Symptoms of anxiety and panic

Panic attacks and panic disorder - Symptoms and causes


A panic attack is a sudden episode of intense fear that triggers severe physical reactions when there is no real danger or apparent cause. Panic attacks can be very frightening. When panic attacks occur, you might think you're losing control, having a heart attack or even dying.

Many people have just one or two panic attacks in their lifetimes, and the problem goes away, perhaps when a stressful situation ends. But if you've had recurrent, unexpected panic attacks and spent long periods in constant fear of another attack, you may have a condition called panic disorder.

Although panic attacks themselves aren't life-threatening, they can be frightening and significantly affect your quality of life. But treatment can be very effective.

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Panic attacks typically begin suddenly, without warning. They can strike at any time — when you're driving a car, at the mall, sound asleep or in the middle of a business meeting. You may have occasional panic attacks, or they may occur frequently.

Panic attacks have many variations, but symptoms usually peak within minutes. You may feel fatigued and worn out after a panic attack subsides.

Panic attacks typically include some of these signs or symptoms:

  • Sense of impending doom or danger
  • Fear of loss of control or death
  • Rapid, pounding heart rate
  • Sweating
  • Trembling or shaking
  • Shortness of breath or tightness in your throat
  • Chills
  • Hot flashes
  • Nausea
  • Abdominal cramping
  • Chest pain
  • Headache
  • Dizziness, lightheadedness or faintness
  • Numbness or tingling sensation
  • Feeling of unreality or detachment

One of the worst things about panic attacks is the intense fear that you'll have another one. You may fear having panic attacks so much that you avoid certain situations where they may occur.

When to see a doctor

If you have panic attack symptoms, seek medical help as soon as possible. Panic attacks, while intensely uncomfortable, are not dangerous. But panic attacks are hard to manage on your own, and they may get worse without treatment.

Panic attack symptoms can also resemble symptoms of other serious health problems, such as a heart attack, so it's important to get evaluated by your primary care provider if you aren't sure what's causing your symptoms.

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It's not known what causes panic attacks or panic disorder, but these factors may play a role:

  • Genetics
  • Major stress
  • Temperament that is more sensitive to stress or prone to negative emotions
  • Certain changes in the way parts of your brain function

Panic attacks may come on suddenly and without warning at first, but over time, they're usually triggered by certain situations.

Some research suggests that your body's natural fight-or-flight response to danger is involved in panic attacks. For example, if a grizzly bear came after you, your body would react instinctively. Your heart rate and breathing would speed up as your body prepared for a life-threatening situation. Many of the same reactions occur in a panic attack. But it's unknown why a panic attack occurs when there's no obvious danger present.

More Information

  • Nocturnal panic attacks: What causes them?

Risk factors

Symptoms of panic disorder often start in the late teens or early adulthood and affect more women than men.

Factors that may increase the risk of developing panic attacks or panic disorder include:

  • Family history of panic attacks or panic disorder
  • Major life stress, such as the death or serious illness of a loved one
  • A traumatic event, such as sexual assault or a serious accident
  • Major changes in your life, such as a divorce or the addition of a baby
  • Smoking or excessive caffeine intake
  • History of childhood physical or sexual abuse


Left untreated, panic attacks and panic disorder can affect almost every area of your life. You may be so afraid of having more panic attacks that you live in a constant state of fear, ruining your quality of life.

Complications that panic attacks may cause or be linked to include:

  • Development of specific phobias, such as fear of driving or leaving your home
  • Frequent medical care for health concerns and other medical conditions
  • Avoidance of social situations
  • Problems at work or school
  • Depression, anxiety disorders and other psychiatric disorders
  • Increased risk of suicide or suicidal thoughts
  • Alcohol or other substance misuse
  • Financial problems

For some people, panic disorder may include agoraphobia — avoiding places or situations that cause you anxiety because you fear being unable to escape or get help if you have a panic attack. Or you may become reliant on others to be with you in order to leave your home.


There's no sure way to prevent panic attacks or panic disorder. However, these recommendations may help.

  • Get treatment for panic attacks as soon as possible to help stop them from getting worse or becoming more frequent.
  • Stick with your treatment plan to help prevent relapses or worsening of panic attack symptoms.
  • Get regular physical activity, which may play a role in protecting against anxiety.

By Mayo Clinic Staff


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Symptoms of Panic & Anxiety Attacks

Written by WebMD Editorial Contributors

In this Article

  • What Should I Ask My Doctor?
  • How Can I Learn More About Anxiety?

