How to Identify Panic Attack Symptoms and Know When You're Having One
Author: Dr. Mary Perleoni, Ph.D., LMHC
About the author: Clinical Leader & Tampa-based therapist at It Begins Within Therapy
Published December 17, 2025
You're sitting in traffic when suddenly your heart starts pounding so hard you can hear it in your ears. Your chest tightens, your hands go numb, and you're convinced something is terribly, terribly wrong. You might be dying. You need help now.
This is what a panic attack can feel like. If you've never experienced one before, it can be absolutely terrifying. The good news? Understanding what's happening to your body and mind during a panic attack can make all the difference in managing them. In this article, we'll walk through how to recognize panic attack symptoms, what causes them, and most importantly, what you can do when one strikes.
What is a panic attack?
A panic attack is a sudden episode of intense fear or discomfort that reaches its peak within minutes. During an attack, your body's "fight or flight" response kicks into overdrive, even though there's no actual danger present. It's like your internal alarm system has gone haywire, triggering a cascade of physical and emotional responses that can feel completely overwhelming.
Panic attacks are more common than you might think. Research suggests that up to 11% of people experience a panic attack in any given year, and about 2-3% of adults meet the criteria for panic disorder, which involves recurrent, unexpected panic attacks. You're far from alone in this experience.
Quick Answer: Am I having a panic attack?
A panic attack is likely if your symptoms came on suddenly, peaked within minutes, and include intense fear along with physical sensations like a racing heart, shortness of breath, dizziness, or chest tightness — even though there’s no immediate danger.
Panic attacks are frightening but not dangerous, and they always pass. If this is your first experience or you’re unsure, seek medical care to rule out physical causes.
Recognizing panic attack symptoms
The first step in managing panic attacks is learning to identify them. Panic attack symptoms can vary from person to person, but there are several hallmark signs that most people experience.
Physical symptoms
The physical sensations of a panic attack can be intense and frightening. You might notice:
Rapid or pounding heartbeat (heart palpitations)
Chest pain or tightness
Shortness of breath or feeling like you can't get enough air
Sweating, even when you're not hot
Trembling or shaking
Numbness or tingling in your hands, feet, or face
Dizziness or lightheadedness
Nausea or stomach upset
Hot flashes or sudden chills
Many people having their first panic attack genuinely believe they're having a heart attack or another serious medical emergency. The physical symptoms are that real and that powerful.
Emotional and psychological symptoms
Beyond the physical sensations, panic attacks also create a storm of psychological distress:
Intense fear or sense of impending doom
Feeling like you're losing control or "going crazy"
Fear of dying
Feeling detached from yourself (depersonalization)
Feeling detached from your surroundings (derealization)
A desperate urge to escape wherever you are
These psychological symptoms often feed into the physical ones, creating a feedback loop that can make the panic feel even more overwhelming.
How quickly do symptoms appear?
One of the defining features of a panic attack is how rapidly it develops. Most panic attacks reach their peak intensity within about 10 minutes, though some people experience a quicker onset. The entire episode typically lasts anywhere from 5 to 30 minutes, though the lingering effects—feeling shaky, exhausted, or emotionally drained—can persist for hours afterward.
Anxiety attack vs panic attack: What's the difference?
People often use the terms "anxiety attack" and "panic attack" interchangeably, but there are actually some important distinctions between the two. Understanding the difference between panic attack and anxiety attack can help you better communicate with healthcare providers and find the right treatment approach.
An anxiety attack typically builds gradually in response to a stressor or trigger. You might feel increasingly worried, tense, or on edge over a period of minutes or even hours. The physical symptoms are usually less intense than those of a panic attack, and while uncomfortable, they're generally more manageable.
A panic attack, on the other hand, comes on suddenly and reaches peak intensity quickly. It can happen seemingly out of nowhere, even when you're relaxed or asleep. The intensity of symptoms is usually much higher, and the sense of terror or doom is more pronounced.
