Panic Disorder Symptoms 5 Facts About Panic Disorder Symptoms By Katharina Star, PhD Katharina Star, PhD Facebook LinkedIn Katharina Star, PhD, is an expert on anxiety and panic disorder. Dr. Star is a professional counselor, and she is trained in creative art therapies and mindfulness. Learn about our editorial process Updated on September 25, 2020 Medically reviewed Verywell Mind articles are reviewed by board-certified physicians and mental healthcare professionals. Medical Reviewers confirm the content is thorough and accurate, reflecting the latest evidence-based research. Content is reviewed before publication and upon substantial updates. Learn more. by Daniel B. Block, MD Medically reviewed by Daniel B. Block, MD LinkedIn Twitter Daniel B. Block, MD, is an award-winning, board-certified psychiatrist who operates a private practice in Pennsylvania. Learn about our Medical Review Board Print Panic attacks, the main symptom of panic disorder, are often misunderstood, but there are many interesting facts about this experience. Unfortunately, prevalent myths about panic disorder have contributed to the confusion about these attacks. For example, many people believe panic attacks are just an overreaction to a feared event or an inability to control one’s reactions to stress. Such misconceptions only add to the stigma of having panic disorder. If you have been diagnosed with panic disorder, you may have a firsthand understanding of what it’s like to have panic attacks. But even you may be unaware of some characteristics of these attacks. This list outlines commonly overlooked facts about panic attacks. 1 Panic Attacks Can Occur While You're Asleep Peter Dazeley/Photographer's Choice/Getty Images As strange as it may sound, it is possible to have a panic attack while you are sound asleep. Nocturnal panic attacks occur when you experience panic attack symptoms that startle you out of your sleep. The symptoms of these attacks can be similar to those of daytime attacks, such as shaking, excessive sweating, and chest pain. When a nocturnal attack occurs, the person may experience shortness of breath or gasping for air upon awakening. As with daytime panic attacks, nocturnal panic attacks are also characterized by intense fears and feelings of dread. It is not uncommon for the person to feel as though they are losing control of themself or having a medical emergency. Symptoms of depersonalization and derealization are also typical, as the panic sufferer may have feelings of numbness and fogginess. They may have a strange sense that they are disconnecting from their surroundings, feeling as though they are dreaming or watching themself from a distance. Nighttime attacks can impact your life by potentially making you feel fatigued throughout your day, causing additional anxiety and leading to sleep disturbances. If nocturnal panic attacks are disrupting your ability to get a good night’s rest, it may be time to seek professional help. A doctor can work with you to treat your panic attacks and any possible sleep disorders. 2 Panic Attacks Don't Just Occur With Panic Disorder Dougal Waters/Getty Images Panic attacks are the hallmark symptom of panic disorder, but panic attacks can also occur with other mental health disorders. According to the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), the reference guide mental health specialists use to make accurate diagnoses, panic attacks present in a variety of conditions. Panic attacks are often linked to other mood and anxiety disorders, including agoraphobia, specific phobias, post-traumatic stress disorder (PTSD), obsessive-compulsive disorder (OCD), depression, and bipolar disorder. Panic attacks can be similarly associated with other mental health conditions, including eating disorders, personality disorders, and substance-related conditions. In some cases, panic attacks can be a part of certain medical conditions, such as gastroesophageal reflux disease (GERD), irritable bowel syndrome (IBS), and sleep disorders. 3 Diet and Exercise Can Have a Profound Impact on Panic Attacks Daniel Sambraus/Getty Images Regular exercise and proper nutrition have countless benefits, but did you know that your lifestyle choices can have a profound impact on your experience with panic attacks? Research has found that participating in a regular exercise program can decrease your feelings of stress, anxiety-related tension, and tightness throughout the body. It may lessen the frequency of panic attacks as well. Your diet can also influence your experience with panic attacks. Studies have revealed that certain foods and substances can trigger anxiety and other panic attack symptoms. For example, consuming excessive amounts of caffeine, alcohol, or monosodium glutamate (MSG) can potentially increase anxiety and panic attacks. 