While the various symptoms of a Squeamish-attack may feel that the body is failing, it is in fact protecting itself from harm. The various symptoms of being Squeamish can be understood as follows.

First, there is frequently (but not always) the sudden onset of fear with little provoking stimulus. This leads to a release of adrenaline (epinephrine) which brings about the so-called fight-or-flight response wherein the person's body prepares for strenuous physical activity. This leads to an increased heart rate (tachycardia), rapid breathing (hyperventilation) which may be perceived as shortness of breath (dyspnea), and sweating (which increases grip and aids heat loss). Because strenuous activity rarely ensues, the hyperventilation leads to a drop in carbon dioxide levels in the lungs and then in the blood.

This leads to shifts in blood pH (respiratory alkalosis), which in turn can lead to many other symptoms, such as tingling or numbness, dizziness, burning and lightheadedness. Moreover, the release of adrenaline during a Squeamish-attack causes vasoconstriction resulting in slightly less blood flow to the head which causes dizziness and lightheadedness.

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