Identifying The Symptoms Of A Panic Attack

Medically reviewed by Melissa Guarnaccia, LCSW
Updated June 5, 2024by BetterHelp Editorial Team

Note: Please be advised, the below article discusses prescription medication. The information found in the article is not a substitute for professional medical advice. Always seek the advice of your physician or other qualified health providers with any questions you may have.

About 2.7% of the U.S. adult population will have a panic attack (sometimes called an anxiety attack) in any given year. This number only includes the people who recognize their panic attack symptoms or have been diagnosed with panic disorder by their doctors. While panic disorder, which is often responsible for panic attacks, can develop at any time, research suggests that it often arises in early adulthood. No matter when panic disorder or panic attacks begin to manifest, it may be helpful to know the symptoms ahead of time.

If you suspect you've had a panic attack, it can be important to examine the incident and related symptoms, as this can help you identify when a panic attack occurs (rather than a different emergency that may require medical care.) In some cases, knowing what is actually happening is necessary in order to have your panic disorder treated in a way that relieves your symptoms. 

Knowing your panic attack symptoms can also help you recognize certain situations that increase the likelihood of an attack. However, not everyone has specific triggers that cause panic attacks. 

This article examines what panic attacks are, the symptoms associated with them, and methods like talk therapy that can help you manage them. 

Are you or a loved one experiencing panic attacks?

Emotions associated with unexpected panic attacks

The overriding emotion at the center of most panic attacks (especially those that are unexpected) is fear. You might have a clear idea about what you're afraid of or the feeling of overwhelming fear may not have an immediate apparent cause. After repeated panic attacks, you might begin to fear the attack itself. This constant state of fearing another attack can actually bring on an attack that might not otherwise have happened. 

You may feel intense worry or the sensation of “looking on from outside yourself” while the attack is going on. You might also feel an overwhelming sense of impending doom or that you’re in real danger and might be in a life-threatening situation.

Panic attack physical symptoms and sensations

Signs of a panic attack can also be physical in nature. The first time you have a panic attack, you may think you are in physical danger of losing your life. However, with experience, you can learn to recognize what leads someone to develop panic disorder, as well as the symptoms that could be part of a panic disorder. 

While not everyone experiences these symptoms, the following are some panic disorder signs that can mimic physical conditions.

Chest pain or discomfort

Some people with panic disorder may feel chest pain. You might have other sensations in your chest that cause discomfort, too. Your heart rate may increase, you may experience heart palpitations, you may feel pressure in your chest as if you were choking, or your chest can feel tight. While these feelings may indicate that something is wrong with your heart, they could alternatively mean that you are feeling intense anxiety and panic.

Breathing difficulties

With panic disorder, you may experience difficulty breathing or shortness of breath that can feel very physical in nature. You might gasp for air or feel your airways constrict. When these are symptoms of a panic attack, they are likely harmless. After the attack has subsided, your breathing will most likely return to normal.

Feelings of weakness

Several signs of panic attack may seem similar to what you might experience if you had a medical condition that causes weakness. You might feel dizzy or lightheaded. Losing control of your body and experiencing trembling or shaking is also common. The feeling of weakness can be so profound that you might fear you will fall before the attack is over.

Stomach discomfort

The constant fear that comes with a panic attack can cause you great stomach discomfort. You might feel abdominal distress, such as extreme nausea while the panic attack is going on, but it will likely subside when the attack is over.

Feelings of body temperature changes

Several symptoms of a panic attack can make you feel physically ill. You might sweat or have chills as if you had a fever. You may also experience hot flushes. 

Numbness

Often, people with panic attacks can feel numbness and tingling in their hands and feet. These are physical symptoms that can be generated by your nervous system in situations where a sense of fear overwhelms you.

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How to distinguish a panic attack from a heart attack

Because a panic attack can have symptoms that feel purely physical, it is important to be able to distinguish between a panic attack and a physical issue such as a heart attack. 

You may not be able to tell at that moment whether you are experiencing the symptoms of panic disorder or a heart attack. If you are unsure, treat it like a medical emergency until you find out otherwise. An ER doctor may ask for a detailed medical history and run tests to rule out a heart attack or other physical ailments.

If you don't or are unable to seek help at the time of the first attack, it is wise to go in for a heart checkup as soon as possible. The results can give you a rough estimate of how likely it is that further attacks will require medical attention. Still, you may never be able to know with 100% accuracy when you need to seek medical help during what may be a panic attack.

According to the Mental Health Foundation, panic attacks usually last for 5 to 20 minutes – if the symptoms persist for long periods, you may be experiencing another form of anxiety disorder. 

