What does a panic attack feel like?
A panic attack comes on quickly, often for no apparent reason. It can happen at any time, sometimes even during sleep. Symptoms are both physical and emotional, and they can include:
- A pounding or racing heart
- Trouble breathing, or a feeling of smothering or choking
- Chest pain or discomfort
- Sweating, chills or hot flashes
- Trembling or shaking
- Weakness, dizziness or feeling faint
- Numbness or tingling in the hands, feet or face
- Nausea or stomach pain
- Feeling detached from your body or as though things are not real
- A fear of dying, of losing control, or of impending doom
How long does a panic attack last?
Published estimates vary a little, and attacks vary from person to person. The National Institute of Mental Health says a panic attack can last from a few minutes to an hour or sometimes longer. MedlinePlus says an attack most often peaks within 10 to 20 minutes, with some symptoms continuing for an hour or more. The UK's National Health Service says most last 5 to 20 minutes, with some reported to last up to an hour.
The physical symptoms usually fade with time. Many people with panic disorder then worry about when the next attack will happen.
How do I know whether chest pain is panic or my heart?
You cannot reliably tell on your own, and you should not have to. Chest pain, a racing heart, sweating, nausea and shortness of breath can happen in a panic attack, and they are also on the list of symptoms that call for emergency care. Chest pain has many possible causes, and some of them are life threatening.
Treat chest pain as a medical question first
- Call 911 if you have sudden crushing, squeezing, tightening or pressure in your chest, or if pain spreads to your jaw, left arm or between your shoulder blades.
- Call 911 if chest pain comes with nausea, dizziness, sweating, a racing heart or shortness of breath.
- Do not assume it is panic because you have had panic attacks before. People with panic attacks can also have heart or lung problems.
- Going to the emergency room is not an overreaction. Many people with panic disorder first seek treatment there, because the attack feels so much like a heart attack.
Are panic attacks dangerous?
Once a medical cause has been ruled out, there is some reassuring news. The National Institute of Mental Health says panic attacks themselves are not life-threatening, and physical symptoms usually resolve with time. Some researchers think of them as false alarms, in which the body's normal survival response switches on too often or too strongly.
That does not make them minor. An attack can be frightening and distressing, and the fear of the next one can start to shape your life. Mentioning your attacks to a health care provider is how you find out what is behind them.
What is the difference between a panic attack and panic disorder?
Having one panic attack does not mean you have a disorder. Not everyone who has a panic attack will develop panic disorder. What matters is whether attacks keep happening unexpectedly and what they do to your life between attacks.
| Question | Panic attack | Panic disorder |
|---|---|---|
| What it is | A one-time or occasional episode of intense fear with physical and emotional symptoms | Recurrent, unexpected panic attacks, often interfering with daily life |
| Is it a mental disorder? | An isolated attack is not | It may be diagnosed by a health care professional |
| Between attacks | Some people feel ongoing anxiety about another attack | At least 1 month of worrying about more attacks, fearing what they mean, or changing behavior to avoid them |
Why does avoiding things sometimes make panic worse?
It makes sense to stay away from a place where something frightening happened. Over time, though, avoidance can feed what the UK's National Health Service calls living in fear of fear, which can add to the sense of panic. Some people become afraid to be alone or far from medical help. Agoraphobia, an intense fear of places where escape or help might be hard to get, can sometimes develop alongside panic disorder.
Noticing that your world is getting smaller is a good reason to get help, even if the attacks themselves are rare.
What can care for panic attacks involve?
A first step is making sure nothing else explains the symptoms, which may include a physical exam, a mental health assessment and sometimes blood tests. Other conditions, including depression and thyroid problems, can occur alongside panic disorder.
Treatment typically involves psychotherapy, medication, or both. Cognitive behavioral therapy teaches different ways of thinking, behaving and reacting to the sensations of an attack, and attacks can become less frequent as people learn this. Exposure therapy, sometimes with relaxation and breathing training, helps people return to activities they have been avoiding. Medications used for panic disorder include antidepressants such as SSRIs and SNRIs, which may take several weeks to work. Getting enough sleep and exercise and reducing caffeine may also help, although habits alone cannot replace treatment.
Any decision about medication comes after an evaluation and is made with you. Not every medication can be prescribed at every kind of visit, some may require an in-person appointment, and we explain what applies to you. Our medication management page describes follow-up care. Please talk with your prescriber before starting, stopping or changing a medication.
What is care like at DanShalom Behavioral Clinic?
Your first visit is a conversation of about 60 minutes with Victor Onodjacha, MSN, PMHNP-BC, a board-certified psychiatric-mental health nurse practitioner, either in our Sugar Land office or by secure video if you are physically in Texas, Idaho, Arizona or Maryland at the time. It helps to note when attacks started, how often they happen and what you have begun to avoid. You can read more about anxiety disorders and how we evaluate them. Ask us which kinds of therapy can be provided here and when a referral to a dedicated therapist makes more sense.
We are not an emergency service. For possible heart or breathing emergencies, or if there is immediate danger, call 911. For a mental health crisis or thoughts of suicide, call or text 988.
When to seek urgent or higher-level care
An outpatient clinic is the right place for evaluation and ongoing care. It is not the right place for an emergency. Get help right away if you or someone you care for:
- Sudden crushing, squeezing or tight pressure in your chest
- Chest pain that spreads to your jaw, left arm or between your shoulder blades
- Sudden, sharp chest pain with shortness of breath
- Symptoms you have never had before, when you cannot tell whether this is panic or a medical emergency
- Thoughts of suicide or of harming yourself
Call or text 988 (Suicide & Crisis Lifeline), call 911, or go to the nearest emergency room. More crisis resources
Questions patients ask
Can a panic attack happen while I am asleep?
Yes. The National Institute of Mental Health notes that panic attacks can occur at any time, sometimes even during sleep. Waking suddenly with a racing heart and fear can be very frightening. If it keeps happening, tell a health care provider so they can check what else may be involved.
If tests at the emergency room were normal, what should I do next?
Follow any instructions you were given and share the results with your primary care provider. If attacks are interfering with your work, relationships or self-esteem, it is a good time to contact a mental health provider. Bring your discharge papers if you have them, since they show what has already been checked.
How often do panic attacks happen?
It varies widely. They can occur as often as several times a day or as rarely as a few times a year. Frequency alone does not decide whether someone has panic disorder. Ongoing worry about future attacks and changes in behavior because of them matter as well, so mention both at a visit.
How is a panic attack different from everyday anxiety?
Panic comes on suddenly and intensely, with strong physical symptoms, while ongoing worry tends to build and linger over days or months. Some people experience both. Our guide on normal worry and anxiety disorders explains the signs that long-lasting worry may need an evaluation.
How do I request a visit, and what will it cost?
Send a short appointment request or call us. We check your coverage before the first visit. We accept many major plans, which differ by state, and also offer self-pay and a sliding scale. Our insurance page has the current details, including our cancellation policy.
References
Reviewed by Victor Onodjacha, MSN, PMHNP-BC, . This page is general information, not medical advice or a diagnosis.