Panic attacks are the main symptom of panic disorder. A panic attack is a sudden surge of intense fear or discomfort which reaches a peak within several minutes and is accompanied by at least four of the following:
- heart palpitations, or racing/pounding heart
- shaking or trembling
- shortness of breath or a feeling of choking
- chest pain or discomfort
- nausea or abdominal upset
- chills or heat sensations/sweats
- dizziness, light-headedness, or feeling faint or unsteady
- numbness or tingling sensations
- derealisation (the feeling that what is happening around the person is not real)
- depersonalisation (the feeling of being outside one’s body looking in)
- fear of losing control or of ‘going crazy’
- fear of dying.
Two types of panic attack have been identified: expected and unexpected. Expected panic attacks occur following a particular cue or trigger, for example, for some people being in a plane or in a lift might frequently trigger a panic attack. Unexpected panic attacks, on the other hand, do not have an identifiable cue or trigger and can occur at any time, even if the person is in a calm state or asleep.
For a diagnosis of panic disorder, a person must experience at least one unexpected panic attack followed by one month or more of:
- ongoing concern or worry regarding the experience of further panic attacks or their consequences; and/or
- changes in behaviour in order to prevent further attacks from happening, for example, the person may avoid situations where they fear a panic attack could occur, such as public transport.