What brings on a panic attack?

The source of the intense fear behind a panic attack can be either obvious or unclear. In fact, you may have no warning at all that you're about to have a panic attack. Stressful situations can initiate panic attacks, but attacks can also happen when life seems otherwise peaceful. 

Furthermore, you can push yourself into an attack if you anticipate that you'll have a panic attack. That anticipation can lead to overwhelming anxiety, which is a short step away from a full-blown panic attack for someone with panic disorder.

Evaluating symptoms of panic attack

A doctor's first job is to rule out medical conditions that might cause the same symptoms as panic attacks and panic disorder. To do this, the doctor typically orders blood work, an EKG, and other tests that might show a physical connection. They will ask about your medical and family history, inquiring as to whether anyone in your family has suffered from medical conditions that could cause the symptoms. They listen to your heart and perform a thorough physical examination to find any potential source of medical problems.

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Are you or a loved one experiencing panic attacks?

If all these results come back negative for medical conditions, the doctor will likely move on to conducting a mental health examination or refer you to a mental health professional for such an assessment. This evaluation is based on conversations between you and the person conducting the interview. They may ask you about the symptoms you experience and what situations or experiences preceded the symptoms. This can help them to narrow down their diagnosis and rule out other mental health conditions, including other anxiety disorders, depression, and post-traumatic stress disorder. 

If you are experiencing trauma, support is available. Please see our Get Help Now page for more resources.

Once the doctor or mental health specialist determines that you have panic disorder instead of other mental health conditions, they may recommend a course of treatment to help you deal with or overcome the situation.

Treatments for panic attacks

While methods like exposure therapy may be an effective treatment for many mental health conditions, including panic disorder, the two main types of treatment for panic attacks may be medication or cognitive behavioural therapy. Medications like serotonin-norepinephrine reuptake inhibitors (SNRIs) and selective serotonin reuptake inhibitors (SSRIs), which are often used to treat depression, may be prescribed for panic disorder and panic attacks. Beta-blockers may also be prescribed to reduce the fight-or-flight response in stressful situations. 

These and other medications may need to be taken regularly or in some cases as needed when the triggers that have caused your panic in the past are present. They may have to be taken as the panic attack begins (as would be the case with medications like benzodiazepines). The doctor can prescribe the medication to be taken safely and effectively in a way that they deem best for you.

Cognitive behavioral therapy (CBT) is a therapy that consists of talking about the symptoms, triggers, and after-effects of your panic attacks and devising ways to deal with them. Because they often have a genetic basis, you may not be able to prevent panic attacks. However, with the therapist's help, you can reduce the symptoms and the stressors that seem to set off the attacks. Your therapist may also recommend self-help books that teach CBT techniques you can use at home to improve your quality of life. These methods may be useful when you begin to experience anxiety and panic symptoms or feel like you’re losing control in a moment of panic. 

One of the most important things you may learn through cognitive behavioral therapy is that a panic attack typically comes and goes without causing you any emotional or physical harm at all. You also may learn to deeply understand that the attack will eventually end and that soon you will return to the way you normally feel in everyday life. Reminding yourself of this heartfelt realization can diminish your symptoms even while you are in the midst of a panic attack.

A part of cognitive behavior therapy may be changing your way of thinking. Just as important, you can practice the behaviors that come from your new perspective. This can take time, but the end result might be that your panic attacks become less frightening and more manageable if they don't end altogether.

Finding help for the symptoms of panic attack

If you do find out that what you are experiencing are panic attacks, the next step may be to get help from a qualified professional. Your doctor may prescribe medications, but they'll likely suggest that you see a therapist for cognitive behavioral therapy (CBT) as well. CBT may be able to help you learn what commonly triggers an episode., as well as ways to deal with your next panic attack.

You can decide for yourself who you will see for CBT. You need to talk to someone who is trained in this method and who understands panic attacks and how to treat them effectively. Paid licensed/certified counselors are available online at BetterHelp.com to help you where you are, at times that work best for your schedule.

Clinical studies have demonstrated that online clinical behavioral therapy is effective in treating panic disorder. In addition, they’ve been shown to be effective at treating anxiety disorders, and specific phobias. Reviews have also shown that online therapy is cheaper than in-person talk therapy, especially when you consider added costs like childcare, time off work, and transportation costs.

Takeaway

As you explore the triggers and symptoms of panic attacks, you can learn to manage them. Your panic attacks may never completely go away, but when you know what to expect and what to do when they happen, you can live a more peaceful, productive life with less fear than you ever may have thought possible.
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