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Panic Attacks and Low Self Esteem

Written by Karl Perera BA, MA, DipLC
Updated: January 25th, 2021

self esteem and anxiety

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Panic attacks happen to a lot of people. According to the Cleveland Clinic up to 11% of Americans suffer from them. Most panic attacks last for between 5 and 10 minutes (NHS 2020) and cause symptoms similar to a heart attack. As well as getting treatment, there are things you can do to help yourself manage this problem, especially if low self esteem is part of the cause.

I have a great deal of experience of suffering from low self esteem and working with clients who need to build self esteem and confidence. Let’s start with a description of what panic attacks are and how they may be partly caused by low self esteem.

Low self esteem can cause anxiety, depression and stress. Panic attacks can result from extreme anxiety and sudden stress. Building self esteem and confidence can help reduce the fear that is often behind the attacks.

What Causes Panic Attacks?

A Traumatic Event 

Trauma is closely linked to panic attacks (Bryant and Panasetis, 2001).

If something traumatic happened to you, revisiting the memory of the occurrence could invite a panic attack. For example, if you get in a car accident, you may be extremely anxious whenever it’s time to drive again. Any time you face this situation the sudden stress can trigger a panic attack with symptoms that make you feel like you are having a heart attack.

Personal triggers such as these may happen unconsciously without you even realizing it. It’s essential to identify your triggers so that you can avoid them and know how to handle them without losing control. Getting medical advice about your possible triggers and what you can do about them is very important.

Traumatic events may take time to recover from, but you can begin the work you need to do as soon as you have guidance from a professional.


Being susceptible to anxiety increases the probability of having panic attacks, according to this study published in the Journal of Abnormal Psychology in 1997. Anxiety is the fear you may feel as a result of stress (see, therefore stress can cause panic attacks.

Everyone experiences some stress from time to time. Between getting stuck in traffic or receiving a bill, most people feel stressed at some point. However, chronic stress on a daily basis can start to take its toll on your well being, both mental and physical. It’s important that you limit your exposure to stress as much as possible, especially if you’re frequently experiencing panic attacks. Letting it go on too long could cause a variety of health issues and even worsen your feelings of anxiety. 

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Stress can be made worse by low self esteem. Negative thinking, lack of confidence and negative self talk can all increase your fears, anxiety and stress. Building your self esteem can have very positive effects on your mental health and stress levels.

Depending on how severe your level of stress is, it may be necessary to get help. See a professional or talk to your doctor for guidance how to ease your stress and manage it better. If your stress levels are not severe, and if you have checked with your doctor, you may find different forms of self help make you feel much better.

There is much more information on this page about dealing with anxiety.

Social Anxiety 

Some people get extremely worried of being around strangers. Social Anxiety Disorder is the fear of what others will say or think and the possibility of being embarrassed or judged by others (according to this article published in the Lancet in 2008).

The article goes on to explain that Social anxiety can cause full-fledged panic attacks due to the fear of social situations. If you notice problems when you’re in public situations, then perhaps social anxiety was triggering your attacks. 

Low self esteem can be one of the causes of Social Anxiety Disorder because it increases negative thoughts and self-criticism (this article published in Comprehensive Psychiatry, 2015).

The good news is that social anxiety is completely treatable over time. You can learn the necessary tools to control your feelings and navigate social situations without an anxiety attack. 

Low Self Esteem

Low self esteem has been discovered to be connected to panic attacks (see Boscarino and Adams, 2009). Another study, published in the Journal of Affective Disorders in 2010, found that those suffering from low self esteem had more frequent panic attacks.

One reason why low self esteem may cause panic attacks is that it increases stress in social situations, which can lead to social anxiety disorder, (as discussed above). I have experienced this first hand. At school I was extremely shy and lacking confidence, so much so that I was terrified of being asked a question in class or being put on the spot in front of others. I now realise that I was suffering from social anxiety though fortunately it didn’t cause panic attacks.

As I discovered, building self esteem was necessary to improve my confidence and feel better about social interactions. Nowadays I have transformed myself into a much more sociable person and I am much happier as a result.

Relationship Problems

If you are often experiencing arguments with family friends or your partner, then it’s likely a huge reason for your anxiety. Relationship problems can make you feel like you have no support system. If arguing is a common theme in your life, then consider talking to a therapist ( about how to improve your communication skills. 

Self esteem plays a role in your relationships and can have a positive or negative effect. Please check if you have relationship issues that may be caused by low self esteem.


Whatever triggers your anxiety is important to know. Anxiety can develop into more serious symptoms such as panic attacks. Low self esteem makes it worse so it is important to fix this.

By identifying and getting to know your triggers, you can learn how to cope with your anxiety rather than be a victim of it. Stay consistent and try to lead as healthy a lifestyle as possible. Over time you can build your self esteem and confidence and overcome your anxiety and ease your worries. Be sure to get advice first and use self help strategies to further help yourself to relax.

Self Help Strategies That Will Help You 

Try the following to lesson your anxiety, stress and combat the causes of the fear that is behind panic attacks:

  • Build self esteem. There is so much advice on how to do this but you should start here.
  • Boost your self confidence. Download my audio “A More Confident You.” This will guide you on the path to supreme confidence!
  • Listen to positive inspirational audiobooks.
  • Try meditation. So much research proves that it truly works.
  • Make a challenge for yourself each week. Some may come up naturally, but if not think about something that will move you forward. Just a small positive step each week will soon make all the difference. Write about each success and challenge in your journal and build up a record of motivating successes!
  • Try self hypnosis. Again, thousands of visitors to this website, just like you, have found this immensely helpful.
  • Use positive affirmations.
  • Practice gratitude. Here’s a video on my YouTube Channel where I explain how to make this work for you.


  • Batelaan, N. M., de Graaf, R., Spijker, J., Smit, J. H., van Balkom, A. J., Vollebergh, W. A., & Beekman, A. T. (2010). The course of panic attacks in individuals with panic disorder and subthreshold panic disorder: a population-based study. Journal of Affective Disorders121(1-2), 30-38.
  • Boscarino, J. A., & Adams, R. E. (2009). Peritraumatic panic attacks and health outcomes two years after psychological trauma: Implications for intervention and research. Psychiatry research167(1-2), 139-150.
  • Cleveland Clinic Website. (2020). Panic Attacks: Panic Disorder.
  • (2020). Stress and Anxiety: Causes and Management.
  • Iancu, I., Bodner, E., & Ben-Zion, I. Z. (2015). Self esteem, dependency, self-efficacy and self-criticism in social anxiety disorder. Comprehensive psychiatry58, 165-171.
  • NHS Website. (2020). Panic Disorder.
  • Schmidt, N. B., Lerew, D. R., & Jackson, R. J. (1997). The role of anxiety sensitivity in the pathogenesis of panic: Prospective evaluation of spontaneous panic attacks during acute stress. Journal of abnormal psychology106(3), 355.
  • Stein, M. B., & Stein, D. J. (2008). Social anxiety disorder. The lancet371(9618), 1115-1125.
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Website Author and Editor Bio

Photo of Karl Perera, MA, DipLC Karl Perera is a fully qualified Life Coach (DipLC), Teacher (MA) and author of Self Esteem Secrets. He has taught at various universities including Durham, Leicester and Anglia Ruskin, Cambridge. He has run since 1997 and is an expert in Self Esteem and Self Confidence.