I’m Dying: What a Panic Attack Feels Like

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?”

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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