A panic attack is one of the most intense and confusing psychophysiological experiences a person can have. Although it is not medically dangerous, it is subjectively perceived as a vital threat, which is why many patients end up in the emergency room for the first time, convinced they are suffering a heart attack or other serious medical emergency.

In my practice as a psychologist in Iasi, I frequently meet people who say: "I know I was told it's panic, but my body feels like I'm dying". This discrepancy between medical reality and internal experience explains why a panic attack is so hard to tolerate and why it requires a structured, empathic, and evidence-based therapeutic approach.

What is a Panic Attack?

According to DSM-5 and ICD-11, a panic attack is a sudden episode of intense anxiety, accompanied by physical, cognitive, and perceptual manifestations, which peak rapidly – usually in less than 10 minutes. For diagnosis, at least 4 of the 13 cardinal symptoms are required, but many people experience many more simultaneously.

Important to emphasize: a panic attack is not dangerous, does not lead to a heart attack, fainting, or "madness," but it is extremely convincing subjectively.

Symptoms of a Panic Attack

Physical Manifestations (Somatic)

The most common symptoms occur as a result of the activation of the sympathetic nervous system – the automatic "fight or flight" response:

  • Palpitations, tachycardia, strong heartbeats
  • Difficulty breathing, feeling of suffocation, lump in the throat, hyperventilation
  • Chest pain or discomfort, often interpreted as a sign of a heart attack
  • Dizziness, instability, feeling of fainting, "empty" head
  • Tremors, sweating, chills, or heat waves
  • Paresthesia (numbness, tingling in hands and feet)

These symptoms are real physiologically, but they do not indicate a cardiac or neurological condition.

Panic Attack or Myocardial Infarction?

Differentiating between the two is essential, as the symptoms can be similar. A panic attack usually involves a sharp, localized sting, while a heart attack is felt as a crushing, diffuse pressure that may radiate to the left arm or jaw. A panic attack typically lasts 10–30 minutes, whereas a heart attack is progressive and often occurs during effort.

Important recommendation: at the first episode of chest pain or if cardiovascular risk factors exist, medical evaluation is mandatory. Afterwards, if investigations are normal, the psychological approach becomes the key to healing.

Effective Treatment for Panic Attacks

The gold standard in treating panic attacks is Cognitive-Behavioral Therapy (CBT), especially the interoceptive exposure component. This involves gradual, controlled confrontation with feared bodily sensations (palpitations, dizziness, shortness of breath), so that the brain learns, through direct experience, that these are not dangerous.

When is it Recommended to See a Psychologist?

It is advisable to consult a psychologist when panic attacks repeat, when a constant fear of a new episode appears, or when you avoid places or activities because of the symptoms. Early intervention significantly reduces the risk of panic disorder becoming chronic.