Understanding Panic Attacks

According to WebMD, one in 10 adults in the U.S. have a panic attack each year and they usually begin between the ages of 15 and 25.  It may be common to think that panic attacks happen when someone is anxious, but they can occur in an anxious or calm state. You can be sleeping and have a panic attack. They can be expected or unexpected. Expected panic attacks are caused by a trigger or cue. Unexpected panic attacks occur without the trigger or cue. 


The DSM-5’ defines panic attacks as an abrupt surge of intense fear or intense discomfort that reaches  peak within minutes and during which time 4 or more of the following symptoms occur:

  • Palpitations, pounding heart, or accelerated heart rate
  • Sweating
  • Trembling or shaking
  • Sensations of shortness of breath or smothering
  • Feelings of choking
  • Chest pain or discomfort
  • Nausea or abdominal distress
  • Feeling dizzy, unsteady, light-headed, or faint
  • Chills or heat sensations
  • Paresthesia (numbness or tingling sensations)
  • Derealization (feeling of unreality) or depersonalization (being detached from oneself)
  • Fear or losing control or “going crazy”
  • Fear of dying

Panic Disorder

Panic Disorder is diagnosed as experience an attack a month and it’s followed by 1 month of the following:

  • Persistent concern or worry about additional panic attacks or their consequences such as losing control.
  • A significant maladaptive change in behavior related to the attacks such as avoidance.
  • The disturbance is not attributed to the physiological effect of a substance such as substance use disorder.
  • The disturbance is not better explained by another mental disorder such as social anxiety.

Some other symptoms which are not for used for diagnosing but may accompany a panic attack include:

  • Tinnitus
  • Neck soreness
  • Headache
  • Uncontrollable screaming or crying

If you feel you have panic attacks, seek help from a professional who can help diagnose you and properly treat you.

Work Accommodations

If you find yourself missing work because of panic attacks,  work accommodations can be implemented.  You are entitled to reasonable work accommodations under the  Americans with Disabilities  Act  (ADA). Examine your work environment and what your specific needs are then seek accommodations to help you succeed in the workplace.

Per Job Accommodation Network (JAN), here are the most common:

  • Flexible Schedule
  • Modified Break Schedule
  • Rest Area/Private Space
  • Support Animal
  • Support Person
  • Identify and Reduce Triggers

For an extended explanation on these accommodations, see Work Accommodation Ideas for Anxiety.

Requesting Accommodations

If you feel uncomfortable requesting accommodations, please read How to Ask for Reasonable Accommodations at the Workplace for guidance.

Here’s a video on asking for reasonable accommodations.

If you would like to speak to someone at JAN, below is their information:

Voice: 800-526-7234

TTY:   877-781-9403

Seeking Help

Substance Abuse and Mental Health Services (SAMHSA) can provide free referrals.  They are open 24/7, 365 days a year.

Call: (800) 662-Help (4357).  

Visit:  SAMHSA’s National online treatment locator

Text: Your zip code to 435748

If you are experience suicidal thoughts, please contact 988 for help. The calls are free, confidential, and they are open 24/7 to help you navigate difficult emotions.

Attend a Workshop

If you are interested in attending a live webinar on improving your relationship with your finances, please visit my events.


American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: Author.

Cleveland Clinic. (n.d.). Panic attacks & panic disorder. Retrieved from  https://my.clevelandclinic.org/health/diseases/4451-panic-attack-panic-disorder#:~:text=Panic%20attacks%20are%20common.,the%20U.S.%20have%20panic%20disorder

Job Accommodation Network. (n.d.). Anxiety disorder. Retrieved from  https://askjan.org/disabilities/Anxiety-Disorder.cfm

NAMI Cobb. (n.d.). Panic disorder. Retrieved from https://namicobb.org/panic-disorder/#:~:text=The%20syhttps://askjan.org/a-to-z.cfmmptoms%20of%20the%20disorder,late%20teens%20or%20early%20twenties.

National Institute of Mental Health. (n.d.). Any anxiety disorder. Retrieved from https://www.nimh.nih.gov/health/statistics/any-anxiety-disorder

National Institute of Mental Health. (n.d.). Panic disorder: when fear overwhelms. Retrieved from  https://www.nimh.nih.gov/health/publications/panic-disorder-when-fear-overwhelms

Richmond, C. (2021). Panic disorder and panic attacks. Retrieved from https://www.webmd.com/anxiety-panic/guide/mental-health-panic-disorder

Small, S. (n.d). Panic attacks, they don’t always wait until after hours. Retrieved from https://askjan.org/articles/Panic-Attacks-They-Don-t-Always-Wait-Until-After-Hours.cfm