How to understand that I am having a panic attack: symptoms, causes and algorithm of actions

Imagine the situation: you are calmly riding in transport, working at the computer or walking down the street, when suddenly your heart starts pounding, you feel short of breath, and a sharp, paralyzing terror appears inside. It seems that something irreparable is going to happen right now – a heart attack, fainting or loss of consciousness.

This is what a panic attack feels like. It’s one of the most terrifying experiences a person can have, but the important thing to know is that panic attacks don’t kill you, and you can learn to control them.

We will figure out how to recognize this condition in time and distinguish it from a physical illness.

What is a panic attack?

A panic attack is a sudden, paroxysmal surge of intense anxiety and fear that peaks within minutes and is accompanied by vivid physical symptoms.

In essence, it is a “false alarm” of our nervous system. For some reason, the brain decides that you are in mortal danger and turns on the ancient “flight or fight” defense mechanism. A huge dose of adrenaline is released into the bloodstream, although there is no real threat nearby.

Main symptoms: how to recognize a panic attack?

The attack usually begins suddenly and lasts from 10 to 30 minutes (less often up to an hour). A combination of several of the following symptoms indicates the presence of a panic attack:

Physical manifestations:

Rapid heartbeat (the heart literally “jumps” out of the chest).

Feeling of suffocation: it seems impossible to take a full breath, there is a lack of oxygen.

Chest pain or tightness.

Dizziness, lightheadedness, feeling like you’re about to faint.

Tremors in the hands or the whole body, “waxy” legs.

Sudden waves of heat or cold, increased sweating.

Numbness or tingling in the fingers, toes, or around the lips.

Abdominal discomfort: nausea, cramps, sudden urge to go to the toilet.

Mental manifestations:

Fear of death: The most common thought during an attack is “My heart is going to stop” or “I’m going to die now.”

Fear of losing control or going crazy: It feels like you are losing your mind and doing something inappropriate.

Derealization: The world around you seems alien, hazy, “toy-like,” or unreal.

Depersonalization: a feeling of detachment from your own body (as if you are watching yourself from the outside).

How to distinguish a panic attack from a heart attack?

Because the symptoms overlap with heart problems, people often call an ambulance. Here are the key differences:

Signs of a panic attack:

It often occurs at a young age against the background of chronic stress or fatigue.

Chest pain is usually stabbing, stabbing, or rapidly increasing.

Symptoms peak very quickly and resolve completely within 15–30 minutes.

The main emotion during an attack is uncontrollable fear and panic.

Signs of a heart attack (infarction):

It occurs more often in people with risks (age, blood pressure, heart disease) after physical exertion.

The pain is pressing, burning, squeezing, and often radiates to the left arm, neck, shoulder, or jaw.

The pain is long-lasting, constant, and does not go away with rest or changing body position.

The main feeling is growing physical pain and exhaustion.

If this has happened to you for the first time in your life, be sure to undergo a medical examination (cardiogram, thyroid tests) to rule out somatic diseases. If you are physically healthy, the problem is in the nervous system.

Express algorithm: what to do during a panic attack?

If you feel an attack starting, follow these steps:

Remind yourself, “This is just adrenaline. This is a panic attack. It won’t kill me, and it will pass in 10 minutes.”

Change your breathing (Square Technique):

Slow breath in through your nose for 4 counts.

Hold your breath for 4 counts.

Long exhale through your mouth for 4 counts (the exhalation should be longer than the inhalation!).

Return to reality (Grounding “5-4-3-2-1”):

Name 5 objects you see around you.

Touch 4 things (feel the texture of clothes, a cold wall).

Hear 3 sounds around you.

Smell 2 smells.

Experience 1 taste (take a sip of water or eat a mint).

Why do panic attacks occur and what to do next?

A single panic attack can be triggered by extreme fatigue, exhaustion, too much coffee, or stress. But if the attacks are repeated, “anticipatory fear” (when you’re afraid to leave the house for fear of another attack) appears – this is a sign of panic disorder.

Panic attacks are successfully treated. It helps you understand what thoughts trigger your panic reaction, stop being afraid of your own physical symptoms, and regain full control over your life.