The term “panic attack” is part of our common language. We hear it all the time.
“When I saw the electricity bill I just had a panic attack!” Or, “I had a panic attack when I woke up and saw I was two hours late for work!” Or, “When I realized I’d just eaten a raw oyster I about had a panic attack!” All these statements are inaccurate uses of the term “panic attack,” and are what are called clinomorphisms, or exaggerated use of a medical term.
Panic attacks are no laughing matter, and people who have the real ones cringe when they hear the term bandied about in everyday speech like it was nothing. They know the feeling that you are about to die, the intense fear, and the sudden onset are far more than what most people think of as a “panic attack.”
So how does it really feel to have a panic attack? Few people, aside from panic attack sufferers themselves, really know. It’s the purpose of this post to give you an insider’s view of what it actually feels like to have a panic attack.
What exactly is a panic or anxiety attack?
Sudden surge of overwhelming fear
A panic attack is a sudden surge of overwhelming fear that comes without warning and without any obvious reason. It is far more intense than the feeling of being “stressed out” that most people experience. A panic attack is marked by:
- Occurring suddenly, without any warning and without any way to stop it.
- The level of fear is way out of proportion to the actual situation, and is often completely unrelated.
- It passes in a few minutes, however, repeated attacks can continue to recur for hours.
For detailed information on panic attacks, please see the “Panic Attacks” reference article, For help making it through a panic attack, see the post, “Are You Having a Panic Attack? What Can You Do?“
What do psychiatrists say are the symptoms of a panic attack?
The “official” criteria for panic attacks
First, let’s get the “official” criteria for determining whether what you are feeling is a panic attack or not. The Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) of the American Psychiatric Association is the standard for diagnosis of mental disorders all over the world.
It requires that at least four of the following symptoms develop abruptly and reach a peak within 10 minutes for a diagnosis of panic attack:
1. Palpitations, pounding heart, or accelerated heart rate
2. Sweating
3. Trembling or shaking
4. Sensations of shortness of breath or smothering
5. Feeling of choking
6. Chest pain or discomfort
7. Nausea or abdominal distress
8. Feeling dizzy, unsteady, lightheaded, or faint
9. Derealization (feelings of unreality) or depersonalization (being detached from oneself)
10. Fear of losing control or going crazy
11. Fear of dying
12. Paresthesias (numbness or tingling sensations)
13. Chills or hot flushes
My panic attacks
Muscle constrictions, pounding heart, weakness and tingling, and fear of losing control
I hesitate to insert a personal side to this post, but since I have first-hand knowledge of how it feels to have a panic attack, I believe it is appropriate to describe mine. Each of my panic attacks is a little different, but all follow the same general outline: muscle constrictions, pounding heart, weakness and tingling, and fear of losing control and fainting.
My panic attacks start with muscle constrictions and tingling around the eyes, then the feeling spreads to my mouth and lower face. I develop a headache and feel a choking muscle constriction in my neck and tightening of my chest. There is a funny feeling in my chest, like shooting electricity. My heart starts pounding, my breathing is constricted and I feel very weak, especially in my arms and hands. A tingly feeling spreads over my whole body. I have a sense of unreality, of watching myself from a distance, and a growing fear of being unable to control myself. As things escalate, I desperately look for someplace — any place — to escape to. At its peak, I feel like I am going to faint and if things continue, I will surely die.
What do others say are their symptoms during a panic attack?
An informal compiled list of symptoms
Panic attacks are by their nature subjective experiences, and like all subjective experiences, are open to the interpretation and description of the sufferer. Following is an informal compiled list of symptoms from Wikipedia. They are grouped under “physical,” “mental,” “emotional,” and “perceptual” headings:
Physical
- A sensation of adrenaline going through your entire body
- Sweating
- Shortness of breath (dyspnea)
- Stomach Problems (spastic colon)
- Racing or pounding heartbeat or palpitations
- Chest pain
- Dizziness or vertigo
- Headache
- Lightheadedness
- Nausea or stomach pains
- Hyperventilation
- Choking or smothering sensations
- Hot flashes
- Cold flashes
- Tingling or numbness in the hands, face, feet or mouth (paresthesia)
- Feelings of “crawly,” “itchy,” or “cringy” skin sensations.
