Panic Attack? Get the Facts!

young depressed woman sitting on kitchen floor sad and wasted“I felt like I was going to pass out!”

“I felt like I was going crazy!”

“I thought I was having a heart attack!”

This is how people frequently describe what it’s like to have a panic attack.

A panic attack is a sudden rush of anxiety and terror. It can occur at any time, even during sleep, and frequently seems to happen suddenly, out of the blue. Symptoms include a pounding heart, sweatiness, weakness, faintness, or dizziness. People in the grip of a panic attack may also experience nausea, chest pain, tingling or numbness in their hands, a sense of impending doom, or a fear of losing control.

It is unclear exactly what causes panic attacks. They appear to be correlated with major life transitions, such as graduating from college, getting married, or having a baby. Panic attacks can also be triggered by severely stressful events, such as the death of a loved one, divorce, or job loss.

Some people have one or two panic episodes and then never have another. Other people begin to have recurring panic episodes. One of the ways that one episode can turn into an ongoing problem is anticipatory anxiety. People begin to fear having another panic attack and feel anxious and tense instead of relaxed. They are afraid of their own fear. Three of the biggest fears about having panic attacks are:

  • “I’m afraid I’ll pass out.”
  • “I’m afraid I’ll go crazy.”
  • “I’m afraid I’m really having a heart attack.”

In fact, none of these things can actually happen during a panic attack.

When the panic starts, people feel a temporary dizziness, frequently exacerbated by hyperventilation, which makes them feel like they may pass out. During a panic attack, however, the heart beats faster and blood pressure rises. It is impossible to pass out as blood pressure rises, because people actually pass out due to a lowering of blood pressure.

Being “crazy” means that a person has lost contact with reality. No one has ever “gone crazy” from a panic attack. When people have panic attacks, they are intensely aware of reality—in fact, they are too much in contact with reality. They are very focused on what is happening and the symptoms they are experiencing. People having a panic attack are not “crazy,” and cannot “go crazy” during an attack.

A person experiencing a panic attack is not experiencing heart problems. There are several significant differences between panic symptoms and heart attack symptoms:

  • Hyperventilation almost always precedes a panic attack, and heart attack victims do not hyperventilate.
  • In a panic attack, chest pain is located over the heart and can be described as sharp and intermittent. In a heart attack, the chest pain is focused in the center of the chest and is crushing, as if a heavy weight is on the chest. It is a persistent pain and may radiate to the left arm, neck, or back.
  • During a panic attack, there may be a tingling sensation over much of the body, while during a heart attack, tingling is in the left arm only.
  • People rarely vomit during a panic attack, but vomiting is common during a heart attack.
  • Symptoms of a panic attack can disappear in less than five minutes if deep breathing, relaxation, and self-talk techniques are used. Heart attack symptoms last longer than 10 minutes and do not respond to deep breathing or relaxation techniques.

It is always advisable to seek immediate help if it is not clear that the symptoms are related to panic. If the location of chest pain moves to the center of the chest, does not go away within ten minutes, and is accompanied by more than one incident of vomiting or diarrhea, seek immediate medical attention.

While panic attacks are intensely frightening experiences, they do not cause actual physical harm to the body. Learning the facts about panic attacks and remembering them during an episode can help cut down on the occurrences of attacks and eventually help to eliminate them.

© Copyright 2009 by Becki Hein, MS, LPC, therapist in Mckinney, Texas. All Rights Reserved. Permission to publish granted to GoodTherapy.org.

The preceding article was solely written by the author named above. Any views and opinions expressed are not necessarily shared by GoodTherapy.org. Questions or concerns about the preceding article can be directed to the author or posted as a comment below.

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  • Cassie V.

    December 22nd, 2009 at 4:49 PM

    Ohhhhhh!! I think I had one of those and didn’t know it. Does you become “spaced out”? Like a clockwork toy that has wound down and just stopped? That’s how I would describe the episode. It was as if my mind had been wiped of all thought. I felt very nervous too. It only lasted perhaps three minutes and I was very conscious of the fact that I couldn’t think, which made it scary. Thanks Becki.

  • Miek

    December 22nd, 2009 at 5:50 PM

    I agree with most of your article, but let’s consider ‘angina pectoris’ too… So the duration of the complaints and also (even when one has an heart attack) the place and the type of the pain patients are feeling, aren’t so obvious like you wrote it here. Also, panic can be a provocative factor of angina or a heart attack. Even for a doctor it isn’t always clear what the patient has. An ECG can help to make the differential diagnosis.
    Unfortunately, cases as these, aren’t an exception…: ncbi.nlm.nih.gov/pubmed/15259595

    I don’t say that every pain on the chest has to been seen by a doctor, surely not. We don’t need to increase somatisation by these people.
    But if it’s the first time, or if the person has risk factors for angina or a heart attack, you would better be careful.

  • Katherine

    December 22nd, 2009 at 6:12 PM

    What can you do if you’re in a public place when it happens? I have a fear of falling apart in front of strangers. So far any I had happened at home, late at night. My father would be horrified if I were to make a public spectacle of myself.

  • Shona

    December 22nd, 2009 at 6:30 PM

    Hi Becki. Thank you for a good read. I’ve not had a panic attack although feel that I’m heading towards one due to workplace stress. I’m at my most anxious at work and can’t just go off to find a spot to meditate. Can you suggest what steps could I take to settle myself down when I’m on the job that would be discreet? Our office is open plan.

  • Nathaniel

    December 22nd, 2009 at 7:24 PM

    Meik, thanks for the additional information. What is the meaning of somatisation please? I didn’t understand your phrase: “We don’t need to increase somatisation by these people.”