Panic attacks are intense periods of fear or feelings of doom developing over a very short time frame -- up to 10 minutes -- and associated with at least four of the following:

  • Overwhelming fear (of losing control or going crazy)
  • Palpitations
  • Sweating
  • Trembling
  • Shortness of breath
  • Sense of choking
  • Chest pain
  • Nausea
  • Dizziness
  • A feeling of being detached from the world (de-realization)
  • Fear of dying
  • Numbness or tingling in the limbs or entire body
  • Chills or hot flushes

Panic attacks and panic disorder are not the same thing. Panic disorder involves recurrent panic attacks along with constant fears about having future attacks and, often, avoiding situations that may trigger or remind someone of previous or unexpected attacks. Not all panic attacks are caused by panic disorder. Sometimes, they’re related to conditions like:

  • Social phobia
  • Agoraphobia (fear of not being able to escape, such as flying in an airplane or being in crowds)
  • Other anxiety disorders
  • Post-traumatic stress disorder (PTSD)

Doctors will often look for other medical conditions that might trigger or be related to panic attacks or similar episodes. They might include:

  • Thyroid problems
  • Asthma or other breathing problems
  • Heart problems such as abnormal rhythms or mitral valve prolapse
  • Neurologic problems such as seizures
  • Stimulant or other substance use

Generalized anxiety disorder is excessive and unrealistic worry over a period of at least 6 months. It is associated with at least three of the following symptoms:

  • Restlessness
  • Fatigue
  • Difficulty concentrating
  • Irritability or anger
  • Muscle tension, aches, or soreness
  • Sleep disturbances

Phobic disorders are intense, persistent, and recurrent fear of certain objects (such as snakes, spiders, blood) or situations (such as heights, speaking in front of a group, public places). These exposures may trigger a panic attack. Social phobia and agoraphobia are examples of phobic disorders.

Posttraumatic stress disorder -- or PTSD -- was considered to be a type of anxiety disorder in earlier versions of the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders. But in 2013, PTSD was reclassified as its own condition. It describes a range of emotional reactions caused by exposure to either death or near-death circumstances (such as fires, floods, earthquakes, shootings, assault, automobile accidents, or wars) or to events that threaten one's own or another person's physical well-being. The traumatic event is re-experienced with fear of feelings of helplessness or horror and may appear in thoughts and dreams. Common behaviors include the following:

  • Avoiding activities, places, or people associated with the event
  • Persistently re-experiencing the traumatic event, such as:
    • Unwanted memories
    • Nightmares or flashbacks
    • Emotional or physical distress when experiencing reminders of the trauma
  • Changes in arousal or reactivity, including:
    • Trouble concentrating
    • Trouble sleeping
    • Being hypervigilant (you closely watch your surroundings) or being easily startled
    • Irritability or aggression
    • Risky behavior
  • Negative changes in feelings and thoughts, such as:
    • Feeling a general sense of doom and gloom with diminished emotions (such as loving feelings or aspirations for the future)
    • Feeling isolated or negative about the world
    • Less interest in activities
    • Exaggerated feelings of blame for self or others about the trauma
    • Negative thoughts and feelings about the world

Symptoms such as chest pain, shortness of breath, palpitations, dizziness, fainting, and weakness should not be automatically attributed to anxiety and require evaluation by a doctor.

What Should I Ask My Doctor?

If you have anxiety or were recently diagnosed with an anxiety disorder, consider asking your doctor these questions at your next visit.

  1. How did I get anxiety? Is there a chance I passed this on to my kids?
  2. Are there any underlying medical problems that could be causing my anxiety symptoms?
  3. What are my treatment options for anxiety? Will I need to take an anxiety drug? Will I take it every day or as needed? How long will I need to take it?
  4. What side effects can I expect from medications? Is there a way to minimize or prevent side effects?
  5. What should I do if I miss a dose of medication?
  6. Should I begin therapy sessions? Which type and for how long?
  7. How long before I can expect to feel better?
  8. Once treated, how likely is it that my anxiety symptoms will return?
  9. What lifestyle changes can I make to help me feel better?
  10. How will alcohol or other drugs interact with my medication or affect my anxiety?

How Can I Learn More About Anxiety?

