Identifying The Symptoms Of A Panic Attack

Medically reviewed by Melissa Guarnaccia, LCSW and Dr. Jennie Stanford, MD, FAAFP, DipABOM
Updated October 15, 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 US 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 the condition often arises in early adulthood. No matter when panic disorder or panic attacks begin to manifest, knowing the symptoms ahead of time may be helpful. 

If you suspect you've had a panic attack, examine the incident and related symptoms. Doing so may help you identify when a panic attack occurs (rather than a different emergency that may require medical care). Knowing what is happening for you may lead to faster and earlier intervention. In addition, knowledge can help you recognize certain situations that increase the likelihood of an attack. 

Are you or a loved one experiencing panic attacks?

Emotions associated with unexpected panic attacks

The overriding emotion at the center of panic attacks (especially those that are unexpected) is often 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 fear of another attack can bring on an attack that might not otherwise have happened. 

Some people experience intense worry or the sensation of “looking on from outside themselves” while the attack occurs. You might also experience an overwhelming sense of impending doom or believe 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 experience chest pain. You might also have other sensations in your chest that cause discomfort. 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 seem tight. While these sensations may indicate a heart problem, they could alternatively mean that you are feeling intense anxiety and panic. Talk to your doctor if you’re worried about a heart issue. 

Breathing difficulties

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

Feelings of weakness

Several signs of a 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 significant stomach discomfort. You might have abdominal distress, such as extreme nausea while the panic attack is going on, but this symptom often subsides 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 experience numbness and tingling in their hands and feet. These are physical symptoms that the nervous system can generate 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 seem purely physical, being able to distinguish between a panic attack and a physical issue such as a heart attack can be helpful. 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, go in for a heart checkup as soon as possible. The results can give you a rough estimate of how likely it may be 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 five to 20 minutes. If the symptoms persist for long periods, you may be experiencing another form of anxiety disorder or a medical condition. Talk to your doctor about all physical symptoms, even if you believe you are having a panic attack, as doing so can ensure your symptoms are on your record and available to reference in case of emergency. 

What brings on a panic attack?

The source of the intense fear behind a panic attack can be either obvious or unclear. Some people may have no warning at all that they’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. The doctor may order blood work, an EKG, and other tests looking for a physical connection. They may ask about your medical and family history, inquiring as to whether anyone in your family has experienced or been diagnosed with medical conditions that could cause the symptoms. They may then listen to your heart and perform a thorough physical examination to find any potential source of medical problems.

If results come back negative for medical conditions, the doctor might choose to move on to conduct a mental health examination or refer you to a mental health professional for such an assessment. This evaluation may be based on conversations between you and the interviewer. They may ask you about the symptoms you experience and what situations or experiences preceded the symptoms. This can help them narrow down their diagnosis and rule out other mental health conditions, including anxiety disorders, depression, and post-traumatic stress disorder (PTSD). 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.

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

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Are you or a loved one experiencing panic attacks?

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 are often medication and cognitive-behavioral 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 medications change how certain brain chemicals are absorbed or released. 

These and other medications may be prescribed regularly or, in some cases, as needed when the events that have caused your panic in the past are present. They may have to be taken as the panic attack begins or on a daily schedule. The doctor can prescribe the medication to be taken safely and effectively in a way they deem best for you.

The BetterHelp platform is not intended for any information regarding which drugs, medication, or medical treatment may be appropriate for you. The content provides generalized information that is not specific to one individual. You should not take any action without consulting a qualified medical professional.

Cognitive-behavioral therapy (CBT) is a therapy that consists of talking about the symptoms, inciting events, and after-effects of your panic attacks and devising ways to deal with them. Because these episodes 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 them off. 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 believe you’re losing control in a moment of panic. 

In cognitive-behavioral therapy, you may learn that panic attacks typically come and go without causing emotional or physical harm. You also may learn to deeply understand that the attack will eventually end and that you will soon return to how you usually feel in everyday life. Reminding yourself of this heartfelt realization may diminish your symptoms even while you are in the midst of a panic attack.

A part of cognitive-behavioral therapy may be changing your way of thinking. Throughout daily life, you can practice the behaviors that come from your new perspective. Doing so 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 attacks

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

You can decide for yourself who you will see for CBT or another therapeutic modality. Try to find someone who is trained in this method and who understands panic attacks and how to treat them effectively. Paid licensed and certified counselors are available in person or online through platforms like BetterHelp. Online, you can meet with a therapist on your schedule and choose between phone, video, or live chat sessions. 

Clinical studies have demonstrated that online cognitive-behavioral therapy is effective in treating panic disorder. In addition, CBT therapists are effective at treating anxiety disorders and specific phobias. Reviews have also shown that online therapy is cheaper than in-person talk therapy, especially when considering added costs like childcare, time off work, and transportation costs.

Takeaway

As you explore the causes 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 may live a more peaceful, productive life with less fear. Consider seeking a therapist online or in your area to receive support. 

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