Panic attacks can feature a variety of physical and psychological experiences. When their symptoms aren’t observable to those around you, they’re often referred to as “silent”.

Sudden episodes of overwhelming fear, anxiety, and distress that cause mental or physical symptoms are known as panic attacks. They happen suddenly, with rapidly progressing symptoms, and can be unexpected or related to a particular trigger.

Panic attacks can be a symptom of an underlying condition like panic disorder or generalized anxiety disorder (GAD). You may also experience a panic attack during periods of significant stress or moments that seem to have no evident cause.

Not all panic attacks feature the same signs or affect everyone in the same way. When signs aren’t apparent or visible to others, this is known as a silent panic attack.

A silent panic attack is still a panic attack. However, “silent” is not a formal diagnostic term. “Silent” is used for situations where panic attack symptoms are not obvious to those around you.

Silent panic attack is a non-clinical descriptive word that provides insight into your symptom experience. What changes between a panic attack and a silent panic attack is the symptom presentation.

For example, although you may experience symptoms of a panic attack, like hyperventilation, signs that you feel shortness of breath may be unnoticeable to others.

Ultimately, silent panic attacks are primarily internal experiences. Those around you won’t be aware you’re going through a panic attack because the external signs aren’t obvious.

According to the Diagnostic and Statistical Manual of Mental Disorders, 5th edition, text revision (DSM-5-TR), panic attack is identified by intense fear or psychological distress accompanied by four or more of the following core symptoms:

  • palpations, pounding heart, or accelerated heart rate
  • trembling or shaking
  • sweating
  • shortness of breath or a sensation of smothering
  • feelings of choking
  • chest pain or discomfort
  • nausea or abdominal distress
  • chills or heat sensations
  • dizziness or light-headedness
  • numbness or tingling sensations
  • fear of losing control
  • fear of dying
  • derealization (feelings of unreality)
  • depersonalization (feeling detached from your sense of self)

Any combination of the above will meet the criteria for diagnosis.

Silent panic attack vs. limited-symptom panic attack

Limited-symptom panic attacks are those that feature less than four of the symptoms outlined in the diagnostic criteria. This type of panic attack may only present with one or two signs.

Limited-symptom panic attacks are not the same as silent panic attacks, though it’s possible for a limited-symptom panic attack to be a silent panic attack.

For example, depending on the individual, a person may experience only two symptoms of a panic attack that aren’t easily noticed by those around them.

If you experience a panic attack, you may present psychological distress as well as noticeable external signs like gasping or profuse sweating. However, signs of a silent panic attack will be unnoticeably present.

You may be able to reduce your symptoms with techniques that help you focus on relieving anxiety and reducing stress, such as:

These techniques take some time and practice to be really effective, so it’s a good idea to practice them regularly, even when you’re not experiencing a panic attack.

For long-term management, or when panic attacks are part of underlying conditions like panic disorder, medications and psychotherapy interventions like cognitive behavioral therapy (CBT) may help.

CBT could help you identify and change unhelpful patterns of thinking and behavior that contribute to panic attacks.

Medications, like benzodiazepines and selective serotonin reuptake inhibitors (SSRIs), may be able to relieve your symptoms.

Panic attacks can be unsettling and terrifying. The overall goal to support someone going through this experience is to provide support and comfort.

If someone informs you they’re experiencing a silent panic attack, you can help them by:

  1. Stay calm and letting them know you’re there for them.
  2. Reassure them that they’re safe.
  3. Encourage slow, deep breathing.
  4. Guide them through a grounding technique, like counting slowly from 1-10.
  5. Ask if they would like physical comfort, like a hug or a pat on the back.
  6. Offer a subtle distraction, such as a picture of your pet or shift their focus to something in the room.

Maintaining a safe space for yourself and others is built on mutual trust and consideration. Try to respect their boundaries during this time, especially if they express a need for space and indirect support.

Silent panic attacks are panic attacks. Although it is not an actual condition, the word “silent” is used to describe signs of a panic attack that aren’t obvious to those around you.

If you’re experiencing panic attacks regularly, you may be living with an underlying condition like GAD or panic disorder. It’s also possible to experience symptoms without a known cause.

Consider exploring techniques, such as structured counting, or seeking professional support to help you manage your symptoms.