- Burning sensations
- Trembling or shaking
- Feeling of claustrophobia
- Feeling like the body is shutting down and/or dying
- Tremors in the legs and thighs
- Tingling spine
- Feeling like one is experiencing a heart attack
- Exhaustion
- Muscle spasms
- Feeling of physical weakness or limpness of the body
- Grinding teeth or tensing other muscles repeatedly or for prolonged periods of time
- Temporary blindness
- Sizzling or ringing in ears
Mental
- Intense and/or frightening realizations of reality
- Loss of the ability to react logically to stimuli
- Loss of cognitive ability in general
- Racing thoughts (often based on fear)
- Irrational thoughts
- Loud internal dialogue
- Feeling like nothing is real
- Feeling of impending doom
- Feeling of “going crazy”
- Feeling out of control
- Feeling like no one understands what is happening
- Vision is somewhat impaired (eyes may feel like they are shaking.)
- Feeling like you are going to die any second
- Avoidance behavior
- Agoraphobia
Emotional
- Terror, or a sense that something unimaginably horrible is about to occur and one is powerless to prevent it
- Fear that the panic is a symptom of a serious illness
- Fear that the panic will not subside
- Fear of losing control
- Fear of death
- Fear of living
- Fear of going crazy
- Flashbacks to earlier panic trigger
- Intense “scared” feeling
- Fear of failure
Perceptual
- Tunnel vision
- Heightened senses
- The apparent slowing down or speeding up of time
- Dream-like sensation or perceptual distortion (derealization)
- Dissociation, or the perception that one is not connected to the body or is disconnected from space and time (depersonalization)
- Feeling of loss of free will, as if acting entirely automatically without control
If you think that you are having panic attacks…
Panic attacks are not dangerous in themselves
If you are experiencing four or more of the symptoms listed by the DSM-IV for panic attacks within 10 minutes, you need to contact your doctor as soon as possible. Panic attacks are not dangerous in and of themselves, though you often feel like you’re dying. But the avoidance of the situations that trigger panic attacks can very rapidly lead to a severe constriction of your life, to Panic Disorder, and to Agoraphobia. The danger is not in the panic attacks, but in what they can lead to.
Panic attacks are one of the most treatable of the Anxiety Disorders, and many times a mental health professional can help you manage them without the use of drugs. The course of treatments is often not very long, and you will have the ability to control your condition for the rest of your life.
What do you think?
- Do you have panic attack symptoms that are not listed here?
- Can you describe your own panic attacks?
- What do you think of people who misuse the term “panic attack?”
What can you do now?
Your comments are always welcome, and are important to this blog’s community! Leave a comment now.
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©2008 Anxiety, Panic & Health. All rights reserved.
Resources used in this post:
Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition. Arlington, VA: American Psychiatric Association. 1994.
Wikipedia. (2008). Panic attack. Retrieved June 28, 2008 from Wikipedia Web site: http://en.wikipedia.org/wiki/Panic_attack
Related Posts:
- Are You Having a Panic Attack? What Can You Do?
- Conquering Your Panic: Dave’s Success Story
- Can Anxiety Disorder and Panic Attacks Be Cured?
- Anxiety Disorders: Just What Are They? – Part 2
- The Evil Trick Anxiety Plays on You and How to Turn the Tables
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Harry, I’m glad that your mind is relieved and that I was able to help you. You seem to be an accomplished young man, and I wish you all joy and good fortune in your life.
Thought I would post my experience with panic attacks. I’ve experienced what were probably Limited Symptom panic attacks since I was in elementary school. I remember feeling incredibly anxious, with nausea and tingling in my face. It happened every once in a while. Sadly this would occur more frequently when I would go over to a friends house. I have no idea why. Maybe separation anxiety that triggered LS panic attacks?
