Panic Disorder Symptoms How to Recognize and Cope With Panic Attack 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 February 13, 2023 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 Steven Gans, MD Medically reviewed by Steven Gans, MD Steven Gans, MD is board-certified in psychiatry and is an active supervisor, teacher, and mentor at Massachusetts General Hospital. Learn about our Medical Review Board Print Table of Contents View All Table of Contents Heart Issues Trembling or Shaking Excessive Sweating Hyperventilation and Choking Chest Pain Nausea or Abdominal Pain Dizziness and Lightheadedness Derealization and Depersonalization Numbness and Tingling Fears of Dying or Losing Control Panic attacks cause a variety of symptoms that may feel overwhelming, uncontrollable, and frightening. These can include heart palpitations, shaking, sweating, hyperventilation, chest pain, nausea, dizziness, depersonalization, numbness, and fear. Panic attacks are the main symptom of panic disorder, but they can occur with other mental health and medical conditions. It's helpful to explore the most common symptoms of panic, what causes them, and management strategies for each. Verywell / JR Bee 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, an 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. 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. What Are Anxiety Shivers? 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. 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. 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. Why Panic Attacks Cause Shortness of Breath Chest Pain People who've experienced panic attacks report that chest pain is one of the most frightening symptoms. In cases of panic, the chest pain is 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 new onset chest pain to be initially evaluated medically in order to determine that this indeed is a symptom of panic and not a more serious cardiac problem. 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. 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. 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. Treating Depersonalization and Derealization 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. Shaking your limbs and body may also help. Fears of Dying or Losing Control 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. Medications That Treat Panic Disorder If you or a loved one are struggling with anxiety and 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. How to Help Someone Having a Panic Attack 3 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. American Psychiatric Association. Diagnostic and statistical manual of mental disorders, 5th edition. 2013. Bystritsky A, Khalsa SS, Cameron ME, Schiffman J. Current diagnosis and treatment of anxiety disorders. P&T. 2013;38(1):30-57. 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 Additional Reading Bourne, E. J. The Anxiety and Phobia Workbook. 5th ed. Oakland, CA: New Harbinger. 2011. 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? Other Helpful Report an Error Submit Speak to a Therapist for Panic Disorder Advertiser Disclosure × The offers that appear in this table are from partnerships from which Verywell Mind receives compensation.