Panic Attacks: Common Symptoms and How to Cope

Panic attacks are the main symptom of panic disorder​, but they can occur with other mental health and medical conditions. These attacks are characterized by a variety of physical, emotional, and cognitive symptoms that may feel overwhelming and uncontrollable, but have a cause and management options.

It's helpful to explore the most common symptoms of panic, what causes them, and management strategies for each.

Panic Attack signs and symptoms
Illustration by JR Bee, Verywell
1

Heart Palpitations or Accelerated Heart Rate

When experiencing a panic attack, many people feel as though their heart is pounding. Heart palpitations are often fearfully perceived, as many people who experience panic attacks believe that they are a sign of a medical emergency such as a heart attack.

However, accelerated heart rate is normal when it comes to panic attacks (or even when you're nervous or excited). It is associated with the fight-or-flight response you are experiencing. If you notice your heart racing, a strategy as simple as deep breathing can help you get it back in control.

Heart rate typically returns to normal as the panic attack subsides.

2

Trembling or Shaking

When having a panic attack you may feel trembling sensations, especially in the arms, legs, hands, and feet. Similar to other panic attack symptoms, uncontrollable trembling and shaking are a result of the fight-or-flight reaction, which prepares the body to either fight off or flee from a real or imagined threat in the environment.

This response is triggered frequently in people with panic disorder and often without cause, but options like talk therapy, and in some cases medication, may help in the management of this. Meditation, deep breathing, and acknowledging that you're having a panic attack may also help.

3

Excessive Sweating

As anxious feelings arise, it's not uncommon to begin to sweat. Much like other anxiety-related symptoms, excessive sweating is part of the body’s innate stress response. This reaction signals the body to be aware of feelings of danger.

The type of sweating can vary. You may experience either a cold or hot sweat or both. You may sweat from your underarms, forehead, or multiple parts of your body. You may or may not experience chills or hot flashes along with the sweating.

While uncomfortable and sometimes embarrassing to deal with, know that excessive sweating is not necessarily harmful. Finding strategies to calm yourself down can help decrease the stress response leading to the sweating. Once again, something as simple as relaxed breathing can go a long way in stopping the symptom.

As with all of these symptoms, psychotherapy and medications can help in the management of the underlying disorder.

4

Hyperventilation and Choking

Hyperventilation involves rapid breathing that may be brought on by panic and anxiety. During a panic attack, your normal breathing pattern may change in a way that doesn't allow you to take full, complete breaths. Instead, you will take quick and short breaths.

Hyperventilation may be accompanied by taking loud gasps of air, but may also be evidenced more subtly through coughing and rapid breathing. At times it may cause you to feel like you are choking, which only further intensifies the panic.

5

Chest Pain

People who've experienced panic attacks report that chest pain is one of the most frightening symptoms. Those with panic disorder may even experience chest pain caused by the anxiety itself.

Chest pain is one of the most common symptoms of panic attacks that leads people to seek immediate medical assistance. Even if it turns out to be unnecessary, it's especially important for those with known heart problems to make the trip to the doctor or emergency room. It's important to not miss heart-attack related pain by thinking it's a symptom of a panic attack.

6

Nausea or Abdominal Pain

Panic attacks can cause sensations of discomfort, nausea, or pain in the abdominal region.

Most people don't vomit when having a panic attack, but it's not uncommon to feel nauseous until the attack subsides.

7

Dizziness and Lightheadedness

When going through a panic attack, you may begin to feel dizzy, unsteady, lightheaded, or faint. This makes it hard to focus and can heighten anxiety.

Although uncommon, it's possible for someone experiencing a panic attack to faint. If you experience these symptoms, go ahead and sit or lie down, preferably somewhere quiet. Close your eyes and focus on your breath to help you come out of the panic attack.

8

Derealization and Depersonalization

During a panic attack, you may feel disconnected from yourself and/or the surrounding environment. When experiencing these symptoms, you view surroundings as distorted, foggy, or unfamiliar and may feel as though you are robotic, outside the self, or just going through the motions.

Derealization and depersonalization tend to negatively impact the person experiencing it and often leads to increased fear, panic, and anxiety. Once you acknowledge what's happening, slow down your breathing and use your senses to bring yourself back to reality—touching something cold or lightly pinching your hand will work. And once the underlying panic disorder is treated, you're less likely to experience this symptom.

9

Numbness and Tingling Sensations

Feelings of numbness and tingling can also occur during a panic attack. Areas of the body may have pins-and-needles sensations or feel completely frozen and numb. These symptoms can occur anywhere on the body but are most often felt in the hands, arms, legs, fingers, toes, and face.

Focused breathing can help here, too. You can also try to shake your body out to get blood flowing.

10

Fears of Dying, Losing Control, or Going Crazy

It's not surprising that the experience of having a panic attack is often terrifying. As the attack escalates, you may worry about your own personal safety and experience a fear of dying. Additionally, panic attacks can make you feel as though you're going to lose control or possibly "go insane."

Such thoughts and fears often increase the intensity of the attack. Do your best to acknowledge that they are a result of panic, which often times is an effective first step to quelling the attack. The simplest strategy is deep, focused breathing, but working with a healthcare professional will help you identify personalized strategies to best manage your condition.

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Article Sources

  1. American Psychiatric Association. Diagnostic and statistical manual of mental disorders, 5th edition.

  2. Bystritsky A, Khalsa SS, Cameron ME, Schiffman J. Current diagnosis and treatment of anxiety disorders. P&T. 2013;38(1):30-57.

  3. Heppell JL, Denis I, Turcotte S, Fleet RP, Dionne CE, Foldes-busque G. Incidence of panic disorder in patients with non-cardiac chest pain and panic attacks. J Health Psychol. 2019 doi:10.1177/1359105319859062

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