Anyway, I have always been very anxious, but I think there was a period of time where I didn’t experience panic attacks of any sort between maybe 5th and 7th grade. I started feeling chronically depressed. I experienced a full blown panic attack for the first time (in memory at least) in either 8th or 9th grade (at a friends house). I thought I was going to die. It didn’t make any sense at the time, because I had a lot of fun with her, and I had just gotten the ok to stay another day. Around this time I ceased being able to eat outside of my home/school because of LS panic attacks.
Increased anxiety in high school with what could be described as full blown panic attacks (but less severe than I would have later). You are right that avoiding panic attacks and triggers can ultimately lead to avoiding life. I spent most of my time at home. I started seeing a counselor because of (related?) depression and anxiety. Stopped seeing counselor after a few months of treatment. Continued feeling depressed, experiencing anxiety, a few LS panic attacks through the first few years of college.
A few years ago (’06) I started having full blown panic attacks with increasing frequency. It was summer, and I was on vacation (on a boat) when I had a particularly bad one. I think this is partially because there was no physical means of escape. I was on a boat. With a bunch of people. On the ocean.
My symptoms.
Blood rushing from my face, tingling in my hands and face, nausea, shakiness,
the feeling that my physical face was constricting my actual face (I cannot describe this any better.), heart palpitations (ku thunk-a.. it felt like when you go over a bump and it feels like your heart/stomach drops), very tense muscles, time slowed down, noise was irritating (people trying to talk to me was VERY irritating.), heat in my chest and stomach, sharp breathing, tunnel vision, having to shake my legs. I’d like to add that because I am stubborn, I went out the next day on another boat, and to my happiness, I did not get a panic attack.
After that summer I had a very, very rough semester. Multiple panic attacks ( maybe one prolonged attack with recurring symptoms?) during a class. I dropped down to one course (this one course I loved so much, it was a workshop type setup. When I had an attack I could simply walk out of the class and get some air/ sit by myself until it passed).
They became gradually less frequent over the past few years, with incidental full blown panic attacks (maybe 4-6 in a year? it’s hard to estimate) and small LS panic attacks.
I most recently experienced a prolonged full blown one yesterday. I was on what would be a 4 hour car ride to Boston and back. Ugh. This time though it wasn’t that my hands tingled, but they BUZZED. My legs too. It felt like I had my hand on a car thats motor was running, or like my extremities were in a field of really strong static electricity (or that they were generating one). First time I had experienced that, and I felt it when my other symptoms had started to subside a little bit. I had experienced an LS panic attack about a week ago when I made the same trip.
At this point, I know that I am not going to die when I get one. I think knowing this helps. I usually get through them by trying to alter my breathing (this is usually not successful in that it stops the attack, but this can make it less intense for me.) I become aware of my heartbeat and try to slow it with my breathing (note that this is very hard to do when you’re experiencing a panic attack, but if you can do even a little bit, it does help). I have found it helpful to press on my chest about three inches below where my collarbones hit my sternum. Sometimes I will run a line of pressure from there down to where my sternum ends. I also find it helpful to press on my neck at the base of my skull and at the sides of my neck underneath my jawbone (maybe repeated activities help? I’m not sure why these would help otherwise). I purposefully bounce my legs to let off some energy (they’ll shake anyway, so why not). Strangely this last time since the radio was on I found it soothing to follow along in my head with the songs I know. Talk though, continued to be very irritating. Anyone else experience this?
I.D.K- I’ll try that next time if I’m near a faucet.
If I am not in a confined space, I find somewhere that I can dispose of the excess energy by punching the air, kicking, running, ANYTHING active.
If I have access to water I put it on my neck and my chest.
Anyway, sorry for the long post, just felt like writing.
Hi there. I’m 14 years old and i have Panic disorder and agoraphobia… my life has been so difficult and I’m glad I found this article. Its really quite pleasant to know that I’m not alone because ever sincei first started getting these attacks, I’ve felt like I was all by myself with it. I’ve been better lately but i still get random “break outs” of panic attacks. I think I’ve started another one and I must say, I’m very scared. I just cant seem to keep my attacks away..
DO you have any methods are techniques that you know of that work? Please and thank you.
