Something is very wrong. You’re suddenly flushed with intense anxiety and you didn’t see it coming. The anxiety is so strong that it feels like you’re going crazy.

You could just be momentarily freaking out or it could be a panic attack.

Telling the Difference Between a Panic Attack and a Freak Out

If it’s panic, you’re likely to feel a strong need to escape, but not always, as some wake up in the night with a panic attack.

Common symptoms of a panic attack are trembling, rapid heart rate, a sense of impending doom, chest pain, a sense of choking or suffocating, dizziness, nausea, vomiting, hyperventilating and tunnel vision.

Panic attacks are commonly associated with tight spaces, crowded places or gatherings where you perceive judgment or failure can take place.

The fear is often irrational, such as the idea that you’ll run out of air on the subway or crash on a plane.

Unfortunately panic attacks tend to repeat and they can come out of nowhere, but the sensations are often familiar (“Huh, I’ve had that feeling before last time I was this anxious.”)

The irrational element present when panicking allows many people to also say to themselves, “I totally know that there’s nothing to fear but I can’t help it.”

Panic attacks are often followed by a depressive experience, even a day later. There’s a strong correlation between panic disorder and depression, especially panic that is accompanied by agoraphobia, which is an anxiety disorder involving the fear of situations in which you might panic, such as a theater or on a bridge. Agoraphobia leads people to avoid these contexts to avoid potential panic attacks. A severe manifestation of agoraphobia is when you avoid leaving home in fear of having panic attacks.

Amanda Chatel, a wonderful writer for Bustle, interviewed me about the distinction between panic disorder and freaking out.