Social anxiety disorder (previously called social phobia): People with social anxiety disorder have a general intense fear of, or anxiety toward, social or performance situations. They worry that actions or behaviors associated with their anxiety will be negatively evaluated by others, leading them to feel embarrassed. This worry often causes people with social anxiety to avoid social situations. Social anxiety disorder can manifest in a range of situations, such as within the workplace or the school environment.
There is evidence for panic disorder-like diagnoses across cultures, such as ataque de nervios in Latin American communities. Research has shown that African Americans experience more functional impairment (i.e., impact on one's ability to complete daily activities) than non-Latino white Americans. This is not an exhaustive list of cultural factors related to panic disorder, but it does highlight cultural differences that may affect the presentation of panic disorder as well as individual differences in the interpretation of panic symptoms (Asnaani, Gutner, Hinton, & Hofmann, 2009; Hofmann & Hinton, 2014; Lewis-Fernández, et al., 2010).

Now as you feel slightly calmer, you need to identify and face the roots of the anxiety attack. The truth is – there’s always a trigger for it. Even if it’s not obvious, it’s always there. Panic attacks can happen as a response to a stressful or traumatic issue that happened months ago.  Try digging into your mind and thinking of the exact cue that might have caused it.  Remember, an anxiety attack is just a host of physical reactions. No matter how real it feels, the danger is usually non-existent.


This disorder is characterized by panic attacks and sudden feelings of terror sometimes striking repeatedly and without warning. Often mistaken for a heart attack, a panic attack causes powerful physical symptoms including chest pain, heart palpitations, dizziness, shortness of breath and stomach upset. Many people will go to desperate measures to avoid an attack, including social isolation.
A condition in which parting with objects (e.g., household items or personal possessions) causes significant distress. In addition, many individuals continuously acquire new things and experience distress if they are not able to do so. The inability to discard possessions can make living spaces nearly unusable. Relatedly, the cluttered living space can interfere with the performance of daily tasks, such as personal hygiene, cooking, and sleeping (e.g., the shower is full of stuff, the bed is covered with clutter).
In particular, the doctor will be concerned with the person's past medical history, past history of any mental illness, and any surgery the person may have had. In addition to exploring whether the person suffers from any other mental illness, the practitioner often explores whether the panic attack sufferer has a specific anxiety disorder in addition to or instead of panic disorder, like post traumatic stress disorder (PTSD), phobias, obsessive compulsive disorder, or generalized anxiety disorder.
Hyperventilation syndrome may occur when a person breathes from the chest, which can lead to overbreathing (exhaling excessive carbon dioxide in relation to the amount of oxygen in one's bloodstream). Hyperventilation syndrome can cause respiratory alkalosis and hypocapnia. This syndrome often involves prominent mouth breathing as well. This causes a cluster of symptoms, including rapid heart beat, dizziness, and lightheadedness, which can trigger panic attacks.[12]

Agoraphobia is often comorbid with panic disorder — meaning people often suffer from both conditions at the same time. It's an intense fear of not being able to escape whatever place you're in, and can often lead to an avoidance of leaving the house. People with agoraphobia can fear situations where this anxiety might flare up, and typically don't feel comfortable or safe in public, crowded places. 

Prevention is more effective than treatment for panic attacks. Prevention involves stress management methods such as meditation and mindfulness to reduce your stress so that it doesn’t accumulate and eventually erupt into a panic attack. Prevention is not about stopping a panic attack just before it happens. The best you can do just before a panic attack is manage it.
iv suffered with severe anxiety since i suffered a massive panic attack 2 years ago on holiday in spain . i have battled with it and im still fighting now i go through times were im fine but other times like now im still fighting the anxiety attacks . the above advice has helped me so much :)one thing i wanted to ask does anxiety attacks cause headaches (pressure type) ? xxx
Repeated and persistent thoughts ("obsessions") that typically cause distress and that an individual attempts to alleviate by repeatedly performing specific actions ("compulsions"). Examples of common obsessions include: fear that failing to do things in a particular way will result in harm to self or others, extreme anxiety about being dirty or contaminated by germs, concern about forgetting to do something important that may result in bad outcomes, or obsessions around exactness or symmetry. Examples of common compulsions include: checking (e.g., that the door is locked or for an error), counting or ordering (e.g., money or household items), and performing a mental action (e.g., praying).