Anni
Hi Anni,
I’m very sorry to hear that you have been having panic attacks, but I’m very glad to see that you are trying to reach out and do something about it! As you can see, you are not alone; there are many people that suffer from this as well as many who had suffered and have been cured. In fact, there are probably people that you know which suffer from this (teens and adults), but they just don’t talk about it.
There are several things that you can do to begin down a path of recovery and release from this disorder, many of which are listed on this website or have been commented on by Mike and others.
The first most important thing is this: begin to do something about this now; don’t let it continue to keep hold of you. The longer you wait, the harder it’s going to be and the longer you have suffered. I waited for 8-9 years before ever doing something about it. At that point, I was having severe panic attacks and was increasingly “home bound” (or at least somewhere “safe”).
That said, there are definitely some very good books on this subject, one which I found very good is “Overcoming Panic, Anxiety & Phobias” by Shirley Babior. I found it helpful to understand what was going on in my body and mind when I suffered panic attacks, so that then I could see that (a) I wasn’t going to die from them and (b) how doing certain things could help/hurt the situation. (p.s. I wrote quite a bit about this in a post found here ( http://anxietypanichealth.com/2009/01/08/conquering-your-panic-daves-success-story/#more-667 ) as well as in previous comments in this blog entry above.
I believe that what is ultimately necessary is to seek help from a trained professional that specializes in treatment of panic disorder (this would be a psychiatrist). They will help you through both gaining control of your current symptoms and then to get to the root of the issue that is driving your panic attacks.
So – another important thing – have you discussed your panic attacks with anyone or have you been keeping this all to yourself? Have you talked to your parents about it? If not, then you need to. If yes, then what has their reaction been? Are they supportive in treating this? Many people don’t know what panic attacks are and so they just brush it off. They just need a little bit of an education and then they will understand both how real they are and how horrible and controlling it is.
Take care Anni! I’m sure we’ll all talk more… :-)
- Dave
Thank you so much! :)
To answer your questions,
yes ihave talked to my parents and most of the teachers at my school. My mother had panic attacks as well when she was younger. I’m also on medicationfor it and i do see a pyschiatrist. I’ve gotten panic attacks my whole life but was only diagnosed 2 years ago. The difficult thing about my attacks is that i get bouts of them. Sometimes i wont get them for a really long time and then ill start getting them everyday for a few months. I just really need to find out if there is any way of gaining full control for long-term amounts of time. And i feel as though, im the only person who gets these phases… So if any one else does, please let me know and tell me what you did about it. Im really quite desperate. I barely go out to see my friends because its just so hard for me to lewave home and im afraid of having another attack…
Thank you TONS,
Anni
Sara, thank you so much for your comment. Your description of what you do to dissipate a panic attack are very interesting, and I’m sure will be helpful to others. And no, your comment was not too long!
Many of the things you are doing — your breathing and the areas where your apply presssure — remind me of the Alexander Technique, a technique of body re-education and coordination. I learned about the Alexander Technique from a professor in music school as a way to relieve tension. I’ve applied them all my life, particularly as a way to reduce headaches and to head off a panic attack.
I’m sorry it’s taken so long to reply. I got involved in the big “Surviving the Recession”series and got way behind on comment follow-up.
Hi, Anni! Thank you for your comments. I want to be sure you know you have friends here who understand what you’re going through and want to help you.
One of the cruelties of Anxiety Disorders in general and panic attacks in particular is that you feel so all alone, like you are the only one in the world that is having these horrible experiences. But like Dave says, there are lots of people who have panic attacks and just are not showing it — have you thought that you are having panic attacks and not showing it to the people around you?
And you are not alone in having panic attacks! Up to 17 million Americans have panic attacks! That means that one in every 16 people you see has panic attacks! That also means that in every classroom you sit in and every mall you go to, you can look around and know that you are seeing someone else who has panic attacks!
One of the main bad things panic attacks do to you is to make you avoid the situations that cause them. But avoidance only makes the panic attacks worse — really! The mind focuses more and more on all the places and situations that you could have a panic attack, even though you have never had one in those places and situations. And guess what? You avoid those. And the mind thinks more, and you avoid more. As you can see, it gets worse and worse.
