Q. What is a panic attack?

A. We often hear the term “panic attack” to describe fear or stress, but the medical definition is much more specific and severe. “A panic attack is something that often occurs out of the blue,” says Christopher Palmer, a psychiatrist at McLean Hospital. “It’s quite frightening when it happens.” Attacks may last only a few minutes, but during that time, he says, people “think that they are going to die or that they’re going crazy.” This belief is incredibly strong, even in those who have experienced an attack before.

Physical symptoms can include a racing heart, chest pain, shortness of breath, sweating, trembling, dizziness, or chills. While the symptoms overlap with general anxiety or fear, the unexpected onset and severity are different. Palmer says that many people end up in an emergency room because they appear to be having a heart attack.

A panic attack may be a one-time event, or can happen again; recurring cases can lead to a type of chronic anxiety disorder called panic disorder. Palmer says that the anticipation of another attack often causes more problems than the attack itself. “It’s that fear of it happening again that really debilitates people,” he says. They may avoid activities or even begin to fear leaving the house, a condition called agoraphobia. The time to seek treatment, he says, is when you're having recurrent episodes, “or if the fear of having another panic attack is limiting your activities in any way.”