By Jennifer Copley (Last Updated 24 January 2015)
Panic attacks seem to come on quite suddenly, though there are often subtle signs that warn of an impending attack (such as muscle tension, increased heart rate, sweating, etc.). Panic attacks may occur in response to something frightening or stressful, but they may also come out of the blue, with no apparent warning or trigger. People typically describe panic attacks as the most terrifying experiences of their lives.
Psychological and Physical Panic Attack Symptoms
Panic attack symptoms fall into two categories: psychological and physical. Most people won’t have every single symptom during an attack, but they will have at least a few of the following symptoms from each category.
- Overwhelming terror
- Belief that they are dying
- Belief that they will go crazy
- Expectation of losing control
- Urgent need to escape
- Feeling of threat, extreme danger, or impending doom
- Feeling of detachment from themselves or their surroundings
- Feeling of unreality (dreamy, unreal, surreal, etc.)
- Difficulty thinking clearly or rationally
- Inability to concentrate
- Heart palpitations/rapid heart rate/pounding heart/irregular heartbeat
- Dizziness /faintness/lightheadedness
- Chest discomfort /pain/tightness in the chest
- Nausea/upset stomach/fluttery stomach/stomach pain/heartburn
- Numbness or tingling, most often afflicting the face, hands, or feet/pins-and-needles sensation
- Smothering sensation/suffocating sensation/feeling unable to get enough air
- Choking or strangling sensation/tightness in the throat/lump in the throat/difficulty swallowing
- Chills or hot flashes
- Dry mouth
- Urgent need to urinate or defecate
- Tense muscles
- Blurred vision
A person experiencing a panic attack is often too disabled to explain to others what is happening. He may hyperventilate (breathe too rapidly, taking in too much oxygen) due to a feeling of suffocation, which can worsen physical sensations such a dizziness (this is why calm, slow breathing can reduce panic symptoms).
People who are experiencing panic attacks usually feel that their symptoms are very obvious to others and that they are publicly embarrassing themselves. However, the reality is that other people usually can’t tell that a person is having an attack unless they know him very well because outward signs are often too subtle to notice.
Panic Attack Symptoms Mimic Disease Symptoms
It often takes time to get a diagnosis of panic disorder because the symptoms mimic those of various diseases. Many people mistakenly assume that they are having heart attacks when their first panic attacks occur (up to one-third of those who go to the emergency departments of hospitals complaining of chest pain are actually suffering panic attacks, according to various studies reviewed by Belleville et al., 2010). Panic sufferers often go to the hospital emergency ward or consult various doctors before receiving a diagnosis of panic disorder.
Panic attacks are not life-threatening. They are caused by a false activation of the body’s fight-or-flight response, which triggers a number of physiological responses, including:
- Shunting blood away from the arms and legs toward the head and central body
- Tensing the muscles for combat or flight
- Activating the sweat glands for cooling
- Increasing the heart rate to facilitate intense exercise
- Shutting down digestive functions so that all energy can be put toward escape or defense
- Raising blood sugar to provide extra energy
It is these physiological reactions that trigger panic symptoms.
The first time these symptoms occur, it’s worth consulting a doctor to rule out physical illness. Assuming that you receive a clean bill of health, you have probably experienced a panic attack. However, you shouldn’t assume that the problem is panic disorder without first getting a doctor’s diagnosis.
For more information on panic attacks, see:
- A.D.A.M. Medical Encyclopedia. (2011, April 11). “Panic Disorder: Panic Attacks.” PubMed Health.
- A.D.A.M. Medical Encyclopedia. (2010, March 30). “Panic Disorder with Agoraphobia.” PubMed Health.
- American Psychological Association. (2012). “Answers to Your Questions About Panic Disorder.” APA.org.
- Anxiety BC. (2011). “Panic Disorder.” AnxietyBC.com.
- Anxiety and Depression Association of America. (2012). ADAA.org.
- Anxiety Network. (2012). AnxietyNetwork.com.
- Belleville, G., PhD. (2010). “Characteristics of Panic Disorder Patients Consulting an Emergency Department with Noncardiac Chest Pain.” Primary Psychiatry, 17(3), 35-42.
- Bourne, Edmund J., PhD. (2005). The Anxiety and Phobia Workbook. Oakland, CA: New Harbinger Publications.
- Bressert, S., PhD. (19 January 2005). “Anxiety: Panic Disorder.” PsychCentral.com.
- Dryden-Edwards, R., MD (Author), Conrad Stoppler, M., MD (Editor). (2010, March 25). “Panic Attacks.” EMedicineHealth.com.
- Ham, P., MD; Waters, D.B., PhD; & Oliver, M.N., MD. (2005). “Treatment of Panic Disorder.” American Family Physician, 71(4), 733-739.
- Lazenbatt, A. (2010). “The impact of Abuse and Neglect on the Health and Mental Health of Children and Young People.” NSPCC.org.uk.
- Mathur, R., MD, FRCP(C)(Author), & Shiel, W.C., Jr., MD, FACP, FACR (Editor). (2012). “Hypoglycemia.” Medicine.net.
- Maertz, K. (2014). “Panic/Anxiety Attacks.” University of Alberta, UWell.UAlberta.
- ScienceDaily.com. (2010). “Science Reference: Panic Attack.”
- Smith, M., MA; Segal, R., MA; & Segal, J., PhD. (2012, January). “Panic Attacks and Panic Disorder.” HelpGuide.org.
- Wilson, R., Dr. “Panic Attacks.” Anxieties.com.
- Wilson, R., PhD. (1996). Don’t Panic: Taking Control of Anxiety Attacks. New York, NY: Harper Collins Publishers, Inc.