These organizations offer information about and resources for anxiety disorders:

Anxiety Disorders Association of America

This nonprofit organization is dedicated to advocacy and education about anxiety disorders. This link will take you to its website:

Anxiety and Depression Association of America

American Psychological Association

Get information on anxiety and help finding a psychologist. This link will take you to its website:

American Psychological Association

American Psychiatric Association

Learn more about children’s anxiety disorders and other mental health problems. Get help in finding a psychiatrist. This link will take you to the website:

American Psychiatric Association

National Alliance on Mental Illness

Learn more about panic disorder, phobias, and treatment that helps. This link will take you to the website:

National Alliance on Mental Illness

Anxiety & Panic Disorders Guide

  1. Overview
  2. Symptoms & Types
  3. Treatment & Care
  4. Living & Managing

Anxiety and panic disorders | Articles by doctors of the EMC clinic about diseases, diagnosis and treatment

Anxiety treatment at the European Medical Center:

  • Thorough diagnosis of the patient's mental state, identification of risk factors.

  • Drawing up an individual treatment program, including pharmacotherapy, cognitive-behavioral therapy, if necessary, TMS. nine0007

  • The Clinic for Psychiatry and Psychotherapy constantly organizes trainings that teach relaxation skills and coping with anxiety symptoms.

Anxiety disorders are a group of disorders in which irrational, uncontrollable fear and persistent feelings of anxiety become the predominant symptoms, which can occur in situations that do not actually pose a current danger. nine0006 The experience of anxiety is a normal adaptive response of the body to changing conditions or threatening events. However, fears can be a serious problem for a person if the level of anxiety reaches pathological proportions. This imposes restrictions on the normal functioning of the patient, which significantly reduces his quality of life. Also, the long-term existence of an anxiety disorder dramatically increases the risk of other mental disorders, such as depressive disorder (by about 15 times) and pathological addictions (by about 20 times). nine0007

Major anxiety disorders include:

Panic disorder - the main symptoms of the disease include recurring attacks of irrational anxiety (panic), not limited to a specific situation or any specific circumstances.

Dominant symptoms : sudden onset of tachycardia (rapid heartbeat), sweating, tremors, dry mouth, chest pain, difficulty breathing, feeling of choking and nausea, as well as dizziness and a feeling of unreality of what is happening. nine0007

Agoraphobia is a group of anxiety disorders that encompasses a range of phobias, which include a morbid fear of open spaces and public places. Patients experience uncontrollable anxiety when they are in a crowd, refuse to visit shops and other crowded places, limit their exits from the house unaccompanied, and have difficulty using public transport on their own. Agoraphobia is one of the most maladaptive types of phobic disorders. nine0007

Dominant symptoms : when immersed in a frightening situation, anxiety increases sharply in patients, heartbeat and breathing become more frequent, sweating and dizziness appear, in some cases a panic attack develops. As a rule, such patients try in every possible way to avoid those situations that cause them a panic attack, which contributes to the consolidation of an anxiety disorder, changes their usual lifestyle and interferes with normal life.

nine0006 Generalized Anxiety Disorder - is manifested by a constant feeling of anxiety, tension and persistent anxiety about a variety of life events, the likelihood of which is extremely small. In this case, anxiety is not limited to any specific external circumstances, so it is often difficult for the patient to outline the circle of situations that trigger panic.

Dominant symptoms : the most typical complaints are a feeling of constant nervousness, trembling, muscle tension, sweating, tachycardia, dizziness, discomfort in the epigastric region. Often the patient experiences fear for his loved ones, suffers from gloomy forebodings. For a diagnosis of generalized anxiety disorder, the symptoms described must have been present for at least 6 months. nine0007

Social phobia - this anxiety disorder is based on the fear of being seen by others, as well as being in an awkward position, being ridiculed or humiliated, which leads to the formation of a reaction to avoid such situations. Often this disorder is combined with low self-esteem and fear of criticism. Fears can manifest themselves when eating in a public place, the need to maintain a conversation during a casual meeting with friends in the presence of strangers, visiting public places and group activities. nine0007

Dominant symptoms : hand tremor, nausea (fear of vomiting may be present), urge to urinate or defecate (or fear of such urge), flushing of the face. Sometimes the patient takes one of these side manifestations of anxiety for the underlying disease. Avoidance of frightening situations causes significant psycho-emotional stress, since the person himself realizes that his reaction is excessive and has no reasonable grounds. nine0007

Specific phobias are fears limited to narrowly specific situations, such as, for example, being in close proximity to animals of a certain biological species, being in the dark, at height, in a confined space. Specific phobias also include fear of air travel, fears of eating certain foods, visiting a doctor, medical procedures, and the sight of blood. When confronted with fearful stimuli or when thoughts about them arise, the person "triggers" anxiety and the symptoms described above are observed. nine0007

Panic attacks and anxiety disorders

Sometimes a panic attack or unreasonable anxiety visits a person only once, and then does not recur. It happens that the problem manifests itself several times, and also disappears on its own. However, if you regularly encounter such disorders, you should not wait until they go away on their own, because this may not happen.

