What Is a Panic Attack?

An uncontrollable fear

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Panic attacks are episodes in which the body has a physical reaction of extreme fear that feels out of control. Some estimate that 11% of adults experience panic attacks within a year-long period of time.

These episodes can occur without a specific trigger, or they can occur as a result of anxiety about something that is perceived as scary. A panic disorder is a condition in which a person has recurrent and unexpected panic attacks and becomes apprehensive about the possibility of having them.

Panic attacks are defined by the fifth version of the Diagnostic and Statistical Manual of Mental Health Disorders (DSM-5) as sudden episodes of extreme feelings of fear, accompanied by a variety of physical signs and symptoms.

Panic attack
Ghislain & Marie David de Lossy / Cultura / Getty Images

Types 

Panic attacks can be expected or unexpected. An unexpected panic attack seemingly happens out of the blue, and an expected panic attack happens in response to being exposed to a trigger. Sometimes specific objects or situations that provoke panic attacks are described as phobias.

Things that can trigger a panic attack include:

  • Social gatherings 
  • Public places
  • Speaking in public 
  • An intimidating encounter
  • Enclosed spaces
  • Being in a high place
  • Ledges
  • Driving in an unfamiliar place 
  • Seeing a certain type of animal or an insect 
  • Elevators
  • Bridges
  • Tunnels
  • Airplanes

A person can have a panic attack whenever they encounter a specific trigger, or even when they are concerned that they might have to face that trigger.

Panic Disorder 

When someone has recurrent unexpected panic attacks and a persistent concern about having additional attacks, this condition is described as a panic disorder.

This sense of being on high alert can be exhausting, and it causes anxiety, even if the trigger does not appear. Furthermore, the efforts that go into avoiding a trigger can interfere with a person's life.

Having a history of unprovoked panic attacks can be similarly exhausting because it is so difficult to predict when an episode might suddenly occur. Someone who has unprovoked panic attacks can be filled with apprehension about possibly having to endure the experience. A person may avoid being around others to prevent having a panic attack in front of people.

If you or a loved one are struggling with panic attacks, contact the Substance Abuse and Mental Health Services Administration (SAMHSA) National Helpline at 1-800-662-4357 for information on support and treatment facilities in your area.

For more mental health resources, see our National Helpline Database.

Physical Signs 

A panic attack can last between a few minutes to 30 minutes, and rarely, up to an hour. The effects can quickly worsen within a few minutes. 

Physical signs of a panic attack can include:

  • Rapid pulse and heart rate 
  • Pounding in the chest 
  • Rapid, shallow breathing 
  • Trouble catching breathe 
  • Nausea or vomiting 
  • Abdominal discomfort 
  • Sweating and/or chills 
  • Tremors or trembling 
  • Blurred vision 
  • Lightheadedness or dizziness 
  • Paresthesias (numbness and tingling) in the hands or feet 
  • Chest pain 

A panic attack can include some, but not necessarily all, of these physical signs and symptoms at once. Generally, an individual who has recurrent panic attacks may experience a pattern in which some of the signs and symptoms begin at the start of the panic attack and then others may develop. 

What It Feels Like

A panic attack is often described as overwhelming and uncontrollable. People who are in the middle of a panic attack may feel a sense of impending doom and may even feel that they might die.

Another key feature is that people often feel that a panic attack is getting stronger over time, it can't be stopped, and that it’s impossible to predict when the episode will be over.

It doesn't feel easy to stop or control a panic attack, although sometimes psychotherapy can help a person learn to manage them.

Helplessness

Often, a person “freezes” during a panic attack and doesn't have the ability to constructively manage the situation.

For example, if a panic attack is triggered by seeing a dog on a leash with its owner on the street, the situation poses no actual danger—nevertheless, the person having a panic attack in this situation may run, freeze, cry, or scream.

Isolation

It can be difficult to communicate effectively with others during a panic attack. Sometimes it's worse if strangers or certain people who are perceived as unsympathetic are nearby.

Afterward, a person may feel exhausted, confused, or embarrassed. This often leads to isolation. Alternatively, some people feel fine after a panic attack, especially if it has been provoked by a trigger that is no longer around. 

How to Recognize a Panic Attack 

It can be hard to know if an event is a panic attack because some dangerous health issues can cause similar symptoms. Generally, a panic attack is recognizable if it is recurrent and other medical causes have been ruled out.

Not everyone has the same exact panic attack experience, but an individual's panic attack may produce the same or very similar symptoms when they recur. 

Other conditions that can have effects similar to those of a panic attack include:

It isn’t a good idea to assume that someone is having a panic attack if they are having the symptoms of a panic attack unless they have had an appropriate medical evaluation.

Medical problems that produce symptoms similar to the symptoms of panic attacks can be identified with a medical history, physical examination, and diagnostic tests.

Related Psychiatric Issues

Often people who have other anxiety disorders or post-traumatic stress disorder (PTSD) also have panic attacks, and there are some overlaps between the conditions.

Some distinctions include.

  • In generalized anxiety disorder, the symptoms are more constant than the episodic nature of panic attacks.
  • PTSD is associated with a specific traumatic event. Sometimes the triggers of a panic attack are associated with past traumatic events, but often that's not the case.

A Word From Verywell

Panic attacks are not rare, and they can be distressing. Panic disorder can affect a person’s quality of life and may lead to avoidance, social isolation, and a sense of shame and embarrassment.

If you have panic attacks, know that you are not alone. It’s important to seek medical attention for panic attacks because medication and therapy can help improve a person’s quality of life.

5 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.
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  2. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 5th ed. Washington D.C.

  3. Domhardt M, Letsch J, Kybelka J, Koenigbauer J, Doebler P, Baumeister H. Are Internet- and mobile-based interventions effective in adults with diagnosed panic disorder and/or agoraphobia? A systematic review and meta-analysis [published online ahead of print, 2020 Jul 15]. J Affect Disord. 2020;276:169-182. doi:10.1016/j.jad.2020.06.059

  4. National Institute of Mental Health. Anxiety disorders.

  5. American Psychiatric Association. What are anxiety disorders?

By Heidi Moawad, MD
Heidi Moawad is a neurologist and expert in the field of brain health and neurological disorders. Dr. Moawad regularly writes and edits health and career content for medical books and publications.