Panic Attack Symptoms

Patient Expert

About ten years ago, my best friend called me, very shaken. "I think I may have just had a panic attack," she blurted out, as soon as I answered the phone. "I couldn't breathe all of a sudden and I just freaked out." I was surprised, as I had known her for many years, and she'd never had one.

My friend had been in therapy for a few months, and had recently started to deal with some very painful memories from her childhood. It seemed possible that there was a connection between this and her first ever panic attack. Panic attacks can be triggered by stress or major life transitions.

I urged my friend to call her psychiatrist immediately. She was reluctant. She was hoping this was a one-time deal, which I knew was possible, but unlikely, and I felt strongly that she needed to get some medication to get her through this period. There was a good reason to prevent another one from occurring, which I'll explain later.

Panic attacks are sudden episodes of intense fear that develops for no apparent reason. They're thought to be caused by the wiring in our brain mistakenly producing a "fight or flight" response, which nature gave us to protect us in a dangerous situation. That's obviously entirely appropriate and desirable if you're facing a lion; if you're looking at cans of soup in the grocery store, not so much.


Many people who have experienced panic attacks have described them, in general, in three different ways:

  • Feeling like you're having a heart attack.
  • Feeling a strong need to escape although there is no present danger.
  • Feeling, irrationally, like you're going to die.

More specifically, the DSM-IV criteria for a panic attack is:

A discrete period of intense fear or discomfort, in which four (or more) of the following symptoms developed abruptly and reached a peak within 10 minutes:

  • Palpitations, pounding heart, or accelerated heart rate
  • Sweating
  • Trembling or shaking
  • Sensations of shortness of breath or smothering
  • Feeling of choking
  • Chest pain or discomfort
  • Nausea or abdominal distress
  • Feeling dizzy, unsteady, lightheaded, or faint
  • Derealization (feelings of unreality) or depersonalization (being detached from oneself)
  • Fear of losing control or going crazy
  • Fear of dying
  • Paresthesias (numbness or tingling sensations)
  • Chills or hot flashes

A Limited Symptom Attack, or Limited Symptom Panic Attack, is a milder version of a panic attack, with fewer than 4 panic related symptoms.

Most panic attacks peak within ten minutes. Your body can't sustain the "fight or flight" response for any length of time. However, the attacks can continue to come back over the course of a few hours.

It is very important to talk to a medical professional and get help. First of all, panic attack symptoms can be the same as those produced by potentially life-threatening illnesses. You need to see a doctor to get a diagnosis. It's also important to get a diagnosis and treatment because panic attacks can lead to phobias. If you have an attack in a mall, you may start avoiding malls in an attempt to prevent a re-occurrence. Now, this is not a big deal if you aren't crazy about shopping, but what if you have an attack while driving, or at work? You can see how this could gradually take over your life, and this is how some people end up afraid to leave their houses.

My friend got a prescription for her panic attacks, for Xanax, if I remember correctly. Without the prospect of panic attacks hanging over her head, she was able to continue on with her therapy and work through her issues. Eventually she tapered off of her medication and hasn't had an attack since.