  • Pearl

    December 22nd, 2009 at 8:03 PM

    It is so good to see the differences between a heart attack and a panic attack laid out in such a clear, easy manner. When you get to my age, you want to know how to tell them apart and fast. Thanks Becki!

  • danielson

    December 23rd, 2009 at 1:48 AM

    Well I just think it is very important for an individual to think for himself and make sure that he does not troublem himself by getting under unnecessary worries. Although no one’s life is without problems and issues, it is far better to think of getting a solution to the problems and issue than to fret about them and afftect our health!

  • Sandy

    December 23rd, 2009 at 5:55 AM

    Why is it that some people simply are more prone to experiencing panic attacks and yet there are other people who never have to experience this feeling? I have had one before in my life that I can pinpoint and it was a dang scary feeling, nothing that I would veer wish on anyone else.

  • Miek

    December 23rd, 2009 at 9:08 AM

    Nathaniel, I meant to say that you can’t help people who are suffering of panic attacks, by telling them over and over again that there is maybe something wrong with their heart. Somatization means that one expressess his psychological and social stress by physical symptoms. So, in that case, it’s wrong to give attention only to the body sensations and not to the real cause: the psychological and social factors.(see also: http://en.wikipedia.org/wiki/Somatization).
    So I think it’s important to exclude a disease of the heart, especially the first time someone has a panic attack, or if someone has risk factors for a heart attack. But a professional (doctor, psychologist) won’t help someone with panic attacks if he always think: ‘Oh, I hope he hasn’t got a heart attack!’. Most of the time it’s really clear for a doctor or a professional to see if someone has a heart attack/ angina or a panic attack. But the symptoms that are described here aren’t always as clear! The symptoms are the symptoms for a ‘model’ patient with a heart attack. But, ‘models patients’ are rather rare in the real world. So, if you had a panic attack for the first time, I think it’s better you speak about it with your physician. He/ she knows you better and knows better when you need a physical examination or, hopefully and most of the time, when there is no reason to worry and you probably had a panic attack.
    I’m telling this as a physician and as a student in psychology (who speaks no English, normally, so that’s the reason why sometimes I’m not totally clear ;o) ).

  • carmella Q.

    December 23rd, 2009 at 4:31 PM

    My uncle once had a panic attack and as there was nobody else in the house at that time, I had to go and be by his side and his reaction almost gave me a panic attack! I was so frightened and dialled emergency…

    I think each one of us must educate ourselves about this and will be in a better position if we or anybody around us happens to have a panic attack.

  • Becki Hein

    Becki Hein

    December 31st, 2009 at 9:38 AM

    Thanks for all your comments!
    re: Cassie: So far, “spaced out” is not a description I’ve heard used for a panic attack. Most people report that their thoughts are racing. If you have any doubt about what you’ve experience, I always recommend checking with a doctor.

  • Becki Hein

    Becki Hein

    December 31st, 2009 at 9:42 AM

    re: Meik: I totally agree! Thanks for your comments. The heart attack symptoms I listed are “classic” and there can sometimes be other less common symptoms too.

    I always say, especially if it’s a person’s first “panic” experience, get checked out by a doctor. There’s nothing wrong with eliminating other possible problems by seeing a doctor.

  • Becki Hein

    Becki Hein

    December 31st, 2009 at 9:45 AM

    Re: Shona
    Wow, I’m sorry your workplace is so stressful. You might check out my previous blog article:http://www.goodtherapy.org/blog/self-calming-skills/

    In it I talk about grounding your excess energy and how proper breathing can help alleviate symptoms of anxiety.
    Thanks for your comment!

  • Becki Hein

    Becki Hein

    December 31st, 2009 at 9:51 AM

    re: Katherine
    Many times people start being fearful of having another panic attack, especially in public. Fear just increases the probability that it might happen. I think one of the best ways to combat this is to be prepared. Practice your breathing and grounding skills every day. (EVERY DAY!) That way your body is used to calming itself quickly and easily. Then use your logical thinking. You know that the panic symptoms are not harmful so as soon as you feel any symptoms coming on, start your breathing, grounding, and “talking yourself down”. Use phrases such as ” I am healthy, strong, and calm”. Some people find that chanting words like this over and over (to themselves if in public) can help re-focus their minds. Some people count. Anything to get your attention off of your symptoms. Read more about grounding here at my previous blog article:
    http://www.goodtherapy.org/blog/self-calming-skills/
    Thanks for your question!

  • Joan

    December 31st, 2009 at 8:58 PM

    This is a fascinating thread! Thank you Becki.

    Can young children have panic attacks too? I saw a five year old have what her mother thinks could be the start of asthma because there’s a family history. I would have said it was more like a panic attack. They had been arguing just before I arrived.

  • John

    January 19th, 2011 at 3:30 PM

    Becki I think people could cut down panic attacks and anxiety if they target the source of the anxiety and try to change their thought patterns. I’ve also written a number of articles on my site which my be helpful.

  • Gabriella

    May 11th, 2012 at 4:09 PM

    I am a regular sufferer of panic attacks that were work related, since I have stopped work I haven’t had one in 7 months when they used to be weekly. Today I was quite disappointed. That I suffered from one, I think because of rapid life changes that I feel are out of my control. I was happy that I was able to implement breathing techniques and focusing on something in the room and telling my self it will pass soon, it has to end. I then out on a meditation cd and relaxed withing five minutes- it felt good to know what was happening and how to deal with it- and win the battle !

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