Anxiety

Chest Pain, Choking, and Other Symptoms of a Panic Attack

13 symptoms of panic disorder and panic attacks.

Posted Feb 22, 2021 | Reviewed by Lybi Ma

Key Points:

  • Panic attacks are anxiety-related events and not triggered by physiological causes
  • For people with panic disorder, the fear of a panic attack can be more debilitating and harmful than the panic attack itself
  • It is important to physically check whether the person is actually suffering from a cardiovascular medical emergency
  • Here are 13 symptoms of panic attack

The word “panic” is often misused, and people say that they are panicking about something when they actually mean they are somewhat worried. For someone having a panic attack, the symptoms are a physiological experience as well as a psychological state of mind. A panic attack is a serious condition that can make a sufferer feel like they are dying, having a heart attack, or completely out of control of their body. It is therefore important to know the American Psychiatric Association’s Diagnostic and Statistical Manual (DSM-V) criteria for the diagnosis of a panic attack and to be aware of cases where the symptoms might fit the criteria.

DSM-V stipulates that a panic attack comprises of any of four or more of the following symptoms, often following from a sudden feeling of fear that becomes magnified within minutes:

  1. A person having a panic attack can feel like they cannot breathe or look like they are breathless.
  2. They may experience pain within the chest area. It is important to physically check whether someone who suspects they are having a panic attack is actually suffering from a cardiovascular event, which is a medical emergency.
  3. A person experiencing a panic attack might feel a choking sensation within their neck or throat area.
  4. They might feel dizziness or light-headedness.
  5. They might feel like they are dying or fear that they are about to die.
  6. A person with a panic attack might feel afraid that they are going “crazy.”     
  7. They might feel very cold or very hot.
  8. They might feel a sense of derealisation, a feeling of being detached from reality.
  9. A person experiencing a panic attack might feel like their heart is pounding. It is important to ensure that they are not suffering from a cardiovascular emergency requiring immediate medical attention.
  10. They might feel nauseous with diarrhea and other signs of gastrointestinal or stomach upset.
  11. They might feel a sense of tingling or numbness within their body.   
  12. A person experiencing a panic attack might be shaking uncontrollably, such as having trembling hands or limbs.
  13. They might experience sweating that is unconnected to room temperature and without having exercised.

People who have had panic attacks before are at risk of having them again but it is important to remember that one panic attack in itself does not mean that a person has panic disorder. A person with panic disorder typically suffers from recurrent panic attacks comprising of a sudden onslaught of a feeling of fear that grows to a high level within minutes. Around that time, the person experiences four or more of the above symptoms of a panic attack.

In cases where a person has panic disorder, the panic attacks are not just recurrent but also followed by abject fear of having another panic attack for at least one month after one or more panic attacks.

Some people who have never had a panic attack are at risk of having them in situations with heightened anxiety but it is important to note that the triggers of panic attacks are not necessarily predictable to people. They can occur at unexpected moments therefore they are not always something that people with panic disorder (or anyone who has a panic attack) can predict or prevent.

In cases where drugs or medication induce symptoms akin to a panic attack, the condition is not labeled a panic attack. Additionally, in cases where a medical condition (e.g., heart disease or thyroid problems) induces symptoms akin to those listed above, they are not defined as a panic attack. This is because panic attacks are anxiety-related events, not events triggered by purely physiological causes.

Additionally, for the symptoms to be considered as a sign of panic disorder, the cause should not be another mental disorder such as a phobia. For example, if a person only suffers panic attacks when they are engaging in public speaking but not in any other context, it is more clinically helpful to diagnose and treat their condition as “glossophobia with panic attacks” rather than panic disorder per se. In this case, the panic attack is defined as a specifier within another mental disorder.

For people with panic disorder, the fear of a panic attack can be more debilitating and harmful to their lives than the panic attack itself. Whereas the panic attack might last minutes or for a short period of time, the fear of having another panic attack could persist and stop them from continuing with their normal life. It can make them afraid of doing things that they associate with previous panic attacks.

For example, someone who had a panic attack when giving a presentation at work might become avoidant of giving presentations and, if that is a major part of their job, they might become avoidant of going to work, resign, and become at risk of unemployment. Another example is someone who had a panic attack while driving. Fear of having another panic attack while driving might make them avoid driving altogether. For someone living in a remote area, the end result might be that they will avoid social occasions, family gatherings, or jobs that require driving and, eventually, become reclusive or housebound.

Therefore, it is important that people suffering from recurrent panic attacks speak to a therapist as soon as possible to understand the symptoms and solutions. Knowing the symptoms will help people recognise when they are experiencing a panic attack. It is also important to learn the difference between chest pain or heart-pounding that is part of a panic attack and that which might be a sign of a medically dangerous cardiovascular event (e.g., a heart attack).