Panic Disorder Symptoms: Panic Attacks & Warning Signs

Quick Glance: Common Panic Disorder Symptoms

Common symptoms of a panic attack in panic disorder include:

Sudden intense fear or a sense of impending danger
Racing or pounding heartbeat
Shortness of breath or a choking sensation
Chest pain or discomfort
Sweating, chills or trembling
Dizziness or light-headedness
Nausea or stomach discomfort
Tingling or numbness

Panic Disorder Symptoms That Should Not Be Ignored

Some symptoms of panic disorders can also occur with other physical or mental health conditions. Seek medical evaluation if you experience:

Symptom	What It May Indicate
Recurrent unexpected panic attacks	May indicate panic disorder or another condition requiring assessment.
Persistent fear of having another attack	Ongoing anxiety that may affect daily activities and quality of life.
Increasing avoidance of places or activities	May indicate worsening anxiety or the development of agoraphobia.
Recurrent chest pain or discomfort	Can occur during panic attacks, but may also have other physical causes.
Repeated shortness of breath	Can occur during panic attacks but may also be linked to respiratory or other medical conditions.
Frequent dizziness or faintness	May occur during panic attacks, but can also have other causes that require evaluation.
Panic symptoms interfering with work, education or relationships	May indicate that the condition is significantly affecting daily functioning.

Why Do Panic Disorder Symptoms Occur?

Panic disorder is linked to the body's natural fight-or-flight response, which prepares a person to respond to a perceived threat. During a panic attack, this response can become intense even when there is no immediate danger. Stress hormones such as adrenaline can increase heart rate, sweating and alertness, while changes in breathing may contribute to dizziness, tingling or light-headedness.

The exact causes of panic disorder are not fully understood and may involve a combination of biological and psychological factors. Panic disorder symptoms can involve different parts of the body:

Brain: Processes fear and responds to perceived threats.
Sympathetic nervous system: Activates the body's fight-or-flight response.
Heart: A faster heartbeat can cause a racing or pounding sensation.
Respiratory system: Rapid or altered breathing can contribute to breathlessness, dizziness and tingling.
Digestive system: The body's stress response may contribute to nausea or stomach discomfort.

Panic Disorder Symptoms That Require Immediate Medical Attention

Seek urgent medical care if you experience any of the following, particularly if the symptoms are new, severe or different from previous panic attacks:

Severe or persistent chest pain
Severe difficulty breathing
Fainting or loss of consciousness
A new or irregular heartbeat accompanied by severe symptoms
Sudden weakness or numbness, especially on one side of the body
Severe confusion or a sudden change in awareness
A seizure or uncontrolled body movements
Thoughts of self-harm or suicide

Panic attacks can cause symptoms that resemble those of heart, breathing, or other medical conditions. New or severe symptoms should not automatically be attributed to panic disorder and should be medically assessed.

Symptoms of Panic Disorder in Children

Panic disorder can occur in children and adolescents, although younger children may find it difficult to describe what they are experiencing. Symptoms of a panic attack may include:

Sudden intense fear without an obvious trigger
Racing or pounding heartbeat
Sweating, chills or trembling
Shortness of breath or a choking sensation
Dizziness or feeling faint
Nausea or stomach discomfort
Fear of losing control or something bad happening
Repeated worry about having another panic attack
Avoidance of school, social activities or other situations because of fear of another attack

Recurring symptoms or significant changes in behaviour should be assessed by a healthcare professional. A medical evaluation can also help rule out physical conditions that may cause similar symptoms.

Can You Have Panic Disorder Without Symptoms?

Panic disorder cannot occur without panic attacks because recurrent and unexpected panic attacks are a key feature of the condition. However, a person may feel relatively well and have no obvious physical symptoms between attacks.

Some people continue to worry about having another panic attack or change their behaviour to avoid situations where an attack might occur. An isolated panic attack does not necessarily mean that a person has panic disorder. A healthcare professional considers the pattern of attacks, ongoing worry and behavioural changes before making a diagnosis.