There are lots of techniques for calming a panic attack once it starts. There have been lots of good suggestions here in the comments on this post, particularly those of Sara. I’m sure your Mother and your psychiatrist can offer more. In addition, the reference article on Panic Attacks has a section toward the bottom entitled “What is the treatment for panic attacks” that has some helpful information.
But the thing I most want to emphasize to you is that you need to work on not letting your mind fantasize about all the places and situations you might have a panic attack in! All that fantasizing will do is to make you avoid more and more situations until you become a virtual prisoner in your own house!
Please keep in touch and let us know how you are doing. We are here for you, care about you, and want to know how you are doing!
P.S. I’m sorry I wasn’t able to respond immediately to your comment. I got way behind because I was working on a big project that took up all my time. Even my dog didn’t get petted like he is used to!
Dave, I just want to take a minute and thank you for all the help you have been to so many people on this blog! Not only the story of your successful treatment for panic attacks, but especially for all the comments you have made to help others. Your generosity and caring concern are an inspiration to me and to the many, many others who read them!
Hi Anni,
I’ve been thinking about your questions and how they related to my experiences. I definitely went through high and low times of panic attacks (high and low being more/less frequent as well as more/less severe). This was most likely traced back to what was going on at the time, how I was handling it personally, etc.
As you look at how this is happening in your case, you should be aware that your immune system does play a part in keeping your anxiety under control. When either your immune system is depressed (or under attack such as is the case with stress) or you are emotionally depressed, your anxiety levels may increase and the chance of a panic attack are higher because your body can’t “fight it”. This is sometimes counter-intuitive because we think of being “depressed” as not being anxious (just want to sleep, no energy, definitely not “hyped up”); almost seems like the opposite. But it works against us in this area. So for instance if you are run down, sick, having lots of homework or having relationship issues with friends at school, parents, etc., then these can all lead to heightened anxiety and contribute to an outbreak of attacks.
And many times, we may not “feel” stress, but the stress is felt sub-consciously (it’s there but we are unaware of it).
I was just talking about this to one of our friends who is 19. She deals with a lot of anxiety; one of her techniques for relieving herself from this is to work out a lot. But of course this is only a technique (which is actually a good thing assuming that it is not “over done”) to deal with the realities of her life.
One thing that I learned to do was to understand how tension/stress built up in my body physically. For me, I tend to hold it in my stomach and my shoulders. I was aware of my shoulders, but not my stomach for quite some time. Even right now as I’m writing this, I noticed that it is/was/is (ooops) tense :-). I’ve then also learned to relax these areas when I begin to feel the tension building; it’s become second nature for me at this point, but I had to focus on pro-actively relaxing – pretty much constantly at times.
I think a key thing here is to recognize this cycle in your body early on and keep it from increasing in strength before it turns into an attack or series of attacks. Yep, that takes “training” in order to do that, but it definitely can be done.
Are there certain techniques that your psychiatrist has been teaching you? Have some worked? Some not? Since you are still liking to stay home where it is “safe” (rather than go out with friends), he/she will need to guide you back out of this to where you are “free” again to enjoy the world. Have they started to do this with you yet?
Take care,
-Dave
Well ive taken quite a liking to yoga but unfortunately that technique isnt available to me when im, lets say, in class ,for example. And I think a lot of my stress is sub-concious because currently, i dont feel overly stressed at all. Perhaps i just need to get more in tune with my body and mind. I also feel like i get break-outs of attacks after i have a particularly bad one…which happens for very obvious reasons. Really, I just think that im not fully practiced in dealing with all of this yet but I believe that I can get through and i find that that belief is the key to winning.
Thank you tons for all your help, its given me so much hope!
Thanks again,
Anni
Hello my name is Paula and I had a panic attack a couple days ago. I actually had my first one about a month ago, I freaked out and went to Urgent Care where a Dr. said it was just that. It came out of the blue, I was at a birthday party eating pizza and I felt like I was going to faint suddenly, then everything else dizzyness, tingling fingers, short of breath, heart racing, disoriented, nausea. The only thing is that I actually am not stressed or anxious, could this be something else? I have 3 children (7 years, 3 years and 11 months) and I know if I were to get one while they are all home I would loose it . The Dr. prescribed Xanax and I did take one the 2nd time it happened a couple days ago. But that one was more intense, how can I stop them from getting worse? Another thing is I don’t have med. ins. and open enrollment is Aug. and won’t kick in until 2010. Does anyone know of low cost or free therapy for Panic attacks??
