What Does a Panic Attack Look and Feel Like?

For Claire Eastham, who lives with social anxiety and panic attacks, the adrenaline surge that accompanies a panic attack is impossible to miss. She says panic attacks feel like liquid terror being injected into her veins — an experience of overwhelming dread. But she doesn’t know the cause or trigger guiding any of it.

“My heart doesn’t beat, it thunders against my ribs like a bird frantically trying to escape a cage,” says Eastham, a mental health blogger and author living in Manchester, England, who has experienced hundreds of panic attacks and written a book about it: How I Learned to Live With Panic. “I can’t catch my breath, and I’m certain that I’ll pass out if I don’t move. My mouth is dry, my vision is blurry, I’m pouring sweat, and my limbs feel numb. The symptoms are violent and relentless.”

While Eastham says there’s no way to predict or prevent the episodes, she has found certain strategies helpful for managing them. Learn more about panic attacks, including how to identify them and ways to manage them.

Panic attacks are the main symptom of panic disorder, but the episodes can happen among people with other health conditions, such as other anxiety disorders, mood disorders, psychotic disorders, or substance use disorders.

While symptoms of a panic attack can vary from one person to the next, they tend to be very physical and can often include some of the factors Eastham describes, says Lauren Cook, PsyD, a licensed clinical psychologist and the founder of Heartship Psychological Services in Pasadena, California.

• Intense feelings of fear
• Shaking
• Sweating or chills
• Shortness of breath
• Rapid breathing
• Increased heart rate
• Nausea
• Dizziness
• A feeling of choking or being smothered
• Derealization (feeling detached from reality)
• Depersonalization (feeling detached from yourself or like you’re having an out-of-body experience)

“People can feel like they are going to die during the experience, and it’s not uncommon that people will go to the hospital believing they are having a heart attack,” says Cook. “It’s important to note, though, no one has ever actually died from a panic attack, even though the brain can make you believe otherwise when you’re actively experiencing it.”

When a panic attack strikes, Eastham focuses on breathing exercises and does her best to find a quiet space away from other people where she can ride it out. She also lets people know why she’s stepping away and what she needs at that moment.

If you think you’re having panic attacks, the best thing to do is reach out to your healthcare provider or a mental health professional for help.

If your doctor diagnoses you with panic attacks, panic disorder, or a related mental health condition, they can help you find a treatment plan that works for you. Here are four common and effective treatment options for panic attacks.

1. Psychotherapy

Psychotherapy (aka talk therapy) can be a key component of managing panic attacks, according to Cleveland Clinic.

Exposure and response prevention therapy is often involved, Cook says. In this practice, people gradually and repeatedly get used to feeling the symptoms of their panic attacks in a safe and controlled setting (like a therapist’s office), so they can learn how to live through the uncomfortable and distressing feelings in their body.

“When we learn how to face the panic rather than fear it so vehemently, it often deflates the power of the fear of future panic attacks,” Cook says.

“We also teach various coping strategies to clients, including things like having a self-care soothing kit when in moments of intense distress,” Cook says. “Having things like gum, sour candy, peppermint essential oil, and music are all ways to downregulate the nervous system when highly activated.”

2. Medication

Medication can help many people manage panic attacks, particularly if they have underlying mental health issues, says Philip Muskin, MD, a professor of psychiatry at Columbia University Irving Medical Center in New York City.

3. Exercise

Lifestyle approaches can be beneficial, Muskin adds. Exercise — especially cardiovascular activity that gets your heart pumping — can be a big help. “When people exercise, they can realize, ‘I am breathing very fast, and my heart is pounding in my chest, and I’m not having a panic attack,’” Muskin says. “This can make the experience of a panic attack itself easier to get through.”

4. Deep Breathing

Breathing exercises are also a big piece of the puzzle when it comes to managing panic attacks, says Muskin. That’s because slow and deep breathing can help reduce panic symptoms like hyperventilating (trouble breathing that involves rapid and deep breaths), which increase feelings of fear during a panic attack, according to Cleveland Clinic.

“I teach people to concentrate on their breath so they know what they’re feeling in their chest and how to control it and how to recognize that a panic attack won’t actually stop their lungs from working,” says Muskin.

Treatment and lifestyle approaches won’t completely stop panic attacks from happening, but these interventions can make panic attacks easier to live with, Muskin says.

“They’re not necessarily preventable — and that is the most important piece to accept,” Cook adds. “Problematically, many people try so hard to prevent panic or live in so much fear of having a future panic attack that they are constantly on the lookout for any and all potential triggers.”

In addition, focusing on the idea that panic attacks are uncomfortable and unavoidable — and concentrating on tools for managing them — can make life much easier for people who experience them, Cook adds. “If we can become okay with having panic attacks, they often, by default, lose their power over us.”

Eastham says, “I can not fight off a panic attack any more than I could a tidal wave, and fighting one only prolongs the experience. Instead, I tell myself that although a panic attack might feel terrifying and uncomfortable, it can not physically harm me nor can it make me lose my mind. My role during the attack is to accept the symptoms and make myself as comfortable as I can while it passes.”

• Panic attacks are characterized as sudden feelings of fear and intense physical responses when no danger is present. The actual episode may be around 10 minutes, but symptoms may last closer to an hour.
• There’s often no trigger for panic attack episodes, and there’s also no cure. However, certain strategies, such as psychotherapy, deep breathing, medication, and exercise, can help with managing them.
• Visit your healthcare provider for help tailoring the best treatment and management plan for your needs.