A first panic attack is usually unexpected, and comes "out of the blue." It may scare you so much that you start taking steps to protect yourself from future attacks. Maybe you start avoiding places that remind you of your first attack. Maybe you only go out after making sure you have your cell phone, a bottle of water, and other objects you hope will keep you safe. Maybe you try hard to "stop thinking about it." You work hard to keep the panic at bay.
Researchers have conducted both animal and human studies to pinpoint the particular parts of the brain that are involved in anxiety and fear. Because fear evolved to deal with danger, it sets off an immediate protective response without conscious thought. This fear response is believed to be coordinated by the amygdala, a structure deep inside the brain. Although relatively small, the amygdala is quite complex, and recent studies suggest that anxiety disorders may be associated with abnormal activity within it.
I acknowledge that Vertical Health will use my information to provide eNewsletters and marketing. I understand I can withdraw permission for this at any time by clicking the unsubscribe link in the footer of any email I receive from Vertical Health. Vertical Health uses third party service providers like MailChimp, Amazon Web Services, Rackspace, and ObjectLabs Corporation (mLab), to store data. My information may be transferred to the aforementioned service providers (or other similar services) for processing in accordance with their privacy policies.
The cognitive effects of anxiety may include thoughts about suspected dangers, such as fear of dying. "You may ... fear that the chest pains are a deadly heart attack or that the shooting pains in your head are the result of a tumor or an aneurysm. You feel an intense fear when you think of dying, or you may think of it more often than normal, or can't get it out of your mind."[22]
Several drugs can cause or worsen anxiety, whether in intoxication, withdrawal or from chronic use. These include alcohol, tobacco, cannabis, sedatives (including prescription benzodiazepines), opioids (including prescription pain killers and illicit drugs like heroin), stimulants (such as caffeine, cocaine and amphetamines), hallucinogens, and inhalants.[57] While many often report self-medicating anxiety with these substances, improvements in anxiety from drugs are usually short-lived (with worsening of anxiety in the long term, sometimes with acute anxiety as soon as the drug effects wear off) and tend to be exaggerated. Acute exposure to toxic levels of benzene may cause euphoria, anxiety, and irritability lasting up to 2 weeks after the exposure.[82]

• Palpitations, pounding heart, or accelerated heart rate • Sweating • Trembling or shaking • Shortness of breath or a sensation of smothering • A choking feeling • Chest pain or discomfort • Nausea or abdominal distress • Feeling dizzy, unsteady, lightheaded, or faint • Feeling detached from oneself or reality • Fear of losing control or of impending doom • Fear of dying • Numbness or a tingling sensation • Chills or hot flashes
Behavioral choices can also significantly impact risk, as excessive tobacco or caffeine use can increase anxiety, whereas regular exercise can decrease anxiety. Specific temperament and personality traits also may confer risk of having an anxiety disorder. With regards to temperament, shyness and behavioral inhibition in childhood can increase risk of developing an anxiety disorder later in life. With regard to personality traits, the Five Factor Model of Personality consists of five broad trait domains including Neuroticism, Extraversion, Openness to Experience, Agreeableness, and Conscientiousness. An individual higher on trait Neuroticism or low on Conscientiousness is at a higher risk for all anxiety disorders, and an individual low on trait Extraversion is at a higher risk of developing social phobia and agoraphobia. Some more narrow personality traits have also been found to relate to risk for anxiety, including anxiety sensitivity, a negative or hostile attributional style, and self-criticism. Personality disorders have also been shown to relate to increased risk for anxiety disorders.
Shortness of breath and chest pain are the predominant symptoms. People experiencing a panic attack may incorrectly attribute them to a heart attack and thus seek treatment in an emergency room. Because chest pain and shortness of breath are hallmark symptoms of cardiovascular illnesses, including unstable angina and myocardial infarction (heart attack), a diagnosis of exclusion (ruling out other conditions) must be performed before diagnosing a panic attack. It is especially important to do this for people whose mental health and heart health statuses are unknown. This can be done using an electrocardiogram and mental health assessments.