That said, both experiences fall under the umbrella of anxiety disorders, and both respond well to similar treatment approaches. Whether you're dealing with panic attacks, anxiety attacks, or a combination of both, working with a Tampa therapist, St. Petersburg therapist, or Sarasota therapist who specializes in anxiety can make a significant difference.
What causes panic attacks?
Understanding what causes panic attacks isn't always straightforward because there isn't just one single trigger or explanation. Instead, panic attacks typically result from a combination of factors that create the perfect storm for your nervous system to go into overdrive.
Biological factors
There's a strong genetic component to panic attacks and panic disorder. If someone in your family has experienced panic attacks, you're more likely to experience them yourself. Brain chemistry also plays a role—imbalances in neurotransmitters like serotonin and norepinephrine can contribute to panic symptoms.
Additionally, certain medical conditions can trigger panic-like symptoms. These include thyroid problems, heart conditions, respiratory issues, and low blood sugar. That's why it's always important to rule out underlying medical causes with your doctor, especially if you're experiencing these symptoms for the first time.
Environmental and psychological factors
Stressful life events often precede the development of panic attacks. Major life transitions, trauma, loss, relationship problems, or work stress can all increase vulnerability. Sometimes, the first panic attack happens during or shortly after a particularly stressful period.
Past experiences matter, too. If you've had a traumatic experience or grew up in an environment where you didn't feel safe, your nervous system might be more reactive to perceived threats—even when there's no actual danger present.
The role of thoughts and beliefs
Here's where things get interesting: your thoughts about the physical sensations you're experiencing can actually fuel a panic attack. If you notice your heart racing and immediately think, "Something is seriously wrong. I'm having a heart attack," that thought triggers more anxiety, which creates more physical symptoms, which reinforces the scary thoughts. It's a vicious cycle.
This is why cognitive behavioral therapy is often so effective for treating panic attacks—it helps you break this cycle by changing the way you interpret and respond to physical sensations.
Substance use
Caffeine, alcohol, and certain medications can trigger or worsen panic attacks. Even quitting substances like nicotine can sometimes precipitate panic symptoms during the withdrawal period. If you're prone to panic attacks, it's worth paying attention to how different substances affect you.
How to know when you're having a panic attack
In the moment, distinguishing a panic attack from a genuine medical emergency can feel impossible. Here are some clues that what you're experiencing is likely a panic attack rather than something like a heart attack:
First, consider the speed of onset. Panic attacks typically come on very suddenly and reach peak intensity within about 10 minutes. They also tend to subside relatively quickly, usually within 20-30 minutes.
Second, think about the pattern of symptoms. During a panic attack, symptoms tend to cluster together—you're not just experiencing chest pain, but also rapid breathing, sweating, and intense fear. Heart attacks, by contrast, typically involve more localized chest pain that may radiate to the arm or jaw, along with nausea, but without the same constellation of panic-related symptoms.
Third, what happens when you try to calm yourself down? Panic attack symptoms often respond somewhat to calming techniques like deep breathing or grounding exercises. Heart attack symptoms don't improve with these approaches.
That said—and this is crucial—if you're experiencing chest pain and you're not sure what's causing it, especially if it's your first time, seek medical attention. It's always better to err on the side of caution. Once medical causes have been ruled out, you can work with a mental health professional to address the panic attacks themselves.
What to do during a panic attack
Knowing what to do in the moment of a panic attack can help you feel less powerless and may even shorten the duration of the episode. Here are some strategies that many people find helpful.
Breathing exercises for panic attacks
When you're panicking, your breathing often becomes rapid and shallow, which can make the physical symptoms worse. Breathing exercises for panic attacks can help interrupt this cycle.
Try this simple technique:
Breathe in slowly through your nose for a count of four
Hold your breath for a count of four
Exhale slowly through your mouth for a count of six
Pause for a count of two
Repeat
The key is to make your exhale longer than your inhale, which helps activate your body's calming response. Don't worry about getting it perfect—even just focusing on slowing down your breath can help.
