Symptoms

The main symptom of a panic attack is an overwhelming feeling of fear or anxiety. This feeling occurs along with physical reactions.

An attack starts suddenly and usually lasts from 5 to 20 minutes. But it may last even longer, up to a few hours. You feel most anxious about 10 minutes into the attack.

It is possible to have one panic attack after another in waves for an extended period of time. This can seem like one continuous attack. But if you have continuous symptoms that don't go away within an hour, you probably aren't having a panic attack. You should seek medical care right away.

Symptoms of a panic attack may include:

• Rapid breathing (hyperventilation), shortness of breath, or a feeling of choking or being smothered.
• A pounding or racing heart or an irregular heartbeat.
• Chest pain.
• Shaking, trembling, or feeling lightheaded or dizzy.
• Sweating, chills, or hot flashes.
• Nausea or an upset stomach.
• Numbness or tingling.
• Fear that you are going to die, lose control, or "go crazy."
• Feelings of being detached from yourself or from reality.

The symptoms of a panic attack can be similar to those of a heart attack. Many people seek emergency medical treatment for a panic attack for this reason. If you have chest pain and other symptoms of a heart attack, get medical treatment right away. For more information, see the topic Chest Problems.

Agoraphobia

Panic attacks may begin without a trigger. Or they can be linked to certain situations, such as being in large crowds of people in restaurants or stadiums. Sometimes just knowing that you'll be in a certain situation can cause severe anxiety.

People who have panic attacks often learn to avoid situations that they fear will trigger a panic attack or situations where they will not be able to escape easily if a panic attack occurs. If this pattern of avoidance and anxiety is severe, it can become agoraphobia, an intense and irrational fear of being in public places.

As many as half of people who have panic disorder also have agoraphobia.¹ Isolating yourself and avoiding social situations can interfere with your ability to work. It can also harm your relationships, especially with your family members and close friends.

Symptoms in children

Panic attacks aren't common in children or younger teens. But children who have panic disorder or panic attacks often have other symptoms in addition to those listed above.

• They may be overly afraid of common objects such as bugs.
• They may worry too much about monsters or about going to bed alone.
• They may refuse to go to school or become unusually upset when they are separated from a parent.