The Truth About Health Anxiety in Panic Attacks

Panic attacks can feel like a sudden storm—fast, intense, and terrifying—your heart races. Your chest feels tight. You might even think you’re dying. But for many people, these moments of fear are not just random. They are deeply tied to something else: health anxiety.

Health anxiety is more than just worrying about getting sick. It’s a constant fear that something is seriously wrong with your body, even when doctors say you’re fine. If you’ve ever panicked over a small ache or a racing heartbeat, you’re not alone. For some people, these worries grow so strong that they can trigger panic attacks.

Researchers have found that health anxiety plays a big role in panic disorder. According to studies, people with panic disorder often show high levels of health anxiety. These fears can create a cycle—worrying about your health causes anxiety, which then leads to panic attacks. And once a panic attack happens, it can make you even more afraid of what’s happening in your body.

So what’s going on here? How does health anxiety make panic attacks worse? And what can we do about it? Let’s break down the truth behind this powerful connection.

What Is Health Anxiety?

Health anxiety is the strong and ongoing fear that something is wrong with your health, even when medical tests show that you’re fine. It goes beyond normal concern. You might check your body for signs of illness every day, search the internet for symptoms, or visit doctors often. Even after hearing you're healthy, the worry doesn’t stop.

People with health anxiety often pay close attention to every small sensation in their bodies. A mild headache might feel like a brain tumor. A skipped heartbeat might feel like a heart attack. These fears can feel very real and overwhelming.

According to studies, about 6% of people in the general population experience health anxiety. But for those with panic disorder, this number is much higher. Ray et al. found that patients with panic disorder had significantly higher scores on health anxiety tests than people without any mental health condition.

This shows that health anxiety is not just a side effect—it may be a key part of panic disorder. The constant fear of being sick or dying can take over your thoughts and push your anxiety to the limit. And when your brain thinks your body is in danger, it may respond with a panic attack.

How Health Anxiety Triggers Panic Attacks

Health anxiety can cause your brain to treat small, harmless body changes as signs of danger. When this happens, panic can build quickly. What starts as worry over a headache or racing heart can suddenly feel like an emergency.

According to studies, people with panic disorder often misread normal body sensations as signs of illness. This fear can grow fast and trigger a panic attack. Over time, this creates a loop: fear of illness → panic → fear of another panic attack → more panic.

Here are some common triggers that can turn health anxiety into panic:

• Noticing a strange body sensation, like a skipped heartbeat or a tight chest
• Feeling sick or having a minor symptom like nausea or dizziness
• Hearing about someone else’s medical condition
• Going to a doctor’s appointment or hospital
• Waiting for or receiving medical test results
• Seeing or reading medical news that feels personal
• Being in a medical setting like a clinic or emergency room

The more often you feel anxious about your health, the more likely your brain is to stay in a state of alert. This constant worry can make panic attacks harder to control and more frequent over time.

What Happens During a Panic Attack

A panic attack is the body’s sudden reaction to fear, even when there’s no real danger. It often starts without warning and can make you feel like something terrible is happening. You might feel out of control or convinced that you’re dying, even if you’ve had a panic attack before.

Inside your brain, the panic response is tied to the amygdala. This area controls your fear signals. When it activates, your body goes into “fight or flight” mode. This process is common in panic disorder and happens even when the actual threat is minor or unknown.

During a panic attack, your brain sends out stress hormones like cortisol and adrenaline. These chemicals prepare your body to respond quickly, but they also cause intense physical symptoms.

You might notice:

• A racing or pounding heartbeat
• Trouble breathing or a choking feeling
• Chest pain or discomfort
• Sweating or chills
• Trembling or shaking
• Nausea or stomach pain
• Dizziness or lightheadedness
• Fear of losing control or going crazy
• Fear of dying
• Feeling detached from your body or surroundings

These symptoms usually peak within 10 minutes. But the emotional impact can last much longer. If you have health anxiety, the fear of these sensations may not stop after the panic ends. Instead, it may make you even more alert to every small change in your body, setting the stage for the next attack.

Health Anxiety vs. Other Anxiety Disorders

Health anxiety can happen on its own or along with other anxiety disorders. But when it appears with panic disorder, it tends to be more intense. People with panic disorder often fear not just the symptoms of anxiety, but what those symptoms might mean for their health.

Health anxiety scores were much higher in people with panic disorder than in people without any mental health conditions. This shows that health fears are a major part of panic disorder, not just a side effect.

Another study by Rudaz et al. found that health anxiety and a history of physical illness made people more likely to develop panic disorder and agoraphobia, compared to those with social phobia. This suggests that health anxiety is a stronger predictor for panic-related conditions than for other types of anxiety.

Here’s how health anxiety in panic disorder stands out:

• More fear of body symptoms, like a fast heartbeat or chest pain
• Stronger belief that those symptoms mean something deadly
• Greater use of medical services, often with normal results
• More frequent panic attacks triggered by health concerns

These patterns show that health anxiety plays a bigger role in panic disorder than in other anxiety disorders. If you notice these signs in yourself or someone you know, it may help to look deeper, not just at the anxiety, but at the fear of illness behind it.

The Role of Dissociation

Dissociation is a feeling of being disconnected from your body, thoughts, or surroundings. During a panic attack, it might feel like you're outside your body or that the world around you isn’t real. This is called depersonalization and derealization, and it happens more often in people with panic disorder.

According to studies, people with panic disorder had higher levels of dissociative experiences compared to people without any mental health condition. These symptoms may not always be extreme, but even mild dissociation can add to the fear during a panic attack.

Some common signs of dissociation during a panic attack include:

• Feeling numb or emotionally distant
• Not recognizing your voice or face
• Feeling like you’re in a dream
• Time feels too fast or too slow
• Trouble remembering parts of the panic episode

These experiences can make panic attacks feel even more confusing or frightening. Some people fear they’re “losing their mind,” which only adds more anxiety.

Research also shows that dissociation can affect treatment. People with high dissociation may respond less to medication or therapy. This means it’s important for doctors and therapists to ask about these symptoms early on.

If you’ve ever felt like your panic attack put you “outside” of yourself, you’re not imagining it. Dissociation is real, and it’s one more way that panic disorder deeply affects both the mind and body.

Conclusion

Health anxiety and panic attacks are deeply connected. When you're always worried about your body, even small symptoms can feel like danger. This fear can build fast and lead to a panic attack. Over time, the pattern can become a cycle that’s hard to break.

If any part of this feels familiar to you, know that support is available. With the right therapy, tools, and care, it’s possible to understand your fears, calm your body, and take back control. Have you spoken to someone about what you’ve been feeling? That small step could open the door to real change.