ACME Center has been helping patients overcome panic attacks and anxiety disorders for over 10 years. Using an integrated approach, we find the root cause and eliminate it, returning patients to a calm and comfortable life. nine0067

What are panic attacks? Normally, these states occur due to ongoing events; this is a normal reaction of the body to the stress experienced, which allows you to instantly mobilize forces to overcome it. Fear, panic is a reaction to a sudden threat. Anxiety, in turn, is associated mainly with the expectation of a dangerous event.

But sometimes these states arise completely without reason, pursuing a person in situations where there is not a single reason for fears and worries. nine0007

This anxious disorder is expressed by the following symptoms:

  • Unreasonable fear or anxiety,
  • insomnia, the inability to relax,
  • pain in the chest,
  • Nausea and vomiting
  • ,
  • ,
  • yeast and chosts,
  • Dizziness
  • Pre-syncope.

If normally such sensations occur during stress, then during an anxiety disorder they may appear suddenly, and the manifestations may be more severe. nine0007

Panic disorder is associated with the occurrence of panic attacks, psychophysical distress in the complex. In some cases, with a high intensity of the attack, a person can commit suicidal acts. Often, panic attacks are combined with other mental disorders, representing a complex disorder - depressive, post-traumatic.

Doctors - there are three types of panic attacks:

  • Spontaneous - characteristic of panic personality disorder, occurring suddenly and without reference to circumstances. A person may wake up from a panic attack that began in a dream. There is no binding to a place, circumstances, situations. nine0008
  • Situational. Panic disorder can manifest itself in some specific situations, without fear of a specific place or process. Sometimes a person experiences a panic attack just by walking in the park. Such attacks can become aggravated for periods or vice versa, subside.
  • Specific. With these attacks, a person reacts to specific situations. So, a patient with social phobia may experience panic if necessary to speak with the seller when it comes to his turn.

Anxiety syndrome is common among the population, it is typical for more than 13 percent of Russians. Panic attacks are also quite common. But these phenomena are curable, you can get rid of them. There are a number of techniques that allow you to forget about the problem forever.

Treatment of panic attacks and anxiety disorders

Panic attacks can worsen over time, leading to suicidal attempts, resulting in heart attacks and other serious consequences. Anxiety disorders are also not safe, they create a huge burden on the body, on the psyche and nervous system of a person, provoking other diseases. With these painful manifestations, as well as with any others, it is worth fighting in a timely manner, because all the possibilities for this exist today. nine0007

Doctors emphasize that complete and lasting relief is achieved by lowering the level of anxiety over a long period of time. At the same time, stabilization of the autonomic nervous system is achieved, the hypothalamus ceases to come into an excited state, adrenaline in the blood falls. A person not only parted with the symptoms of the disease, but also experiences general comfort and tranquility. His performance improves.

In order to receive a full-fledged treatment, it is necessary to consult a psychotherapist. These problems relate specifically to the sphere of the psyche, and therefore it makes no sense to isolate some part of the symptoms and refer to other specialists with it - for example, to detail only the sensations in the heart area, and contact a cardiologist. nine0007

Antipsychotics are also prescribed for severe cases of panic disorder. They are taken for a short period of time in order to suppress excessive symptoms - in this case, complete relief from the symptoms of a vegetative nature does not occur, and therefore it is necessary to use other categories of drugs. Tricyclic antidepressants may be prescribed.

Psychocorrection or hypnotic influence in panic disorder are of an auxiliary nature. These measures do not remove vegetative manifestations, but they allow you to endure the next attack more calmly, realizing that this does not threaten death. The effectiveness of the techniques is manifested only in mild forms of disorders, which often go away on their own even without it. However, activities aimed at relaxation and peace, such as meditation, spa visits or yoga, do help reduce the severity of symptoms. And therefore, psychotherapeutic techniques can also become part of the course of treatment of these pathologies. nine0007

Professional help from doctors allows you to get rid of panic attacks and groundless anxiety - do not delay contacting specialists!

Why patients choose ACME Center

Our specialists have been helping patients with panic attacks for more than 10 years. In our practice, we use proprietary methods and an integrated approach that allows us to most effectively carry out rehabilitation.
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