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Although the exact cause of panic attacks is not yet understood, stress and various biochemical factors are believed to contribute to the attacks. Because panic attacks are more likely in people with a family history of such attacks, heredity may also play a role. In some cases, panic attacks may be associated with another psychological condition, such as agoraphobia, post-traumatic stress disorder (PTSD) or phobias (e.g., social phobias, specific phobias).

Some experts have speculated that panic attacks may be related to the body’s “fight or flight” response. This response occurs in the sympathetic nervous system when the body faces danger. Adrenaline (a chemical secreted by the adrenal medulla in response to stress that is also known as epinephrine) and other hormones are released, allowing the body to either fight the danger or flee from it. Researchers believe that during panic attacks, an unknown trigger activates this response despite the fact that no danger is actually present. Other researchers have cited a similar “suffocation alarm” in the body that falsely indicates that death is imminent, triggering an attack.

In addition, several physical factors may increase the risk of panic attacks. These include:

• Low blood sugar (hypoglycemia).
  
  
• Irregular heartbeat.
  
  
• Mitral valve prolapse. Disorder in which the heart’s mitral valve does not properly close.
  
  
• Substances such as amphetamines, marijuana and caffeine.