Generalized Anxiety Disorder is one of the most common anxiety disorders and affects approximately 3.1% of the American adult population. With 6.8 million reported cases among American adults aged 18 and older, the average age of onset is 31 years old. While it can occur at any point of life, the most common points of onset occur between childhood and middle age. If you are a woman, you are twice as likely to suffer from Generalized Anxiety Disorder than men.


A number of medical conditions can cause anxiety symptoms. These include an overactive thyroid, hypoglycemia, mitral valve prolapse, anemia, asthma, COPD, inflammatory bowel disease, Parkinson's disease, and dementia among others. Your physician may perform certain tests to rule out these conditions. But it is important to remember that anxiety is more often due to poor coping skills or substance abuse than any medical condition.
Have you ever worried about your health? Money? The well-being of your family? Who hasn’t, right? These are common issues we all deal with and worry about from time to time. However, if you find yourself in constant worry over anything and everything in your life, even when there should be no cause for concern, you might be suffering from Generalized Anxiety Disorder. People with this condition often recognize they are “over-worrying” about a lot of issues, but have no control over the worry and associated anxiety. It is constant and can interfere with your ability to relax or sleep well and can cause you to startle easily.
People with panic attacks often report a fear of dying or heart attack, flashing vision, faintness or nausea, numbness throughout the body, heavy breathing and hyperventilation, or loss of body control. Some people also suffer from tunnel vision, mostly due to blood flow leaving the head to more critical parts of the body in defense. These feelings may provoke a strong urge to escape or flee the place where the attack began (a consequence of the "fight-or-flight response", in which the hormone causing this response is released in significant amounts). This response floods the body with hormones, particularly epinephrine (adrenaline), which aid it in defending against harm.[9]
Tip Number 4 is new and interesting to me. I was already coming down off of a panic attack as I was reading this and as I decided to try it. Focusing on my peripheral vision did have a noticeable effect on my momentary stress, though it may have been placebo. Then again, whether or not it was placebo is kind of a moot point, as it still helped. I’ll have to remember this trick and try it again in the future.
When the medical personnel take my vitals, my heart rate has soared above 136 and my breathing is rapid and short. The sweating has slowed, but I am nauseous and dry heaving. It takes about 30 minutes for the aides to update my stats and explain that they think I may be having a minor heart attack or have blood clots going to my heart. They say I need to get to a hospital.
Benzodiazepines are often used to provide short-term relief of panic symptoms. Clonazepam (Klonopin) and lorazepam (Ativan) are examples of this group of medications. Although another benzodiazepine, alprazolam (Xanax), is often used to treat panic attacks, the short period of time that it works can cause the panic sufferer to have to take it multiple times each day. Benzodiazepines tend to be effective in decreasing panic attacks by up to 70%-75% almost immediately; however, this class of medications has a strong addiction potential and should be used with caution. Additional drawbacks include sedation, memory loss, and after several weeks, tolerance to their effects and withdrawal symptoms may occur.
Says Clyman: "You might start to consider your emotions as changing experiences that are always fluctuating. When we feel distressed, it can seem like the distress is going to go on and on forever until we emotionally combust. But instead, emotions act more like a wave, at times increasing and becoming more intense. But inevitably they'll reach a plateau, subsiding and finally passing."
If you have Panic Disorder, the chances are very high that you have altered your life in some significant way in an effort to prevent or avoid additional panic attacks. It is common, for instance, for people to limit their travel; to restrict their driving (maybe staying within a certain radius from home, or avoiding highways); to avoid large, crowded shopping malls; and in general, to attempt to avoid any activity from which "escape" may be difficult.

Exposure therapy for panic disorder with agoraphobia includes exposure to the situations you fear and avoid is also included in treatment. As in exposure therapy for specific phobias, you face the feared situation until the panic begins to go away. Through this experience, you learn that the situation isn’t harmful and that you have control over your emotions.


But some think that nature isn’t as much of an influence as nurture. People theorize that women tend to be socialized in a way that gives them permission to openly discuss emotion. So women may feel more comfortable admitting to feelings than men, who tend to be socialized to keep their feelings to themselves and are less likely to confess to emotional problems. Women may therefore get diagnosed with anxiety disorders more often than men. (9)
×