A limited symptom attack (LSA), also referred to as a limited symptom panic attack (LPA), is a milder, less comprehensive form of

panic attack Panic attacks are sudden periods of intense fear and discomfort that may include palpitations, sweating, chest pain or chest discomfort, shortness of breath, trembling, dizziness, numbness, confusion, or a feeling of impending doom or of losing ...

, with fewer than four

panic Panic is a sudden sensation of fear, which is so strong as to dominate or prevent reason and logical thinking, replacing it with overwhelming feelings of anxiety and frantic agitation consistent with an animalistic fight-or-flight reactio ...

related symptoms being experienced (APA 1994). For example, a sudden episode of intense

dizziness Dizziness is an imprecise term that can refer to a sense of disorientation in space, vertigo, or lightheadedness. It can also refer to disequilibrium or a non-specific feeling, such as giddiness or foolishness. Dizziness is a common medical c ...

trembling A tremor is an involuntary, somewhat rhythmic, muscle contraction and relaxation involving oscillations or twitching movements of one or more body parts. It is the most common of all involuntary movements and can affect the hands, arms, eyes, f ...

accompanied by

fear Fear is an intensely unpleasant emotion in response to perceiving or recognizing a danger or threat. Fear causes physiological changes that may produce behavioral reactions such as mounting an aggressive response or fleeing the threat. Fear ...

that something terrible is about to happen. Many people with

panic disorder Panic disorder is a mental and behavioral disorder, specifically an anxiety disorder characterized by reoccurring unexpected panic attacks. Panic attacks are sudden periods of intense fear that may include palpitations, sweating, shaking, short ...

have a mixture of full blown and limited symptom attacks. LSAs often manifest in

anxiety disorders Anxiety disorders are a cluster of mental disorders characterized by significant and uncontrollable feelings of anxiety and fear such that a person's social, occupational, and personal function are significantly impaired. Anxiety may cause physi ...

phobias A phobia is an anxiety disorder defined by a persistent and excessive fear of an object or situation. Phobias typically result in a rapid onset of fear and are usually present for more than six months. Those affected go to great lengths to avoi ...

and agoraphobia. However, experiencing an LSA is not necessarily indicative of mental illness. Often persons recovering from or being treated for

panic attacks Panic attacks are sudden periods of intense fear and discomfort that may include palpitations, sweating, chest pain or chest discomfort, shortness of breath, trembling, dizziness, numbness, confusion, or a feeling of impending doom or of losing ...

and

will experience LSAs.

Symptoms

According to the

DSM-IV The ''Diagnostic and Statistical Manual of Mental Disorders'' (DSM; latest edition: DSM-5-TR, published in March 2022) is a publication by the American Psychiatric Association (APA) for the classification of mental disorders using a common langu ...

, during an LSA, fewer than four of the following symptoms would be experienced, in contrast to a full blown

, which must include four or more symptoms. *

dyspnea Shortness of breath (SOB), also medically known as dyspnea (in AmE) or dyspnoea (in BrE), is an uncomfortable feeling of not being able to breathe well enough. The American Thoracic Society defines it as "a subjective experience of breathing di ...

(shortness of breath) * heart palpitations *

* chest pain *

perspiration Perspiration, also known as sweating, is the production of fluids secreted by the sweat glands in the skin of mammals. Two types of sweat glands can be found in humans: eccrine glands and apocrine glands. The eccrine sweat glands are distr ...

hot flash Hot flashes (also known as hot flushes) are a form of flushing, often caused by the changing hormone levels that are characteristic of menopause. They are typically experienced as a feeling of intense heat with sweating and rapid heartbeat, and ...

es * headache *

derealization Derealization is an alteration in the perception of the external world, causing those with the condition to perceive it as unreal, distant, distorted or falsified. Other symptoms include feeling as if one's environment is lacking in spontaneity, ...

* paresthesia * hyperventilation *

nausea Nausea is a diffuse sensation of unease and discomfort, sometimes perceived as an urge to vomit. While not painful, it can be a debilitating symptom if prolonged and has been described as placing discomfort on the chest, abdomen, or back of the ...

vertigo Vertigo is a condition where a person has the sensation of movement or of surrounding objects moving when they are not. Often it feels like a spinning or swaying movement. This may be associated with nausea, vomiting, sweating, or difficulties w ...

lightheadedness Lightheadedness is a common and typically unpleasant sensation of dizziness or a feeling that one may faint. The sensation of lightheadedness can be short-lived, prolonged, or, rarely, recurring. In addition to dizziness, the individual may feel ...

* burning sensations * choking sensations * fear of dying * fear of

insanity Insanity, madness, lunacy, and craziness are behaviors performed by certain abnormal mental or behavioral patterns. Insanity can be manifest as violations of societal norms, including a person or persons becoming a danger to themselves or t ...

Duration

As with a

, an LSA typically peaks in 10 minutes. However, attacks can be as short as one to five minutes or can form a series of episodes waxing and waning for a period of hours.

References

* *{{cite journal , author=Katerndahl DA , title=Progression of limited symptom attacks , journal=Depress Anxiety , volume=9 , issue=3 , pages=138–40 , year=1999 , pmid=10356653 , doi=10.1002/(SICI)1520-6394(1999)9:3<138::AID-DA7>3.0.CO;2-4 , url=http://www3.interscience.wiley.com/cgi-bin/abstract/61005541/ABSTRACT?CRETRY=1&SRETRY=0, archive-url=https://archive.today/20121210054138/http://www3.interscience.wiley.com/cgi-bin/abstract/61005541/ABSTRACT?CRETRY=1&SRETRY=0, url-status=dead, archive-date=2012-12-10, doi-access=free
Anxiety B.C.

Anxiety disorders