce anxiety and panic. Focusing on something else will allow your thoughts and nervous system to calm down and return to a more balanced state. It can therefore also reduce dizziness and faintness.
The method is to name three things you can see in your environment; name three sounds you can hear; and move three parts of your body (e.g., fingers, legs, or arms).
Lifestyle Changes
Panic attacks are considered to be related to anxiety. You may not consciously experience anxiety, but your body and nervous system might be in a constant state of hypervigilance (constantly assessing potential threats around you).
That’s why it can be helpful to reduce your levels of anxiety, stress, and fatigue through lifestyle changes. That can include:
- Reducing caffeine intake
- Cutting out alcohol, nicotine, and recreational drugs
- Increasing your sleep hygiene/ having more restful sleep
- Eating a healthy, balanced diet
- Exercising regularly
- Getting out in nature as often as possible
- Practicing mindfulness/ meditation/ yoga
What to Do in the Moment
The feeling of fainting can be very real, and it can increase your anxiety because you are worried about what might happen if you would suddenly lose consciousness. So, to put your mind at ease, do the things a person would do when they feel they might faint:
- Find safety e.g., sit or lie down, leave the room, or find a peaceful place
- If someone is close by, alert them and ask for their support
- Lie on your back and put your legs up against the wall – if you cannot lie down, put your head between your knees
- Get some fresh air
- Smell lavender
Make a Contingency Plan
It might be helpful to create a plan in case you experience another panic attack. It could include:
- What you will do and how you will respond
- Provide your friends/ family with information about what kind of support you would find helpful e.g., don’t ask me questions; don’t stand over me; do sit next to me
- Carry things with you that could be helpful in the moment, such as a smell stick or music
Knowing you have a plan and a few tools at hand can help to reduce the anxiety you experience from the anticipation of having a panic attack.
Can Anxiety Cause Fainting?
The main cause of fainting is a sudden drop in blood pressure, which can result from emotional stress. Strong emotions, especially when they feel overwhelming (like anxiety), can cause a person to pass out.
Because fainting has persisted to exist in humans for millions of years, researchers believe that it serves a function. They suggest that it evolved as a beneficial response to stress and possibly to save a person’s life from extremely high blood pressure and heart rate.
Being overwhelmed by emotions increases the activity of the sympathetic nervous system (the fight/flight response), which increases heart rate and blood pressure.
Fainting (or vasovagal syncope) inhibits the sympathetic system and activates the parasympathetic nervous system (the system responsible for calm and rest). This sudden drop can cause you to faint.
Thus, fainting might serve the purpose of calming down and restoring the heart to its normal function. In other words, although it is unpleasant, it has evolved as a defense mechanism.
Please note that fainting from anxiety is very rare and it usually causes the feeling of fainting, rather than actually fainting.
Sources
Alboni P. & Alboni, M. (2014). Vasovagal Syncope As A Manifestation Of An Evolutionary Selected Trait. Journal of Atrial Fibrillation, 7(2), 1035.
Baker, H.J., Hollywood, A. & Waite, P. (2022). Adolescents’ lived experience of panic disorder: an interpretative phenomenological analysis. BMC Psychology, 10, 143.
Helbig-Lang, S., Lang, T., Petermann, F. & Hoyer, J. (2012). Anticipatory Anxiety as a Function of Panic Attacks and Panic-Related Self-Efficacy: An Ambulatory Assessment Study in Panic Disorder. Behavioural and cognitive psychotherapy, 40, 590-604.
Hewitt, O.M., Tomlin, A. & Waite, P. (2021) The experience of panic attacks in adolescents: an interpretative phenomenological analysis study, Emotional and Behavioural Difficulties, 26 (3), 240-253.
