The two main bodily symptoms of a panic attack are breathing too fast and an increased heart rate. These symptoms can begin up to an hour before a panic attack, although people often do not notice them until the last moment.

One of the best ways of dealing with a panic attack is by controlling breathing. Breathing more slowly helps to lower the heart rate and reduce the feelings of losing control and unreality.

With panic attacks, people often report that they happen spontaneously, without being cued by anything specific. But research suggests they are a result of being very vigilant to relatively small fluctuations in heart rate and breathing that build up over up to an hour.

A recent study of 43 people with panic disorder monitored them around the clock, measuring heart rate, respiration, skin conductance and so on. When they had a panic attack the results showed exactly what happened in the body leading up to it.

The results found that in this hour preceding naturally occurring panic attacks there was a lot of physiological instability. These significant physiological instabilities were not present during other times when the patient wasn’t about to have a panic attack. People reported that the panic attacks were spontaneous, but there were actually many warning signs.

These warning signs did not seem to enter the patient’s awareness. What they report is what happens at the end of the 60 minutes — that they’re having an out-of-the blue panic attack with a lot of intense physical sensations. It was expected that the majority of the physiological activation would occur during and following the onset of the panic attack, but what was actually found was very little additional physiological change at that time.

The classic psychological signs of a panic attack are:

feeling of unreality,
fear of losing control,
and fear of dying.

The physical signs are:

shortness of breath,
heart racing,
chest pain,
hot flashes,
and numbness.

Most patients obviously feel that there must be something going on physically. They worry they’re having a heart attack, suffocating or going to pass out. The data did not indicate that there is anything inherently wrong physically, neither when they are at rest nor during panic.

Those who suffer from panic attacks would benefit from being more attune to changes in increased heart rate and breathing and to manage this prior to a panic attack eventuating.