14 Signs You Could Be Having a Panic Attack

A panic attack is not a typical occurrence of fleeting worry that we all experience from time to time. It can be best described as an explosive manifestation of anxiety, striking suddenly and forcefully.

According to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), a panic attack is characterized by a sudden surge of intense fear or discomfort, accompanied by a chaotic mix of unpleasant sensations.¹ These episodes can be highly distressing, leading some individuals to keep their experiences hidden. Concerns about the social stigma associated with psychiatric diagnoses often cause people to delay seeking treatment, as highlighted in a 2020 review published in Neuroendocrinology Letters.² Furthermore, even after receiving a diagnosis, some individuals continue to visit the emergency room repeatedly, mistakenly attributing their symptoms to heart disease, as noted in a 2022 review in the Journal of Family Medicine and Primary Care.³

It’s important to understand that during a panic attack, you are not in any immediate physical danger. As Russell Hunter, PsyD, a clinical psychologist specializing in anxiety disorders and the author of Attacking Panic: The Power To Be Calm, explains, a panic attack is essentially a "false alarm."

To help you identify when you might be experiencing a panic attack, consider the following indicators:

A Panic Attack Comes on Quickly

The transition from feeling perfectly fine to being engulfed in a state of intense panic can be startling. This sudden shift is attributed to the activation of your body’s fight-or-flight response, as explained by the American Psychological Association. This response triggers the release of hormones, accelerates your breathing, and causes a spike in blood sugar levels, as stated by Russell Hunter in an interview with Health.

Interestingly, certain individuals may even experience what are known as nocturnal panic attacks, which abruptly awaken them from sleep, as documented in a 2013 study published in the Journal of Clinical Sleep Medicine.

There May Be No Obvious Trigger

A panic attack occurs as a response to a perceived threat, although the specific trigger may not be immediately evident. The National Institute of Mental Health suggests that in some cases, an individual’s survival instincts are overly sensitive, leading to excessive panic responses.

According to the DSM-5, panic attacks are a symptom associated with panic disorder. While the exact reasons why certain individuals experience panic attacks remain unclear, it is believed that a combination of factors, such as a family history of panic attacks, stressful life events, and environmental influences, may contribute to their occurrence.

Typically, panic attacks tend to emerge during a person’s teenage years or before the age of 25. However, it’s important to note that panic attacks can also affect children and adults in their 30s.

It’s Short-Lived

The duration of a panic attack can vary from person to person, but on average, the peak intensity of symptoms tends to last for a few minutes. As the minutes pass, you may start to recognize that the perceived threat or danger is not real, as Russell Hunter pointed out. This realization often occurs as the body’s stress response begins to diminish.

It is important to remember that although the peak intensity subsides relatively quickly, some residual symptoms or feelings of unease may linger for a bit longer. However, with time and a deeper understanding of panic attacks, individuals can gain the confidence to navigate through these episodes more effectively.

You May Think You’re Having a Heart Attack

A rapid or pounding heartbeat is a frequently observed symptom during a panic attack, often accompanied by chest pain or discomfort. This similarity to heart attack symptoms is what causes many individuals experiencing a panic attack to believe they are having a heart attack. However, once they arrive at the hospital, they often begin to feel better because they start to realize that the perceived danger is subsiding, as described by Russell Hunter.

It Can Be Hard to Catch Your Breath

Shortness of breath and hyperventilation are common indications that you may be experiencing a panic attack. According to Lily Brown, PhD, an assistant professor of psychology and director at the Center for the Treatment and Study of Anxiety at the University of Pennsylvania’s Perelman School of Medicine, breathing difficulties are among the most prevalent symptoms associated with panic attacks.

You Think You Might Faint

Many individuals experiencing a panic attack frequently report feelings of dizziness or lightheadedness, which can lead to a fear of fainting. As a response, people often adopt a seated position with their head between their legs.

According to Lily Brown, PhD, it is important to note that the sensation of fainting during a panic attack is rare. However, individuals often don’t have the chance to discover that if they allow themselves to endure that feeling, it will eventually diminish.

There’s a Feeling of Doom

During a panic attack, it is common to experience a sense of losing control or even a fear of death. These distressing sensations can be prevalent during such episodes.

In specific social situations, individuals with social anxiety disorder may also encounter similar feelings, such as fear and trembling. However, a small study conducted by Lily Brown and her colleagues in 2016, published in Psychiatry Research, revealed notable differences in the occurrence of panic attacks between panic disorder and social anxiety disorder. The study indicated that the intense and distressing sensations associated with panic attacks are more frequently observed in individuals with panic disorder compared to those with social anxiety disorder.

Your Hands Get Tingly

According to the American Academy of Family Physicians, panic attacks can manifest as a sensation of pins and needles or numbness in the extremities.¹¹ In rare cases, more severe symptoms such as pseudoseizures can occur, as noted by Russell Hunter.

Hunter explains that during pseudoseizures, individuals may collapse to the ground and experience convulsions. However, it’s important to understand that these symptoms are not a result of abnormal brain functioning but rather induced by severe psychological distress, which can occur during a panic attack.

It’s Like an Out-of-Body Experience

A common symptom experienced during a panic attack is a sense of detachment from oneself or the surrounding environment, often described as feeling like an outsider to one’s own experience. Russell Hunter refers to this symptom as derealization. It can give rise to a feeling of unreality, akin to being in a dreamlike state.

You Get Sweaty or Have Chills

During a panic attack, there is a surge of adrenaline that leads to increased blood flow to the extremities, as Russell Hunter explains. As a result, individuals may suddenly feel hot, accompanied by sweating and shivering, which helps regulate the body’s temperature. Lily Brown mentions that patients frequently report sweating on the forehead or palms, although others may experience sweating throughout their body.

You Feel Like You’re Choking

During a panic attack, the body releases stress hormones as a part of the physiological response. This hormone release can cause individuals to experience muscle tension and contractions, including in the throat and chest area, as explained by Russell Hunter.

Your Stomach Might Hurt

It is not uncommon to experience gastrointestinal symptoms when feeling anxious or stressed. The relationship between stress, anxiety, and the digestive system is well-known. Stress and anxiety can disrupt the normal functioning of the digestive tract, leading to symptoms such as nausea and abdominal distress, including stomach pain. These gastrointestinal symptoms often accompany periods of heightened anxiety.

You Avoid Situations That Trigger Similar Symptoms

Lily Brown explains that individuals who experience a great deal of fear regarding their next panic attack may engage in various behaviors to prevent such episodes. They may start avoiding activities like exercise, which can raise their heart rate and accelerate their breathing. By fixating on these physical sensations, their anxiety intensifies, ultimately leading them into a cycle of more frequent panic attacks.

However, it’s important to note that not everyone who experiences panic attacks progresses to develop panic disorder. To receive a diagnosis of panic disorder, one must have one or more panic attacks followed by at least one month of persistent fear related to having another panic attack or engage in behaviors aimed at avoiding panic attacks. This fear and avoidance pattern is a key factor in diagnosing panic disorder.

You Feel Exhausted Afterward

Individuals who experience panic attacks can deplete their body’s resources quickly as they mobilize energy to cope with the perceived danger. The surge in energy, fueled by an increase in blood sugar, eventually subsides, leading to a state of exhaustion or feeling "wiped out," as described by Russell Hunter.

While panic attacks can be terrifying, the reassuring news is that they can be easily identifiable if you know what to look for. It is important to note that experiencing a panic attack does not guarantee that it will happen again. If you are concerned about future occurrences, it is advisable to reach out to your healthcare provider to develop a plan that empowers you to effectively manage those sensations should they arise.