Symptoms of Panic Attacks

A panic attack is an intense episode of physical and emotional distress that typically comes on quickly and can feel alarming in the moment. Many people who experience one for the first time are unsure what is happening, and it is not uncommon to mistake a panic attack for a medical emergency. At Central Minds, our psychologists support individuals experiencing panic attacks and panic disorder regularly, and we know how disorienting and isolating this experience can be.

Understanding what panic attacks are, and what they are not, is often an important first step towards feeling more in control.

Physical Symptoms of a Panic Attack

Panic attacks are characterised by a sudden surge of intense physical sensations. These symptoms are real and can be distressing, even though they are not physically dangerous.

Common Physical Symptoms

• Racing or pounding heartbeat, a sudden awareness of your heart beating rapidly or irregularly
• Shortness of breath or a feeling of being unable to breathe, sometimes accompanied by a tightening sensation in the chest
• Dizziness or lightheadedness, feeling faint, unsteady, or as though the room is spinning
• Trembling or shaking, a physical sense of agitation that may be visible or felt internally
• Sweating, often sudden and unrelated to temperature or physical exertion
• Nausea or stomach discomfort, a churning or unsettled feeling in the abdomen
• Numbness or tingling, particularly in the hands, feet, or face
• Chills or hot flushes, sudden changes in body temperature without an obvious cause
• Chest tightness or discomfort, which can feel similar to cardiac symptoms and is a common reason people seek emergency care

It is worth noting that chest pain and breathing difficulties during a panic attack can closely resemble symptoms of other medical conditions. If you are experiencing these symptoms for the first time and are unsure of the cause, we suggest consulting a medical doctor to rule out any physical health conditions.

Psychological and Emotional Symptoms of a Panic Attack

Alongside the physical experience, panic attacks also involve a distinct set of emotional and cognitive symptoms that can be equally distressing.

Emotional Symptoms

• An overwhelming sense of dread or fear, often with no clear external cause
• Fear of losing control, a feeling that something is about to go very wrong, even when nothing is
• Fear of dying or that something is seriously wrong physically, particularly during a first episode
• Feeling detached from yourself or your surroundings, sometimes described as feeling unreal or as though you are watching yourself from a distance — this is known as derealisation or depersonalisation

How Long Do Panic Attacks Last?

Most panic attacks reach their peak intensity within ten minutes and typically subside within twenty to thirty minutes. Although they feel prolonged in the moment, they are time-limited. Understanding this can be genuinely reassuring for people who experience them regularly.

Common Signs of Panic Attacks

Panic attacks can occur in a range of contexts. The signs below may help you identify whether what you are experiencing is consistent with panic attacks, rather than another condition.

Anxiety and panic attacks are closely connected. Panic attacks are often, though not always, associated with an anxiety disorder or panic disorder, and a psychologist can help you understand what is causing them in your specific case.

How Symptoms Of A Panic Attack Can Change Over Time

Panic attacks do not always remain the same in how they present or how frequently they occur.

• A single panic attack does not necessarily mean a person will go on to experience further episodes, though some people do
• Repeated panic attacks can lead to the development of panic disorder, where concern about future episodes becomes a significant source of distress in itself
• Avoidance behaviours often develop gradually as people try to manage their anxiety by steering clear of situations where attacks have previously occurred.  Over time, this can quietly narrow the range of activities and places that feel manageable
• Co-occurring difficulties, such as social anxiety, stress, or health anxiety, frequently appear alongside panic attacks and that’s why having professional support can help make sense of what’s happening, rather than trying to navigate it all by yourself

How Panic Attacks Differ from General Anxiety

Anxiety and panic attacks are related but distinct experiences. This table may help clarify the difference.

Both experiences are worth taking seriously. A psychologist can help you understand what you are experiencing and identify the most appropriate approach to support you.

You May Benefit From Support If…

It can sometimes feel difficult to know whether what you are experiencing warrants professional support. The following may be helpful indicators:

• You have experienced one or more episodes of intense physical and emotional distress that came on suddenly and subsided within thirty minutes
• You have found yourself worrying about having another panic attack, even when you are not currently having one
• You have started to avoid certain situations, places, or activities because of a previous episode
• Panic attacks are affecting your ability to work, socialise, or go about your daily life
• You have sought medical reassurance but no physical cause has been identified
• You have been managing on your own for some time without noticing any improvement
• The anticipation of a panic attack has become as distressing as the episodes themselves

Our Counsellors And Therapists That Can Work With Panic Attacks

Dr. Melissa Chan

Clinical Psychologist

Dr. Chan is a UK trained Clinical Psychologist, who has worked in the field of mental health taking up clinical and research roles in the community and academic settings for ten years. She is experienced in treating people with symptoms of depression and anxiety disorders (e.g. social anxiety, bipolar tendencies etc). She also works with people who are struggling with low self-esteem, stress, grief and bereavement, adjustment difficulties and those…

Dr. Aurélie Comes

Clinical Psychologist & CBT Therapist

Aurélie is an experienced Cognitive Behavioral Therapist (CBT) who trained and worked in the UK’s National Health Service. In addition to her CBT specialty, she also qualified as an Eye-Movement Desensitization Reprocessing (EMDR) Practitioner.

