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Panic attacks: symptoms and when to seek an assessment

Alanoud AlturkiMedical review: Tatmeen team7 min read
امرأة تضم يديها إلى صدرها وتنظر جانبًا، وخلفها وجوه داكنة متكررة، وعلى اليمين ضوء شمس وطريق.
Article contents
  1. What does a single attack mean?
  2. Why can a physical sensation feel so frightening?
  3. How is panic disorder different from generalized anxiety disorder?
  4. What should you say at an assessment?
  5. When should you seek psychological support?
  6. Frequently Asked Questions
  7. Sources and references
  8. Writer and reviewer

It may start with a racing heart, followed by dizziness and intense fear: “Is something seriously wrong?” These symptoms can occur during a panic attack, but they do not establish that panic is the cause. First consider whether you need medical help now. After that, you can explore the episodes and what happens between them.

Call 997 for an ambulance in Saudi Arabia if you have any of these warning signs:

  • Severe breathing difficulty, such as gasping, choking or being unable to speak.
  • Chest tightness or heaviness, or pain spreading to the arm, back or jaw.
  • Very pale, blue or grey lips or skin.
  • Sudden confusion.

Loss of consciousness also needs medical help. Do not wait for a calming exercise to work, and do not drive yourself. A previous panic diagnosis does not make every new or different symptom1 part of it.

Symptoms that occur for the first time or differ from your usual pattern deserve medical assessment even without these warning signs. Comparing them with an online list is not enough. A doctor can advise on appropriate care based on your symptoms and health history.

What does a single attack mean?

A panic attack is a sudden wave of intense fear3 or discomfort with several physical and mental symptoms. You might experience a racing heart, trembling, sweating, breathing difficulty, nausea or tingling, along with fear of dying or losing control. Some people feel detached from themselves or as though their surroundings are unreal. You do not have to experience every symptom.

One attack does not mean you have panic disorder. Attacks can happen in different circumstances, including other anxiety disorders. A clinician assessing panic disorder asks about recurring unexpected attacks3, fear of their return and changes you have made because of that fear. They also review your health history and other possible explanations for your symptoms. The number of attacks alone cannot establish the diagnosis.

The greatest difficulty may be outside the episode itself: you stop using lifts, go out only with a particular person, or limit journeys because you fear help will not be available. These details matter even if attacks have become less frequent. Tell the clinician about fear of places where leaving or obtaining help would be difficult.

Why can a physical sensation feel so frightening?

You notice your heart beating fast and think, “I'm going to faint.” Fear increases, and you start monitoring every beat, making the sensation harder to ignore. This cycle can be part of a panic problem. Psychological treatment can help3 you understand it and change how you respond. The symptoms you feel are real; this explanation does not replace medical assessment of palpitations or any new physical symptom.

You may also wonder, “Why have the attacks started now?” The causes of panic disorder are not fully understood and may involve several factors. You can seek an assessment even if you do not know the cause or cannot recall a particular event before the attacks began.

How is panic disorder different from generalized anxiety disorder?

They can occur together3. This comparison can help you describe your experience; it cannot diagnose you.

What to notice Panic disorder Generalized anxiety disorder
Repeated focus of fear Another attack, the meaning of bodily sensations, and what might happen during an episode Worry that is difficult to control across several areas, such as health, work, family and money
Between the most intense moments Anticipating an attack or avoiding places and activities because of it Continuing preoccupation with possibilities, sometimes with tension, concentration difficulties or sleep problems
What assessment considers Attacks, anticipation and avoidance, alongside health history The pattern, range and impact of worry, alongside health history

The severity of distress and the length of one episode do not settle the diagnosis. Describe both the attacks and your day-to-day worry, including their effects on sleep, work and going out. Assessment may need to consider more than one problem.

What should you say at an assessment?

You do not need a polished account or a diagnosis ready. Start with what happened, then explain what changed afterward. Brief notes can include:

  • When symptoms started, what you felt, and whether the latest episode differed from earlier ones.
  • Physical conditions, new medicines, stimulants or other substances that may be relevant.
  • Places or activities you now avoid and changes in sleep, work or going out.
  • Previous assessments and treatments, including what helped and what troubled you.

For example: “I had two sudden episodes of a racing heart and fear. I was assessed after the first, but since then I have avoided travelling to work alone. I want to understand the episodes and the fear that stayed afterward.” You do not need to check your pulse repeatedly to prepare the notes.

When should you seek psychological support?

Ask for an assessment if attacks or fear of their return are distressing or restricting your life. You do not have to stop working or exhaust every self-help option first. Assessment may include medical evaluation as needed, followed by discussion of psychological treatment3, medication or other suitable options. Symptoms do not automatically make medication necessary5.

If a clinician has previously assessed these symptoms and you recognise them as familiar panic attacks, read steps for coping with a familiar attack. If attacks or avoidance have become an ongoing difficulty, the panic treatment guide can help you prepare questions. Tell the clinician what you have stopped doing because of fear, even if it seems like a small detail. That may be one of the most useful things for your care plan to address.

Frequently Asked Questions

What are the symptoms of a panic attack?

A panic attack is a sudden wave of intense fear or discomfort with several physical and mental symptoms. You might experience a racing heart, trembling, sweating, breathing difficulty, nausea or tingling, along with fear of dying or losing control. Some people feel detached from themselves or as though their surroundings are unreal. You do not have to experience every symptom, and these symptoms do not by themselves establish that panic is the cause.

When should I call an ambulance if I think it is a panic attack?

Call 997 for an ambulance in Saudi Arabia if you have any of these warning signs: severe breathing difficulty, such as gasping, choking or being unable to speak; chest tightness or heaviness, or pain spreading to the arm, back or jaw; very pale, blue or grey lips or skin; or sudden confusion. Loss of consciousness also needs medical help. Do not wait for a calming exercise to work, and do not drive yourself. A previous panic diagnosis does not make every new or different symptom part of it.

Does one panic attack mean I have panic disorder?

No. One attack does not mean you have panic disorder; attacks can happen in different circumstances, including other anxiety disorders. A clinician assessing panic disorder asks about recurring unexpected attacks, fear of their return and changes you have made because of that fear. They also review your health history and other possible explanations for your symptoms. The number of attacks alone cannot establish the diagnosis.

What is the difference between panic disorder and generalized anxiety disorder?

In panic disorder, fear focuses on another attack and the meaning of bodily sensations, and you may anticipate attacks or avoid places and activities because of them. In generalized anxiety disorder, worry is difficult to control across several areas, such as health, work, family and money, sometimes with tension, concentration difficulties or sleep problems. The two can occur together, and this comparison cannot diagnose you.

When should I seek an assessment for panic attacks?

Ask for an assessment if attacks or fear of their return are distressing or restricting your life. You do not have to stop working or exhaust every self-help option first. Assessment may include medical evaluation as needed, followed by discussion of psychological treatment, medication or other suitable options. Symptoms do not automatically make medication necessary. Symptoms that are new or differ from your usual pattern deserve medical assessment.

Writing and article review

Alanoud AlturkiWritten byAlanoud Alturki

Content writer and researcher at Tatmeen, writing in Arabic and English on mental health and everyday life topics, including relationships, stress, work, habits, and family.

Tatmeen teamMedical reviewTatmeen team

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