Are You Having a Panic Attack?

Have you ever suddenly experienced a rapid heartbeat or shortness of breath alongside a surge of overwhelming anxiety or fear? Did you wonder if you were dying, only to have the feelings go away within minutes or a half-hour?

Chances are, what you experienced was a panic attack.

So what is a panic attack, and how do you know the difference between a panic attack or something more serious, such as a heart attack? We asked UNC Health psychiatrist Mary Kimmel, MD, these and other questions about this frightening experience.

What is a panic attack?

A panic attack is a sudden episode of intense fear that triggers a physical reaction, a primitive response in your body that doesn’t match the actual threat. Put another way: Your nervous system feels like you’re in grave danger even though you’re probably safe.

“Your body is trying to protect you by going into fight-or-flight mode,” Dr. Kimmel says.

Many people have had panic attacks at a highly stressful moment. For example, if you have a fear of heights and you walk across a tall bridge and look down, it’s expected that you’ll feel intense fear. Your heart will pound and you may feel unable to move your legs.

People with panic disorder have these episodes seemingly out of the blue. Their panic attacks are often unprovoked and unexpected and can even wake them up from sleep. The fear of having a panic attack may cause them to avoid certain places or situations.

What are the signs of a panic attack?

The symptoms of a panic attack vary by person but can include:

  • A rapid heart rate
  • Sweating
  • Shaking
  • Shortness of breath or inability to catch a breath
  • Feeling of being choked or smothered
  • Chest pain
  • Nausea
  • Dizziness
  • Blurry vision
  • Chills or feeling hot
  • Tingling sensations
  • An out-of-body feeling
  • Trouble focusing or, in contrast, feeling hyperaware of your surroundings

“The reason people think they’re going to die is that they’re having physical symptoms that feel like an emergency,” Dr. Kimmel says. “It’s a sense of impending doom.”

Panic attacks usually resolve on their own in a matter of minutes, and it’s uncommon for a panic attack to last more than 15 to 20 minutes—though for the person experiencing one, that time might feel much longer. It’s important to know that panic attacks are not life-threatening, though they often feel that way.

Who gets panic attacks?

Panic attacks are very common; most people at some point feel overwhelmed and panicked, Dr. Kimmel says. Panic disorder, characterized by repeat panic attacks, affects nearly 3 percent of Americans each year and from survey data has been found more common in women than men. Those with panic disorder are also more likely to have depression or other anxiety disorders.

How can you stop a panic attack?

When a panic attack strikes, you can try accepting that you’re feeling panicked and commit to moving through it, knowing that no panic attack lasts forever, Dr. Kimmel says.

“As you move through it, over time your system learns, I don’t have to be in fight-or-flight in this situation,” she says.

Dr. Kimmel says it’s not typically helpful to try to ignore the panic or try to distract yourself from it. Instead, consider bringing other things to your experience when you feel panicked. These might include breathing exercises, calling a friend, going for a walk or utilizing your five senses: smelling a scented candle or rubbing lotion on your hands, for example.

How can you tell the difference between a panic attack and something more serious?

Panic attacks can feel like heart attacks and other scary medical emergencies. It’s not always easy to tell the difference, especially when you’re panicking, and it’s very common for people to go to the emergency department during or after a panic attack. If that happens to you, “be kind to yourself,” Dr. Kimmel says. “It’s always OK to seek help, and panic attacks are not ‘all in your head.’ The stress system is a complex mix of multiple systems that engage to try to protect us.”

Doctors want you to err on the side of caution if you’re having chest pain, trouble breathing or intense pain or physical sensations. If a life-threatening condition is ruled out, then you can find out what treatment options are available for panic disorder.

It’s helpful to talk with a physician about your risk factors for heart conditions and risk factors for panic disorder, Dr. Kimmel says. “Of course, an individual can have risks for both and having had past medical emergencies can increase the sensitivity of an individual’s stress system,” she says. “Having a relationship with a primary care physician will help you feel more confident about what is going on with your health and in navigating an episode of panic.”

If you think you might be experiencing a heart attack, call 911 or go to the nearest emergency department. If you think you may be having a panic attack, call your doctor. Need a doctor? Find one near you.