Can you pass out from a panic attack?

Your heart is pounding, your head feels light and the room seems to tilt. You’re sure you’re about to pass out, which makes the panic even worse.

If this happens to you, here’s the reassuring news: feeling faint is very common during a panic attack, but actually fainting is uncommon.

Why panic makes you feel faint

During a panic attack, your body’s fight-or-flight response kicks in. Your heart beats faster and your blood pressure tends to rise, to get you ready to act.

At the same time, you often breathe faster and more shallowly. Over-breathing lowers the carbon dioxide in your blood, which can cause:

• dizziness or lightheadedness
• tingling in your hands, feet or face
• feeling unreal or detached
• blurred vision
• feeling like you might faint

These feelings are frightening, but they’re a normal part of panic. Our posts on dizziness from anxiety and tingling from anxiety explain more.

Why fainting is uncommon in panic

Fainting usually happens when blood pressure suddenly drops, so less blood reaches your brain. In a typical panic attack, heart rate and blood pressure go up, not down. That’s why most people who feel faint during panic don’t actually pass out.

It’s not impossible. The NHS lists being very upset or in severe pain among the causes of fainting, and some people do faint with very strong emotions. But it isn’t the usual course of a panic attack.

The exception: fear of blood, needles or injury

People with blood-injection-injury phobia are much more likely to faint. Researchers describe a two-step response: first, heart rate and blood pressure rise as in any fear response, then they can suddenly drop, which can lead to fainting.

If you faint at the sight of blood or needles, a technique called applied tension can help. You tense the muscles in your arms, legs and body to keep your blood pressure up. Exposure therapy, gradually facing the fear, also helps. Our post on exposure therapy explains how it works.

What to do if you feel faint

The NHS suggests that if you feel like you’re about to faint, you:

• lie down with your legs raised, or sit with your head lowered between your knees
• drink some water
• cross your legs while standing, or rock up and down on your toes
• clench your fists

If it’s panic, also:

• Breathe out slowly. Make each out-breath longer than the in-breath. This helps rebalance your breathing and calm your body.
• Remind yourself: “This is panic. I feel faint, but I’m very unlikely to pass out, and this will pass.”
• Ground yourself: feel your feet on the floor and name 5 things you can see.

When to see a doctor

See a doctor if you actually faint, even if you think it was caused by panic, so they can check for other causes. Call 911 if someone who has fainted:

• isn’t breathing, or can’t be woken within a minute
• hasn’t fully recovered, or has trouble speaking or moving
• has chest pain or a pounding, fluttering or irregular heartbeat
• has seriously hurt themselves
• is shaking or jerking, like a seizure
• fainted while exercising or while lying down

Frequently asked questions

Can you pass out from a panic attack?

It’s possible but uncommon. Most people who feel faint during panic don’t pass out, because blood pressure tends to rise during panic, while fainting usually happens when it drops.

Why do I feel like I’m going to faint when I’m anxious?

Usually because of fast, shallow breathing, which lowers carbon dioxide in your blood and causes dizziness and lightheadedness. Slowing your breathing helps.

Can anxiety make you black out?

Feeling dizzy, unreal or detached is common with anxiety. Actually blacking out is uncommon, and should be checked by a doctor if it happens.

What should I do if I feel faint during a panic attack?

Sit or lie down, breathe out slowly, and remind yourself that the feeling will pass. If you do faint, see a doctor.

How Breatheasy can help

When you feel faint during panic, Breatheasy helps you slow your breathing down. Tap “I’m feeling anxious” and Luma guides you through slow breaths as your phone pulses gently, so you can sit down and keep your eyes closed. Then 5-4-3-2-1 grounding brings you back to the room, and you can see how far your anxiety came down. It works offline and without an account. Breatheasy is coming soon to iPhone and Android.

Sources

• Fainting, NHS
• Panic disorder, NHS
• The psychophysiology of blood-injection-injury phobia: looking beyond the diphasic response paradigm, Ritz and others, International Journal of Psychophysiology, 2010
• Treatments for blood-injury-injection phobia: a critical review of current evidence, Ayala and others, Journal of Psychiatric Research, 2009