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In contrast to the often ever-present feelings of anxiety, a <anchor>panic attack</anchor> usually comes on suddenly and unexpectedly. Panic attacks are characterized by a racing heart, quick and shallow breaths, chest pain, dizziness, and feelings of dread or doom. Someone having a panic attack may think they are dying or have a sensation that they are outside of their own body.
12 Symptoms of a Panic Attack and What to Do Afterwards
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# What Are the Symptoms of Panic Attacks?

Updated on November 30, 2023

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Panic attack symptoms come on quickly, feel like they last an eternity, and can leave you with a sense of dread. This frightening experience happens to about 11% of adults in the United States each year.

During a panic attack, the nervous system overreacts to a perceived danger. This leads to a wide range of distressing symptoms: a rapid heartbeat, difficulty breathing, dizziness, and chest pain that can feel like a heart attack.

This article discusses panic attack symptoms. It explains what a panic attack feels like and possible complications. It also discusses when to see your healthcare provider about symptoms.

## Trembling or Shaking

You might feel your hands and fingers start to shake first and find it difficult to hold small objects like a pen, utensils, or your phone. This shaking can then grow to full-body trembling, making it difficult to stand.

It is believed that the shaking that occurs during a panic attack is an overreaction of the sympathetic nervous system, part of the fight-or-flight response. As your muscles tense to "take flight," or run away from the triggering situation, you will experience twitching and tremors.

### What Does a Panic Attack Feel Like?

People often use words like "crushing," "pounding," "feels like an eternity," "losing my mind," and "can't get enough air" to describe panic attacks. Many people grow to dread panic attacks and alter their lifestyle to avoid having another one. They may change their routines, limit the places they go, or stay away from people who may trigger them.

## Numbness and Tingling

Paresthesias, which is more commonly known as numbness and tingling, can also occur during a panic attack. You will most likely experience this as numbness, or "pins and needles," in certain areas, such as your lips, face, fingers, arms, feet, and legs.

This is another symptom that is due to a miscalculation of the evolutionary fight-or-flight response. During this response, blood rushes to important organs such as the heart, lungs, and central organs. This can leave "less important" body parts, in particular your extremities, lacking blood and subsequently feeling tingly.

## Chills or Hot Flashes

Many people also report experiencing thermal sensations, including chills or hot flashes, during a panic attack. The physiological mechanisms behind this are not completely understood, although one theory is that this is also a result of the fight-or-flight response.

Although hot flashes are included in the "Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision" or DSM-5 TR, as symptoms of a panic attack, research shows that sometimes panic can actually be a response to a hot flash.

This may be the case for people who are in menopause when hot flashes are often a result of hormone disruptions. Experiencing a sudden hot flash is uncomfortable and frightening and may actually trigger a panic attack on its own.

## Sweating

Sweating is a physical manifestation of panic attacks. Clammy palms, along with sweat in your armpits, back, or temples, are frequent symptoms of panic attacks and many anxiety disorders.

It can sometimes be hard to identify a panic attack in another person, since many of these symptoms are experienced internally.

However, if you see someone excessively sweating, whether on their forehead or through their shirt when there is no obvious physical or environmental cause, one explanation could be a panic attack.

## Nausea

Nausea is another common symptom of panic attacks. In rare cases, the nausea may lead to vomiting, although this is less common.

This feeling of nausea may stem from the feeling of "butterflies in your stomach" that is often described by people who are experiencing anxiety. This is actually thanks to the fight-or-flight response, when the body overproduces adrenaline, which can make you feel sick to your stomach.

## Heart Palpitations

Heart palpitations and tachycardia, or abnormally high heart rate, are additional symptoms of a panic attack. Feeling your heart skip a beat, or feeling an unusually high pulse, can be a scary experience that can exacerbate your panic attack.

Like nearly all symptoms of a panic attack, a high or irregular heart rate is linked to the fight-or-flight response. As your body is pumping out blood to important organs and large muscle groups to aid in your fighting (or running away), your heart will work overtime.

## Shortness of Breath or Hyperventilation

The DSM-5 TR lists shortness of breath, or feelings of choking or being smothered, as symptoms of a panic attack. These respiratory symptoms can also present as hyperventilation.

Taking deep, diaphragmatic breaths (in which the stomach, rather than the chest, expands as you inhale) can help your body and re-regulate your breathing. A benefit is that deep breathing can also activate the parasympathetic nervous system, calming the body's fight-or-flight response and reducing feelings of anxiety.

## Dizziness

Dizziness is a common symptom of panic attacks you should be aware of. In some cases, this could be secondary to taking short, shallow breaths (which affect your blood chemistry).

If you start to experience sudden, intense dizziness, it's important to find a safe place to sit down. A panic attack is not dangerous by itself, but falling over or injuring yourself secondary to dizziness is a possibility.

If you are with someone who is feeling lightheaded or dizzy due to a panic attack, have them sit down and place their head between their legs or lie down and elevate their legs. This can help regulate blood pressure and reduce feelings of faintness.