Grounding techniques
Grounding techniques help bring you back to the present moment and out of the panic. One popular method is the 5-4-3-2-1 technique:
Name 5 things you can see
Name 4 things you can touch
Name 3 things you can hear
Name 2 things you can smell
Name 1 thing you can taste
This exercise engages your senses and gives your mind something concrete to focus on besides the panic.
Remind yourself: This will pass
In the midst of a panic attack, it can feel like it will never end. But panic attacks always pass. Always. Remind yourself: "I've felt this before, and it passed. This is temporary. I am safe."
Even if you don't fully believe these statements in the moment, repeating them can help create a bit of distance from the intense fear.
Move your body
If possible, gentle movement can help discharge some of the adrenaline coursing through your system. This might mean standing up and walking around, doing some gentle stretches, or even just shaking out your hands and arms. Movement signals to your body that you're safe and can help bring your nervous system back into balance.
How to help someone with a panic attack
If someone you care about is having a panic attack, you might feel helpless or unsure of what to do. Here's how to help someone with a panic attack in a way that's supportive and calming.
Stay calm yourself
Your calm presence can be incredibly reassuring. Speak in a soft, steady voice and maintain a relaxed body posture. Your nervous system can help regulate theirs.
Don't dismiss their experience
Even though you might know they're not in actual danger, to them, the fear is completely real. Avoid saying things like "You're fine" or "Just calm down." These statements, while well-intentioned, can make someone feel like their experience isn't being taken seriously.
Instead, try:
"I'm here with you"
"You're safe"
"This will pass"
"Let's breathe together"
Guide them through breathing
Offer to breathe with them. You might say, "Let's take some slow breaths together. In through your nose... and out through your mouth." Modeling calm breathing can help them regulate their own.
Respect their space
Some people want physical comfort during a panic attack—a hand to hold or someone sitting close by. Others need space. Ask what they need: "Would it help if I sat with you, or would you prefer some space?"
Don't push them to talk
While the panic attack is happening, don't pressure them to explain what's going on or why they're panicking. There will be time for conversation later. Right now, just being a steady, calm presence is enough.
Panic attack treatments: What works?
While the strategies above can help in the moment, longer-term panic attack treatments focus on reducing the frequency and intensity of attacks over time. The good news is that panic attacks are highly treatable, and most people see significant improvement with the right approach.
Therapy for panic attacks
Cognitive Behavioral Therapy (CBT) is considered the gold standard for treating panic attacks. A therapist for panic attacks will help you:
Identify and change thought patterns that trigger or worsen panic
Gradually face situations you've been avoiding due to fear of panic
Learn to tolerate the physical sensations of anxiety without catastrophizing
Develop a toolbox of coping strategies
Another effective approach is Acceptance and Commitment Therapy (ACT), which teaches you to accept the presence of anxiety rather than fighting against it, while still moving forward with your values and goals.
Many people also benefit from specialized techniques like interoceptive exposure, where you deliberately create some of the physical sensations of panic (like elevated heart rate or breathlessness) in a controlled way. This helps you learn that these sensations, while uncomfortable, aren't dangerous.
Working with a licensed therapist who specializes in panic attacks and anxiety — whether through our therapy office in Tampa, St. Petersburg therapy location, Sarasota therapy services, or via telehealth in Florida — can make a significant difference.
Panic attack medication
For some people, panic attack medication can be an important part of treatment, especially in the early stages or when panic attacks are severe and frequent.
Selective Serotonin Reuptake Inhibitors (SSRIs) are often prescribed as a first-line medication for panic disorder. These medications help regulate brain chemistry over time and can reduce the frequency and intensity of panic attacks. They take several weeks to become fully effective and are typically taken daily, not just when you feel panicked.
Benzodiazepines work more quickly and can provide relief during an acute panic attack. However, because they carry a risk of dependence, they're generally recommended for short-term use or occasional situations rather than daily management.
Beta-blockers can help manage some of the physical symptoms of panic, like rapid heartbeat, and might be prescribed for situational use—for example, if you get panic attacks in specific scenarios like public speaking.
