Panic Attacks and Panic Disorder - Symptoms

Symptoms

The main symptom of a panic attack is an overwhelming feeling of fear or anxiety, along with physical reactions. The symptoms come on suddenly, often unexpectedly, and the intensity usually peaks within 10 minutes. Although most symptoms fade within 30 minutes, it may take up to an hour for all the symptoms to go away completely. It is possible to have one panic attack after another in waves for an extended period of time, and it can seem like one continuous attack. However, if you have continuous symptoms that do not go away within an hour, you probably are not having a panic attack and you should seek immediate medical care.

Symptoms of a panic attack may include:³

• Rapid breathing (hyperventilation), shortness of breath, or feeling "smothered."
• A pounding or racing heart or an irregular heartbeat.
• Chest pain.
• Lightheadedness.
• Sweating.
• A choking feeling.
• Nausea or an upset stomach.
• Dizziness, shaking, or trembling.
• Numbness or tingling.
• Chills or hot flashes.
• Fear that you are going to die, lose control, or "go crazy."
• Feelings of being detached from yourself or from reality.

Panic attacks can begin with a stressful event or appear without cause. They also can be associated with medications, such as heart medications, and medical conditions, such as an overactive thyroid (hyperthyroidism).

Panic attacks may begin without a trigger or can be linked to certain situations, such as being in large crowds of people in restaurants or stadiums. Sometimes just the anticipation of being in a certain situation can cause severe anxiety. People who experience panic attacks often learn to avoid situations that they fear will trigger a panic attack or situations where they will not be able to escape easily if an attack occurs. If this pattern of avoidance and anxiety is severe, it can become agoraphobia.

The symptoms of a panic attack can be similar to those of a heart attack. Many people seek emergency medical treatment for a panic attack for this reason. If you have chest pain and other symptoms of a heart attack, seek immediate medical treatment. For more information, see the topic Chest Pain.

Panic attacks are not common in children or younger teens. But children who have panic disorder or panic attacks often have other symptoms in addition to those listed above. They may be overly afraid of common objects such as bugs, or worry excessively about monsters or about going to bed alone. They also may refuse to go to school or become unusually upset when they are separated from a parent.

Not everyone who experiences panic attacks develops panic disorder. A person is diagnosed with panic disorder if he or she has at least two unexpected panic attacks along with fear or worry about having another panic attack and avoiding situations that may trigger it.³