Your sitting on a train on your way home from work and suddenly out of the blue you become aware of your heart. It pounds rapidly, reverberating throughout your whole body. Your attention is drawn to a terrifying choking sensation. You can’t seem to get enough air into your lungs. You wonder if you are about to suffocate or pass out from lack of oxygen. You look down and notice your hands and legs trembling. You feel dizzy, like the world is closing in on you. You wonder if are about to lose control, faint or maybe even go “crazy” right here on the train in front of all of these staring faces.

If this scene feels familiar to you, you may have experienced a panic attack. Panic attacks are much more common than you might think. According to BeyondBlue up to 40% of people will experience a panic attack at some point in their life.

In the last decade or so, the term “panic attack” and “anxiety attack” seems to be used more commonly in our everyday language. But what exactly is a panic attack?

A panic attack includes four or more of the following symptoms:

  • Racing or pounding heart or heart palpitations
  • Trembling or shaking
  • Chest pain, tightness or discomfort
  • Choking feeling
  • Sweating, chills or feeling hot all over
  • Nausea or stomach pains
  • Feeling short of breath or smothered
  • Feeling dizzy, numb, faint, lightheaded or unsteady
  • Derealisation (feeling like everything around you doesn’t feel real) or depersonalisation (feeling detached from yourself)
  • Fear of losing control or “going crazy”
  • Fear of dying

The above symptoms can be experienced when we feel anxious about a particular situation or as part of particular types of anxiety, such as generalised anxiety or social anxiety. The difference between these types of anxiety and panic attacks is that the symptoms are sudden, intense and overwhelming. Panic usually comes out of the blue and seems to be un-triggered by specific situations or worries (although sometimes in hindsight people are able to figure out specific triggers for their panic). Many of my clients describe their panic as a “surge” or “wave” of terror washing over them. The symptoms of a panic usually peak at around ten minutes and subside within about 30 minutes. Panic attacks take up a huge amount of physical and mental energy and can leave you feeling exhausted and shocked.

Sometimes after experiencing a panic attack people can develop Panic Disorder. Panic Disorder involves reoccurring and unexpected panic attacks, ongoing worry about having another panic attack and concerns about what might happen during the panic attack. For example, fears about having a heart attack, fainting, dying, “going crazy” or losing control. This can sometimes lead to people avoiding situations that might trigger anxiety or panic symptoms. For others the fear of panic becomes so strong that it feels difficult or impossible to leave the house at all.

If you feel like you might be experiencing panic attacks or Panic Disorder, the first and most important step is to speak to your General Practitioner (GP). It’s important that you have a thorough physical health assessment to ensure that your symptoms are a consequence of anxiety and not related to a medical condition. If your GP thinks that you may be experiencing panic attacks or Panic Disorder you may be eligible for a referral to a clinical psychologist under the Medicare Mental Health Treatment Plan. Clinical psychologists help people to overcome panic attacks using psychological strategies such as Cognitive Behaviour Therapy, Mindfulness and Relaxation.

If you are interested in learning about how to cope with panic attacks, be sure to check out part two of this blog. You can also contact Inner Melbourne Clinical Psychology on (03) 9376 1958 or via email: if you have any questions or would like to book an appointment to discuss ways to manage panic attacks.