When Can Panic Disorder Symptoms Become Life-Threatening?

Panic attacks themselves are generally not life-threatening. However, some symptoms can resemble serious medical conditions, so new, severe or unusual symptoms should not automatically be attributed to panic disorder.

Check out the symptoms of panic disorders that can become life-threatening:

Severe chest pain: May require urgent assessment to rule out a heart or other medical problem.
Severe breathing difficulty: Requires urgent evaluation, particularly when it is new or does not settle.
Loss of consciousness: Fainting should be medically assessed rather than automatically attributed to panic.
Sudden weakness or numbness: These symptoms may indicate a neurological emergency and require immediate assessment.
Severe confusion or altered awareness: Sudden changes in awareness require urgent medical evaluation.
Suicidal thoughts: Require immediate mental health and emergency support.

How are Panic Disorder Symptoms Diagnosed?

A healthcare professional assesses the symptoms, medical history, frequency of panic attacks and their effect on daily life. They may also carry out a physical examination or other tests to rule out medical conditions that can cause similar symptoms. Panic disorder is diagnosed based on the overall clinical assessment rather than a single blood test or scan.

Check out the following table to know the assessments used to diagnose a panic disorder:

Diagnostic Assessment	Purpose
Mental health assessment	Evaluates panic attacks, anxiety, ongoing worry and behavioural changes.
Medical history	Reviews when symptoms started, how often they occur and whether there are possible triggers or related conditions.
Physical examination	Helps identify physical conditions that may cause similar symptoms.
Blood tests	May be used when appropriate to check for physical conditions, such as thyroid problems, that can cause similar symptoms.
Heart assessment	May be considered when symptoms such as chest pain or palpitations require further evaluation.

Frequently Asked Questions

Q1. What are the early symptoms of panic disorder?

Ans. Early symptoms of a panic disorder may include sudden intense fear, a racing heartbeat, trembling, sweating, dizziness, nausea, chest discomfort, or difficulty breathing. Recurrent and unexpected panic attacks are an important feature of panic disorder.
Q2. Can panic disorder cause chest pain?

Ans. Yes. Chest pain or discomfort can occur during a panic attack. However, new, severe or persistent chest pain should be medically assessed because it may have other causes.
Q3. Can panic attacks happen without an obvious trigger?

Ans. Yes. Panic attacks associated with panic disorder can occur unexpectedly and without an obvious trigger. This may contribute to the ongoing fear of having another attack.
Q4. Can panic disorder cause dizziness or shortness of breath?

Ans. Yes. Dizziness, light-headedness and shortness of breath can occur during a panic attack. Changes in breathing during an attack may contribute to some of these sensations.
Q5. Can you have panic disorder without symptoms between attacks?

Ans. Yes. A person may feel relatively well between panic attacks. However, they may continue to worry about another attack or avoid situations because of this fear.
Q6. Can children develop panic disorder?

Ans. Yes. Panic disorder can occur in children and adolescents. Younger children may have difficulty describing what they are experiencing, so changes in behaviour or avoidance may also be noticeable.
Q7. When should I see a doctor for panic disorder symptoms?

Ans. Speak to a healthcare professional if panic attacks recur, cause ongoing worry or lead you to avoid everyday activities. New or severe physical symptoms should also be assessed to rule out other medical conditions.
Q8. Which panic disorder-related symptoms require urgent medical attention?

Ans. Seek urgent medical care for severe chest pain, severe difficulty breathing, loss of consciousness, sudden weakness or numbness, severe confusion, seizures or thoughts of self-harm. These symptoms should not automatically be assumed to be caused by panic disorder.

References
- https://www.mayoclinic.org/diseases-conditions/panic-attacks/symptoms-causes/syc-20376021
- https://www.nhs.uk/mental-health/conditions/panic-disorder/
- https://my.clevelandclinic.org/health/diseases/4451-panic-attack-panic-disorder
- https://medlineplus.gov/panicdisorder.html