What is a panic attack?

Posted On June 11, 2019

Palo Alto Health Sciences is starting a blog series about panic attacks, panic disorder, and panic-related conditions. Let’s begin by getting all of us on the same page by defining the panic attack.  Panic attacks have three distinct characteristics:  1.  An abrupt surge of fear that ordinarily will last for 10 to 30 minutes, 2.  A variety of intense and unpleasant physical symptoms, and 3.  Fearful psychological experiences related to the attack.

The most common physical symptoms1 are:

1.  Pounding heart, 2. Sweating, 3. Trembling or shaking, 4. Shortness of breath, 5. Sensations of choking, 6. Chest pain or tightness, 7. Nausea or abdominal distress, 8. Dizziness or faintness, 9.  Chills or heat sensations, 10. Numbness or tingling sensations.

When individuals experience  a sudden onset of these physical symptoms, it’s no surprise that the panic attack can seem like a medical emergency, often with a fear that one is having a heart attack or even dying.  Common also is a fear of losing control or ‘going crazy’. Some people may feel a sense of depersonalization or that the experience is ‘unreal’.

It’s also understandable that such intense and terrifying experiences would change behavior.  The physiological symptoms often prompt panic sufferers to go to the emergency room or to multiple doctors searching for diagnosis and explanation.  Recurrent panic attacks also generate avoidance behaviors:  staying away from experiences or situations (such as airplane travel, crowded elevators, busy freeways, and closed spaces) that provoke fears of the next panic attack. Fear of social situations, making presentations, or phobic fears (heights, snakes, spiders) may be panic triggers.  Fear behavior may grow to the point that ordinary activities are avoided, undertaken with great trepidation, or only while on tranquilizers.

Panic attacks can seem quite mysterious, coming ‘out of the blue’ or provoked by situations that others seem to take in stride.  Panic sufferers may be told, “It’s all in your head,” but that’s an insulting over-simplification. In this series, we’ll discuss the physiology and genetics of panic, talk about how panic attacks can co-occur with a wide variety of psychological and medical conditions, and discuss new approaches to treatment.

Next time, we’ll delve into the fascinating history of panic. Stay tuned.


  1. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA
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