Anni, I’m so glad this discussion is helping you!
A lot of panic attack therapy is geared toward getting more in touch with your body and your mind. There are several available besides yoga: meditation, and learning to relax come to mind right away.
And you are right! Belief that you can get through panic attacks and learn to control them is the biggest and most important step you can take. There are lots and lots of people who have done this, so you do not have to be a victim!
Please keep us informed of your progress! And remember, we are always here for you!
Paula, thank you for your comment!
I’m sorry you’re having panic attacks. They do come out of the blue seemingly for no reason, and are very frightening and confusing. But panic attacks are one of the most treatable of the Anxiety Disorders, and there’s a very good chance that you can learn to control them in a very short period of therapy.
There’s a lot you can do before you are able get therapy, though. Here’s a few things:
I would recommend you read my reference article on Panic Attacks for an in-depth understanding of what they are and how they affect you. There are some tips there too for dealing with them while they are happening. The article Are You Having a Panic Attack? What Can You Do? has more insights and some of the same information.
There are three things you can do immediately to help your Panic Attacks: 1) believe that youcan overcome them, 2) list your symptoms separately so that you can learn to deal with them one at a time (a therapist would have you do this), and 3) always remind yourself that a Panic Attack is not medically harmful, that you’re not dying, and it will go away in just a few minutes.
Your request for information on free mental health care has inspired me to write an article about it. But in the mean time, here are some resources for you, all free:
A guide to find education and screenings locally: Mental health education and screenings
A great article full of resources: Where can you get low cost/free Mental Health Care?
Some ideas about where to find care: Affordable Mental Health Care: How to find free or reduced-fee treatment in your area
These are all national resources that will help you find local mental health care in your area. There are many state organizations, too, but since I don’t know where you live, I didn’t list them. I found all these with a quick search on “free mental health care” on Google.
I wish I could help you more, but I hope this information will get you started.
Please keep in touch, either through the comments on this article, or emailing me directly using the “Contact” tab at the top of every page.
My husband has been having a number of different symptoms. Feeling like his heart is going to stop, numbness in his back, insomnia, nausea, etc… He has been to every doctor with everything coming back normal, several have put him on meds for anxiety that he has not taken yet. He has set in the hospital parking lot night after night just in case something happened. We also have two small children that he can barely be around because he starts having an “attack” Every doctor has told him hes okay and I believe it but unfortunately he can’t , what do you suggest>?
Charlotte, thanks for the comment. I’m really sorry your husband is having such a hard time.
You say your husband has had panic attack-like symptoms and has been checked out by physicians, and even given prescriptions that he hasn’t taken. It seems to me that he is somehow denying to himself that he has a mental condition that must be addressed. He is willing to entertain all sorts of dire physical conditions, but not willing to admit that he might have a mental condition.
This is very, very common. Denial is probably the biggest reason why people don’t get treatment for mental illnesses. I’ve written an article entitled “Denial: Why People Don’t Get Treatment for Anxiety” about the subject, so won’t go into it in depth here.
Panic attacks are one of the easiest and quickest of the Anxiety Disorders to treat. The best treatment is to see a mental health professional for therapy. It generally takes only a couple of months of weekly therapy sessions to learn to control panic attacks for life. Incidentally, the medication is intended to give your husband the space he needs to seek out more long-lasting help. It will not be a “cure” in the long term.
Urge your husband to see a mental health professional. I know he probably is very resistant, but he will not get better until he does. If you can, get him to read “Conquering Your Panic: Dave’s Success Story”, which describes a man in a situation that seems to be very similar to that of your husband’s.
Please keep me updated on his progress. You can use the comments here, or email me privately using the “Contact” tab at the top of each page.
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