Dr. Edward Lam

Clinical Psychologist

Edward is a U.S.-trained and licensed Clinical Psychologist in the state of Massachusetts, now bringing his expertise to Hong Kong. With extensive experience across various settings, Edward has helped clients become stronger, more independent, and resilient in the face of challenges. He creates a supportive and non-judgmental environment where clients can explore their struggles and engage more fully in life.

Teresa Chan

Cognitive Behavioural Psychotherapist

Teresa is a Cognitive Behavioural Psychotherapist who has over 10 years of experience working in the field of clinical mental health. She has a background in Psychology at both an undergraduate and master’s level and completed her training in the UK, where she specialised in the field of Cognitive Behavioural Therapy.

Dr. Elaine Ching

Clinical Psychologist

Dr. Ching is a UK trained Clinical Psychologist, offering support to adults with difficulties around anxiety, low mood, stress and burnout, self-esteem, childhood or event specific trauma, interpersonal relationships, and life adjustments (e.g. relocation, grief, chronic physical health, third culture kids). She also has experience with individuals with individuals with emotional

Dr. Kaili Chen

Clinical Psychologist

Dr. Chen has worked in the field of psychology since 2010 in several non-profit organizations and community mental health centers. Before settling in Hong Kong, she has lived in Singapore, Thailand, Malaysia, China, and the United States, and understands firsthand the stresses expats face living abroad and the intricacies of multicultural lifestyles.

Dr Steven Livingstone

Clinical Psychologist & Systemic Family Therapist

Dr Steven Livingstone is a UK-trained Consultant Clinical Psychologist and qualified Family Therapist with over 20 years’ experience working in the National Health Service and academia.

Stephanie Rose

Counsellor

Stephanie works with high-achieving adults who struggle with feelings of anxiety, perfectionism and self-doubt to embark on professional transitions with confidence. Steph recently conducted practice-based research on the drivers of Imposter Syndrome, identifying mindset and transitionary moments such as; career pivots, promotions, redundancies,  or returning to work after parental leave, as key drivers for psychological distress. 

FAQs About Panic Attack Symptoms

Are panic attacks dangerous?

Panic attacks are not physically dangerous, though they can feel very distressing in the moment. The physical symptoms, including chest tightness and breathlessness, are produced by the body’s stress response and will subside on their own. That said, if you are experiencing chest pain or breathing difficulties and are uncertain of the cause, it is always sensible to seek medical advice to rule out other conditions.

Can panic attacks happen without a trigger?

Yes. Panic attacks can occur in situations that feel entirely ordinary, with no obvious trigger. This is one of the reasons they can be so disorienting. Over time, a psychologist can help you identify any underlying patterns that may be contributing, even when the connection is not immediately apparent.

How are panic attacks different from panic disorder?

A panic attack is a single episode. Panic disorder is a condition in which a person experiences recurrent panic attacks and develops significant concern about future episodes, often leading to changes in behaviour to try to prevent them. Not everyone who has a panic attack goes on to develop panic disorder. A psychologist can assess what you are experiencing and advise on what support might be appropriate. You can find out more on our panic disorder page.

Can panic attack symptoms be caused by something else?

Some symptoms of a panic attack, such as a racing heart, dizziness, or breathing difficulties, can overlap with other medical conditions. It is worth speaking with a doctor if you have not already done so, particularly if this is a new or first-time experience. Once physical causes have been ruled out, a psychologist can carry out a thorough assessment to understand the full picture. Symptoms can also overlap with health anxiety or stress, which are worth exploring as part of a complete clinical picture.

Do I need a referral to speak with a psychologist at Central Minds?

No referral is needed to contact us directly. However, if you are planning to use insurance, we recommend checking with your provider beforehand, as some insurers do require a referral letter. You can find more information on our insurance and fees FAQ.

How are panic attacks treated?

Panic attacks respond well to psychological treatment. Cognitive Behavioural Therapy (CBT) and Psychodynamic Therapy are one of the most well-evidenced approaches, helping people to understand the relationship between their thoughts, physical sensations, and behaviours, and to develop practical strategies to manage episodes when they arise. Our psychologists work with each person individually to find an approach that fits their needs. You can learn more on our panic disorder expertise page.