When you have a panic attack, you generally experience at least four of the following symptoms, according to standards set by the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV):
- Heart pounding
- Choking feeling
- Short, shallow breath
- Chest pain
- Numbness or tingling
- Chills and hot flashes
- A feeling of unreality
- A feeling of going crazy
- A feeling you are about to die
[source: Encyclopedia of Mental Disorders]
A doctor might diagnose you with panic disorder if you experience four panic attacks within four weeks or one attack followed by about four weeks of either consistent fear of having another attack or a dramatic change in behavior [source: MedicalCriteria.com].
So, what is happening inside your body as you experience these panic attack symptoms?
Put simply, a panic attack is a fear reaction minus any obvious danger to the person experiencing the attack. Physiologically, a panic attack works much the same way fear does.
As you might have learned in How Fear Works, your autonomic nervous system (ANS) maintains the involuntary functions in your body. It takes signals from your central nervous system to various organs, including your heart, kidneys and eyes. In this way, it can control hormone secretions, heart rate, blood vessels, muscles and pupil size. The ANS has two parts: the sympathetic and parasympathetic nervous systems. Your parasympathetic nervous system controls normal functioning of your internal systems when your body is calm. Your sympathetic nervous system takes over when you become excited.
When you're afraid, your sympathetic nervous system sets off certain reactions in your body. At the onset of a panic attack, the sympathetic nervous system causes your muscles to tense up. It also sends a message to your adrenal glands to release the hormone adrenaline. This adrenaline has many effects on your body: It produces sweat and increases your heart rate. With your chest and throat muscles contracted and tense, you might find it even more difficult to breathe. To learn more about adrenaline, read How can adrenaline help you lift a 3,500-pound car?
Normally after the onset of fear, your parasympathetic nervous system quickly kicks in to calm your body down by lowering your heart rate and blood pressure. But that does not happen during a panic attack. For some unknown reason, the parasympathetic system doesn't work properly during an attack, which leaves you to face disturbingly prolonged bodily panic [source: The Anxiety and Panic Disorder Center of Los Angeles].
The fear reaction has advantages in life-threatening situations. All that adrenaline and those juiced muscles could help you escape an attacker or swim to safety. But during a panic attack, when no apparent danger exists, that fear reaction seems completely uncalled for and out of place. For this reason, people who have panic attacks often think they're going insane. That, be assured, is definitely not the case.
Now that we understand how the body creates the incredibly uncomfortable panic attack symptoms, we'll take a look at what causes panic attacks. Have researchers solved the mystery?