The first time it happens, many people believe they are having a heart attack. They are at a mall, in a meeting, on the Metro, or sitting quietly at home — and suddenly their heart begins to pound, their chest tightens, they cannot breathe, and a wave of sheer terror washes over them for no visible reason. This is what a panic attack feels like.
Understanding what a panic attack feels like — from the inside — is one of the most useful things you can know, both for yourself and for the people around you.
The Physical Experience
A panic attack is a sudden surge of intense fear that triggers severe physical reactions. The body’s fight-or-flight response activates completely, flooding the system with adrenaline — as though you are facing a life-threatening situation, even though no such situation exists.
Common physical sensations include:
- Heart pounding or racing (palpitations)
- Chest pain or tightness — often mistaken for a heart attack
- Shortness of breath or a feeling of choking
- Dizziness, lightheadedness, or feeling faint
- Numbness or tingling in the hands, feet, or face
- Sweating, chills, or hot flushes
- Nausea or stomach cramps
- Trembling or shaking
- A feeling of unreality — as if you are watching yourself from outside your body
Panic attacks typically peak within 10 minutes and subside within 20 to 30 minutes, though exhaustion and unease can linger for hours afterward.
The Emotional and Mental Experience
- An overwhelming sense of impending doom — a certainty, in the moment, that something terrible is about to happen.
- A fear of dying — specifically, that you are having a heart attack or a stroke.
- A fear of losing control or “going crazy.”
- A desperate need to escape whatever space you are in.
- A feeling of complete helplessness — as if nothing you do can stop what is happening to your body.
What to Do During a Panic Attack
The most important thing to know is that a panic attack, while terrifying, is not dangerous. It cannot hurt you. Your body is responding to a false alarm.
- Breathe slowly and deliberately. Breathe in for 4 counts, hold for 2, out for 6. Slow exhalation activates your parasympathetic nervous system — the body’s calm response.
- Ground yourself in the physical present. Name 5 things you can see, 4 you can touch, 3 you can hear. This technique interrupts the panic cycle by redirecting attention to the present moment.
- Do not fight it. Accepting that it is happening — “This is a panic attack. It will pass. I am not in danger.” — is more effective than resistance.
- Stay where you are if it is safe to do so. Escaping the situation provides short-term relief but reinforces avoidance, making future panic more likely.
When to Seek Help
If you have had more than one or two panic attacks, or if fear of having another is changing your behaviour, please speak to a mental health professional. Panic disorder is highly treatable. Find guidance at RewiredMinds resources.
Frequently Asked Questions
How do I know if I am having a panic attack and not a heart attack?
If you are unsure, especially if it is your first episode or you have cardiac risk factors, seek emergency medical attention. Once cardiac causes have been ruled out, a pattern of similar episodes usually confirms panic disorder.
Can panic attacks happen during sleep?
Yes. Nocturnal panic attacks wake people from sleep and feel disorienting and frightening. They are not nightmares — the person is awake when the panic occurs.
Do panic attacks go away on their own?
An individual episode always passes. Whether panic disorder resolves without treatment is less predictable — for many people it becomes more frequent without intervention.
Are panic attacks a sign of weakness?
No. They are a physiological response related to how the nervous system processes threat signals — not a character flaw. Many high-functioning, resilient people experience panic disorder.