4 Panic Attacks Can Occur Expectedly or Suddenly Tara Moore/Getty Images The DSM-5 describes two types of panic attacks: expected, or cued, and unexpected. Expected panic attacks occur when the person is provoked by certain cues or triggers. For instance, a person who has a fear of heights (acrophobia) is likely to have a panic attack when on a high floor in a building or on an airplane. Unexpected panic attacks, on the other hand, occur suddenly without any obvious cues. Anxious and fearful thoughts or external triggers, such as specific phobias or a traumatic event, can bring them on. Unexpected panic attacks are the type most commonly associated with a diagnosis of panic disorder. 5 Avoiding Phobias Can Increase Your Fears Robert Llewellyn/Getty Images Many panic attack sufferers develop avoidance behaviors by steering clear of situations they believe lead to panic attacks. For example, a person with panic disorder may avoid being in busy shopping malls out of fear that others will witness them having a panic attack. Similarly, a person with a fear of flying (aerophobia) may never travel by plane, knowing that they will have a panic attack on the plane. Avoidance behaviors may seem logical at first, but they can prevent you from enjoying many different experiences in life. Panic and avoidance may keep you from attending social gatherings or traveling far distances. Plus, avoidance behaviors often strengthen your anxiety, further increasing your fears of certain places or situations. Instead of avoiding panic-inducing situations, try to breathe through them. The next time you feel a panic attack coming on, bring your attention to your breath. During a panic attack, you may notice that your breath has become quick and shallow. Take control by breathing slowly and purposely. Inhale deeply through your nose, filling your lungs to their capacity. Exhale out of your mouth, expelling all of the air out of your body. Continue to repeat this deep breathing pattern until you feel more relaxed. If deep breathing exercises and other self-help strategies are not working, you may want to consider finding professional help. Such assistance can help you receive the right diagnosis and develop ways to manage your anxiety and panic attacks. Also, a qualified mental health specialist can provide clear explanations and additional information about treating panic disorder. 16 Sources Verywell Mind 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. Anxiety and Depression Association of America. Myths and Misconceptions About Anxiety. Nakamura M, Sugiura T, Nishida S, Komada Y, Inoue Y. Is nocturnal panic a distinct disease category? Comparison of clinical characteristics among patients with primary nocturnal panic, daytime panic, and coexistence of nocturnal and daytime panic. J Clin Sleep Med. 2013;9(5):461-7. doi:10.5664/jcsm.2666 National Institute of Mental Health. Panic Disorder: When Fear Overwhelms. Weiner E, Mckay D. A preliminary evaluation of repeated exposure for depersonalization and derealization. Behav Modif. 2013;37(2):226-42. doi:10.1177/0145445512461651 Na HR, Kang EH, Yu BH, et al. Relationship between Personality and Insomnia in Panic Disorder Patients. Psychiatry Investig. 2011;8(2):102-6. doi:10.4306/pi.2011.8.2.102 Association AP. 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Cross-national epidemiology of panic disorder and panic attacks in the world mental health surveys. Depress Anxiety. 2016;33(12):1155-1177. doi:10.1002/da.22572 Mkrtchian A, Aylward J, Dayan P, Roiser JP, Robinson OJ. Modeling Avoidance in Mood and Anxiety Disorders Using Reinforcement Learning. Biol Psychiatry. 2017;82(7):532-539. doi:10.1016/j.biopsych.2017.01.017 Ma X, Yue ZQ, Gong ZQ, et al. The Effect of Diaphragmatic Breathing on Attention, Negative Affect and Stress in Healthy Adults. Front Psychol. 2017;8:874. doi:10.3389/fpsyg.2017.00874 Bandelow B, Michaelis S, Wedekind D. Treatment of anxiety disorders. Dialogues Clin Neurosci. 2017;19(2):93-107. Additional Reading Asmundson GJ, Taylor S, Smits JA. Panic disorder and agoraphobia: an overview and commentary on DSM-5 changes. Depress Anxiety. 2014;31(6):480-6. doi:10.1002/da.22277 Bergin JE, Kendler KS. Common psychiatric disorders and caffeine use, tolerance, and withdrawal: an examination of shared genetic and environmental effects. Twin Res Hum Genet. 2012;15(4):473-82. Bourne EJ. The Anxiety and Phobia Workbook, Seventh Edition. Oakland, CA: New Harbinger Publications; 2020. Nabavi B, Mitchell AJ, Nutt D. A Lifetime Prevalence of Comorbidity Between Bipolar Affective Disorder and Anxiety Disorders: A Meta-analysis of 52 Interview-based Studies of Psychiatric Population. EBioMedicine. 2015;2(10):1405-19. doi:10.1016/j.ebiom.2015.09.006 By Katharina Star, PhD Katharina Star, PhD, is an expert on anxiety and panic disorder. Dr. Star is a professional counselor, and she is trained in creative art therapies and mindfulness. See Our Editorial Process Meet Our Review Board Share Feedback Was this page helpful? Thanks for your feedback! What is your feedback? 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