## Fear of Losing Control

Someone having a panic attack might be scared of losing control or "going crazy." A panic attack is defined as a discrete, time-bound episode of panic, and during that time you might indeed lose control of your body and emotions.

It can help to remember that most panic attacks only last a few minutes, and once you're out of it, you will be back in control.

## Derealization or Depersonalization

Derealization and depersonalization are additional, rarer symptoms of panic attacks. When someone experiences derealization, they have a feeling of unreality, or being disconnected from reality as it is occurring around them.

Depersonalization can be described as feeling detached from oneself, or as if you are observing your own behaviors but not identifying with them.

When in a panic attack, you might experience derealization or depersonalization by suddenly feeling like you are "floating above" your body or watching yourself panic.

## Chest Pain or Discomfort

Chest pain is one of the most distressing symptoms of panic attacks. Panic attacks are often mistaken for heart attacks due to chest pain symptoms.

An older study found that approximately 25% of patients who present to their physician with symptoms of chest pain are ultimately diagnosed with panic disorder.

## Fear of Dying

In the moment, a panic attack can be so terrifying and all-consuming that you may experience fear of dying.

With symptoms such as heart palpitations, chest pains, and hyperventilation, it is not surprising that some people think they are dying during a panic attack. If you are in this situation, try to remember that a panic attack by itself cannot kill you.

Illustration by Joshua Seong. © Verywell, 2018.

### Anxiety Attack vs. Panic Attack

Many people use the terms "anxiety attack" and "panic attack" interchangeably. However, only a panic attack is defined in the DSM-5 TR and has a list of identifiable symptoms. An anxiety attack can refer to a less intense episode of acute anxiety than a panic attack.

## Complications

Unfortunately, there can be complications if a panic attack is not dealt with. These can include the following:

### Panic Disorder

While, for some people, a panic attack might be a one-off occurrence, 2% to 3% of people will go on to develop panic disorder.

Panic disorder is a type of anxiety disorder that can be diagnosed by a psychiatrist or your primary care provider. According to the DSM-5 TR, a person must regularly experience unexpected panic attacks to be diagnosed with panic disorder.

At least one of these panic attacks must be followed by a one-month period of the person experiencing intense fear and avoidance behaviors around subsequent panic attacks.

### Avoidance Behaviors

According to the DSM-5 TR, panic attacks can be either expected or unexpected. Some people can identify triggers that lead to panic attacks.

These triggers might include driving, going out in public, speaking in public, going to the gym, hearing loud noises like fireworks or cars backfiring, and countless others.

While avoiding triggers can reduce the occurrence of panic attacks, avoidance behaviors can also lead to limitations in life and relationships, along with feelings of dread.

### Agoraphobia

Experiencing a panic attack in public or while driving leads to an increased chance of developing agoraphobia. Agoraphobia is an intense fear and avoidance of being in a situation where escape might be difficult if you have a panic attack. It can also include the fear of leaving one's home.

For people with panic attacks, this is due to a fear of experiencing another attack in public. Agoraphobia can lead to functional disability and limit relationships, work, social life, leisure, and more.

### Cardiac Conditions

People with panic disorder have higher rates of cardiac conditions, including hypertension (high blood pressure) and cardiomyopathy.

Research is not definitive regarding the direction of causality, as it may be the case that people with these pre-existing cardiac conditions are more likely to experience panic as a result of their disease.

Nevertheless, this is one reason it is important to seek treatment for panic disorder or ongoing panic attacks.

## When to See a Healthcare Provider

Panic attacks are a symptom of a variety of anxiety disorders, such as panic disorder, post-traumatic stress disorder, phobia-related disorders, social anxiety disorder, and more. It's important to get the correct diagnosis so you can seek the most effective treatment for you.

See your healthcare provider if you:

- Experience symptoms of a panic attack
- Feel a sense of dread over the possibility of another panic attack
- Find yourself altering your routine, plans, or behaviors to avoid another one

Your healthcare provider will rule out potential physical causes of your symptoms, discuss your treatment options, and may refer you to a psychiatrist for diagnosis or a psychotherapist for treatment.

Verywell / Cindy Chung

## Summary

Panic attack symptoms, like chest pain, difficulty breathing, dizziness, trembling, and a racing heart, are caused by an overreaction of the sympathetic nervous system. The symptoms of a panic attack peak within a few minutes but may feel like they last an eternity. In some cases, panic attack symptoms are so severe they mimic a heart attack.

Panic—part of the fight-or-flight response—is a normal reaction in times of extreme stress. Many people experience these symptoms when unexpected life changes occur. However, when panic attacks are triggered by less obvious things, occur more frequently, or lead to a sense of dread, see your healthcare provider.

Left untreated, panic attacks can lead to panic disorder, heart conditions, and avoidance behaviors like agoraphobia. Panic attacks can be managed with cognitive behavior therapy and anti-depressant or anti-anxiety medications.

6 Sources

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

Bence is an occupational therapist with a range of work experience in mental healthcare settings. She is living with celiac disease and endometriosis.

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Ⓒ 2024 Dotdash Media, Inc. — All rights reserved

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