A panic attack is a component of a mental health issue (called panic disorder) characterized an intense physical feeling. This physical feeling in most people is usually an extreme shortness of breath (like they can’t breathe) or heart palpitations that may feel like a heart attack.
The attack is usually sudden, painful, and unexpected, and it usually passes as quickly as it comes on. While panic attacks cannot kill a person, they feel like they can by the person who experiences one. There are many simple, successful treatments of panic attacks and panic disorder.
What Does a Panic Attack Feel Like?
A panic attack is primarily identified by a short period of intense fear or serious discomfort where four (4) or more of the following symptoms develop abruptly, and reach a peak within just a few minutes:
- Palpitations, pounding heart, or accelerated heart rate
- Trembling or shaking
- Sensations of shortness of breath or smothering
- Feeling of choking
- Chest pain or discomfort
- Abdominal distress
- Feeling dizzy, unsteady, lightheaded, or faint
- Derealization (feelings of unreality) or depersonalization (a feeling of being detached from oneself)
- Fear of losing control or going crazy
- Fear of dying
- Paresthesias (numbness or tingling sensations)
- Chills or heat sensations
Panic attacks most often occurs in people who are diagnosed with panic disorder. But panic attacks can also occur with other mental disorders, such as a person experiencing post-traumatic stress disorder.
The severity and frequency of panic attacks can vary widely. Some people will experience a panic attack weekly for months on end, while others may have a bout of daily panic attacks, but can go for months inbetween bouts.
Just as troubling as the physical symptoms of a panic attack — and the subjective feeling of, “I’m going to die” — are the worries about the next panic attack and the consequences of having one. Many people with panic attacks will worry that the panic attack will bring about a heart attack or seizure. Others will worry about the embarrassment or being judged if the panic attack occurs in public (as attacks can strike at any time). The fear of losing control or “going crazy” is often present in many people who suffer from panic attacks as well.
Avoidance & Panic
In order to minimize the chances of a panic attack occurring, a person experiencing attacks will work to reduce physical exertion or situations they fear may trigger an attack. For instance, if a person can’t tolerate standing in line because they’ve experience a panic attack previously while standing in line, they’ll avoid situations where standing in line is expected. In extreme cases, this can result in a person limiting their exposure to the outside world, for fear of having one while in public. When a person avoids leaving their home, a separate diagnosis of agoraphobia may be made.
How are Panic Attacks Diagnosed?
Only a mental health professional or properly trained medical professional can reliably diagnose a panic attack. Mental health professionals who diagnose anxiety and panic disorders include psychologists, psychiatrists, and clinical social workers.
A panic attack is not considered a stand-alone mental disorder and so cannot be coded as a diagnosis. Because they represent a constellation of co-occurring symptoms that tend to arise together in certain contexts, disorders, and patients (i.e., those with anxious distress), a panic attack is seen by physicians as clinically important to document.
Panic attacks can occur in the context of any anxiety disorder as well as other mental disorders (e.g., depressive disorders, post-traumatic stress disorder, substance use disorders) and some medical conditions (e.g., cardiac, respiratory, vestibular, gastrointestinal). When the presence of a panic attack is identified, it is noted as a specifier to another diagnosis (e.g., a clinician will document, “post-traumatic stress disorder with panic attacks”). For panic disorder, the presence of panic attack is contained within the criteria for the disorder, and therefore, panic attack is not used as a specifier to prevent redundancy.
Certain culture-specific symptoms (e.g., tinnitus, neck soreness, headache, uncontrollable screaming or crying) are not linked to panic attacks and should not count as one of the four required symptoms.
How are Panic Attacks Treated?
Panic attacks can be successfully treated. You can review the complete guide to panic disorder treatment now.
This criteria has been updated for the current DSM-5 (2013).
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.
National Institute of Mental Health. (2019). Anxiety. Retrieved from https://www.nimh.nih.gov/health/publications/anxiety/index.shtml on March 2, 2019.