Although there are not specific causes for panic attacks in adults or children, like most other emotional symptoms, panic is understood to be the result of a combination of biological vulnerabilities, ways of thinking, and social stressors (biopsychosocial model). According to one theory of panic disorder, the body's normal "alarm system," the set of mental and physical mechanisms that allows a person to respond to a threat, tends to be triggered unnecessarily, when there is no danger. Scientists don't know exactly why this happens or why some people are more susceptible to the problem than others. Panic disorder has been found to run in families, and this may mean that inheritance (genetics) plays a strong role in determining who will get it. However, many people who have no family history of the disorder develop it. Studies differ as to whether nutritional deficiencies like of zinc or magnesium deficiencies may also play a role as a risk factor for developing panic disorder. While some statistics suggest that disadvantaged ethnic minorities tend to suffer from internalizing disorders like panic disorder less often than the majority population in the United States, other research shows that may be the result of differences in how ethnic groups interpret and discuss signs and symptoms of intense fright, like panic attacks.

Psychologically, people who develop panic attacks or an anxiety disorder are more likely to have a history of what is known as anxiety sensitivity. Anxiety sensitivity is the tendency for a person to fear that anxiety-related bodily sensations (like brief chest pain) have dire personal consequences (for example, believing that it automatically means their heart will stop). From a social standpoint, a risk factor for developing panic disorder as an adolescent or adult is a history of being physically or sexually abused as a child. This is even more the case for panic disorder when compared to other anxiety disorders. Often, the first attacks are triggered by physical illnesses, another major life stress, or perhaps medications that increase activity in the part of the brain involved in fear reactions.

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