What is a panic attack? Symptoms and what is really happening
Your heart pounds, you cannot breathe, you are sure something terrible is happening. Here is what is actually going on in your body.
Common symptoms
A panic attack usually comes on suddenly and peaks within about ten minutes. Symptoms can include:
- pounding or racing heart;
- chest tightness or pain;
- shortness of breath or a choking feeling;
- dizziness, light-headedness or feeling faint;
- shaking, sweating, hot or cold flushes;
- tingling or numbness in hands, feet or face;
- nausea or stomach churning;
- feeling unreal or detached from yourself;
- fear of dying, losing control or going mad.
What your body is doing
Panic is the fight-or-flight response switched on at full strength. Your brain thinks there is danger and releases adrenaline:
- the heart speeds up to pump blood to muscles;
- breathing quickens to take in oxygen;
- blood moves away from the stomach and skin, causing nausea and tingling;
- fast breathing lowers carbon dioxide, causing dizziness and tingling.
Every symptom has a protective purpose. None of them is dangerous in itself.
The panic cycle
Panic attacks keep going because of a cycle:
- You notice a body sensation, like a skipped heartbeat.
- You interpret it as dangerous: "I'm having a heart attack."
- Fear rises and releases more adrenaline.
- The sensations get stronger, which seems to confirm the danger.
Breaking this cycle, by learning that the sensations are uncomfortable but safe, is the heart of treatment.
Why it feels like a heart attack
Chest tightness, palpitations and breathlessness overlap with heart symptoms. That is why so many people with panic go to A&E. Getting checked is right, especially the first time. Once heart problems are ruled out, it helps to learn the difference between panic and a cardiac emergency; see panic attack or heart attack?.
What to do next
If you have had a panic attack, you are not going mad and you are not weak. Learn how to stop a panic attack, and if attacks keep happening, read about panic disorder and its treatment.
Questions people ask
What does a panic attack feel like?
A sudden wave of fear with a racing heart, breathlessness, dizziness, shaking and a sense that something terrible is about to happen.
Why do I feel like I am dying during a panic attack?
Adrenaline creates strong sensations in the heart and chest, and the brain reads them as danger. The feeling is real but the danger is not.
Can panic attacks cause chest pain?
Yes, chest tightness and pain are common in panic attacks. New or severe chest pain should always be checked by a doctor.
Why do my hands tingle during panic attacks?
Fast breathing lowers carbon dioxide in the blood, which causes tingling in hands, feet and around the mouth.
Can you faint from a panic attack?
Fainting during panic is rare because blood pressure usually rises during panic. People with blood or needle phobia are an exception.
What causes the feeling of unreality?
Feeling detached or unreal, called depersonalisation or derealisation, is a common part of high anxiety. It is unpleasant but harmless and passes.
Are panic attacks a sign of mental illness?
One panic attack can happen to anyone under stress. Repeated attacks and fear of them may be panic disorder, which is common and treatable.
Can a panic attack happen without a reason?
Yes. Many attacks feel like they come out of nowhere, often triggered by a body sensation you barely noticed.
How do I know if it was a panic attack?
If symptoms came on suddenly, peaked within minutes, and a doctor found no physical cause, it was likely a panic attack.
Do panic attacks damage your heart?
No. In a healthy heart, the raised heart rate during panic is like exercise and does no damage.