Panic Attack Symptoms: What You May Feel and When to Get Help

Emergency signs first: when it may not be panic

Panic attacks and heart problems can share symptoms. The American Heart Association (AHA) article lists chest pain, heart palpitations, shortness of breath, lightheadedness and nausea, and quotes a cardiologist, Dr. Glenn N. Levine, saying that the symptoms of a heart attack and a panic attack are so similar that it sometimes can be hard to tell the difference. He says: "If in doubt, one would want to err on the side of caution and be quickly evaluated in an ER to make sure this was not a heart attack."

Cleveland Clinic says that if you have chest pain, trouble breathing or lose consciousness, you should seek emergency medical care. The NHS says to call 999 in the UK if you have chest pain that feels tight or like squeezing on your chest, chest pain that is spreading to your arms, neck or jaw, severe difficulty breathing (gasping, choking or not able to get words out), pale, blue or grey lips or skin, or if someone has passed out and is not responding normally.

• Chest pain, trouble breathing or loss of consciousness: seek emergency medical care (Cleveland Clinic).
• Chest pain that feels tight or like squeezing, or that spreads to your arms, neck or jaw: call 999 in the UK (NHS).
• Severe difficulty breathing, or pale, blue or grey lips or skin: call 999 in the UK (NHS).
• In the U.S., the AHA article says that for a heart attack, calling 911 and getting immediate treatment is critical.

The symptoms the NHS lists

The NHS describes a panic attack as a rush of intense mental and physical symptoms that can come on very quickly and for no apparent reason. Its list of symptoms is below. The NHS adds that although panic attacks are frightening, they are not dangerous: an attack will not cause you any physical harm.

• A racing heartbeat
• Feeling faint
• Sweating
• Nausea
• Chest pain
• Shortness of breath
• Trembling
• Hot flushes and chills
• Shaky limbs
• A choking sensation
• Dizziness
• Numbness or pins and needles, and a tingling in your fingers
• Dry mouth
• A feeling of dread or a fear of dying
• A churning stomach
• Feeling like you are not connected to your body

What Cleveland Clinic and NIMH add

Cleveland Clinic lists the physical symptoms of a panic attack as chest pain, a racing heart, difficulty breathing (such as hyperventilation), trembling or shaking, chills, nausea, sweating, and tingling or numbness in the fingers or toes. It adds that you may feel intense terror, a choking or smothering sensation, fear of losing control, or like you are going to die, and may have derealization (feelings of unreality) or depersonalization (feeling detached from yourself).

The National Institute of Mental Health (NIMH) lists physical symptoms that may include a pounding or racing heart, sweating, chills, trembling, difficulty breathing, weakness or dizziness, tingly or numb hands, chest pain, and stomach pain or nausea. It also describes a feeling of being out of control and a fear of death or impending doom.

How long the symptoms last

Cleveland Clinic says a panic attack happens suddenly, and that the symptoms usually peak within 10 minutes after it starts and then disappear soon after. The NHS says most panic attacks last between 5 and 20 minutes, and some have been reported to last up to an hour. NIMH says the physical symptoms usually resolve with time.

Cleveland Clinic says to call a healthcare provider if panic attack symptoms last longer than 15 minutes.

Heart, breathing and chest symptoms

A racing or pounding heart, trouble breathing and chest pain appear on all three lists (the NHS says shortness of breath, Cleveland Clinic and NIMH say difficulty breathing). Cleveland Clinic lists difficulty breathing, such as hyperventilation, and says that hyperventilating can increase fear. NIMH says panic attacks often include physical symptoms that might feel like a heart attack, such as trembling or tingling in the body or a rapid heart rate.

Because these symptoms can have other causes, the NHS says most of the symptoms on its list can also be symptoms of other conditions or problems, so you may not always be experiencing a panic attack. As an example, it says you may have a racing heartbeat if you have very low blood pressure. This page cannot tell you which it is, which is why the emergency signs above come first.

Feeling dizzy, tingly or unreal

Dizziness and feeling faint are on the NHS list, and NIMH lists weakness or dizziness. Numbness or tingling is on both the NHS and Cleveland Clinic lists: in the fingers for the NHS, in the fingers or toes for Cleveland Clinic. Cleveland Clinic also lists derealization, a feeling of unreality, and depersonalization, a feeling of being detached from yourself. The NHS list includes feeling like you are not connected to your body.

Cleveland Clinic says a panic attack can make you feel detached from reality or your body, and suggests practising mindfulness and focusing on the present to centre your thoughts and ground yourself. If these feelings are frequent or last, talk to a doctor.

How to settle it

The NHS suggests that when you feel a panic attack coming on, you stay where you are, if possible, breathe slowly and deeply, remind yourself that the attack will pass, focus on positive, peaceful and relaxing images, and remember that it is not life threatening. Cleveland Clinic suggests acknowledging that you are having a panic attack, which it says can help manage the fear, and relaxing your muscles one group at a time.

Our step-by-step guide to stopping a panic attack goes through these in order.

Getting checked

This page is self-help and cannot tell you what is causing your symptoms. Cleveland Clinic says that if you have had symptoms of a panic attack it is important to see a healthcare provider, who can give you an official diagnosis and make sure there is no underlying physical cause, and that a provider may run tests to rule out conditions that cause similar symptoms, such as heart disease, thyroid disease and respiratory problems. The NHS says a GP may carry out a physical examination to rule out other conditions that could be causing your symptoms.

If you ever have thoughts of harming yourself, contact emergency services or a crisis line straight away. In the U.S., you can call or text 988 (NIMH).