Medication decisions should always be made in collaboration with a psychiatrist or other qualified prescriber who understands your specific situation. At It Begins Within Therapy, our medication management services can help you explore whether medication might be a helpful addition to your treatment plan.
Many people find that a combination of therapy and medication works best, particularly in the beginning. As you develop coping skills and your panic attacks become less frequent, you and your doctor might decide to taper off medication. For others, longer-term medication use makes sense. There's no one-size-fits-all approach.
Lifestyle changes that can help
Beyond formal treatment, certain lifestyle modifications can reduce your overall vulnerability to panic attacks.
Regular exercise
Physical activity helps regulate your nervous system, reduces overall anxiety levels, and improves your ability to handle stress. Aim for at least 30 minutes of moderate exercise most days of the week. Even a daily walk can make a difference.
Sleep hygiene
Poor sleep can increase anxiety and make you more susceptible to panic. Prioritize getting 7-9 hours of quality sleep each night. Establish a consistent sleep schedule, create a calming bedtime routine, and make your bedroom a comfortable, distraction-free zone.
Limit stimulants
If you're prone to panic attacks, consider reducing or eliminating caffeine, which can trigger panic-like symptoms in sensitive individuals. Pay attention to other stimulants in your diet as well, like energy drinks or certain medications.
Alcohol awareness
While some people turn to alcohol to manage anxiety, it can actually make panic attacks worse over time. Alcohol disrupts sleep, alters brain chemistry, and can trigger panic during the hangover phase.
Mindfulness and meditation
Regular mindfulness practice helps you become more comfortable with physical sensations and teaches you to observe thoughts and feelings without immediately reacting to them. Even just 10 minutes a day can make a meaningful difference over time.
Stress management
Since stress is a major trigger for panic attacks, developing healthy ways to manage daily stress is crucial. This might include setting boundaries at work, scheduling regular breaks, engaging in hobbies you enjoy, or spending time in nature.
When to seek professional help
You don't have to wait until panic attacks are completely disrupting your life to seek help. In fact, getting support early can prevent panic attacks from becoming more entrenched.
Consider reaching out to a mental health professional if:
You've had more than one panic attack
You find yourself avoiding situations for fear of having another panic attack
Your worry about panic attacks is affecting your daily life
You're experiencing symptoms of depression alongside your panic
You're using alcohol or other substances to cope with anxiety
Your panic attacks are impacting your relationships, work, or overall quality of life
A therapist for panic attacks can provide you with evidence-based treatment tailored to your specific needs. They can also help you understand whether your panic attacks are part of a larger pattern, like panic disorder or another anxiety condition, and develop a comprehensive treatment plan.
If you're in the Tampa Bay area, our team at It Begins Within Healing Center offers specialized anxiety treatment at our Tampa, St. Petersburg, and Sarasota locations. We understand how frightening and disruptive panic attacks can be, and we're here to help you reclaim your sense of calm and confidence
Now what?
If you're struggling with panic attacks, please know that help is available and recovery is possible. The first step is simply acknowledging that what you're experiencing deserves attention and care. You're not being dramatic, you're not weak, and you're certainly not alone.
Consider reaching out to a mental health professional who specializes in anxiety and panic. At It Begins Within Healing Center, our experienced therapists understand the complexities of panic attacks and can provide you with personalized treatment that addresses your specific needs and circumstances. We offer comprehensive anxiety therapy services designed to help you understand your panic, develop effective coping strategies, and ultimately reclaim your life from fear.
Remember, seeking help isn't a sign of failure—it's a sign of strength and self-awareness. You deserve to feel safe in your own body and to live without the constant worry of when the next panic attack might strike. With the right support, tools, and treatment, you can get there.
Whether you're in Tampa, St. Petersburg, Sarasota, or anywhere in the surrounding areas, we're here for you. Your journey toward managing panic attacks starts with a single step, and we're ready to walk alongside you every step of the way.
