Often, a combination of psychotherapy and medications produces good results in the treatment of panic disorder. Improvement is usually noticed in about two to three months. Thus, appropriate treatment for panic disorder can prevent panic attacks or at least substantially reduce their severity and frequency, bringing significant relief to 70%-90% of people with the illness. More than 18% of people who are assessed but not treated for this condition tend to relapse in less than two years. As these statistics indicate, access to appropriate mental health care is key to a positive prognosis for people who suffer from panic attacks. Therefore, it is imperative to alleviate the well documented economic and racial disparities that exist in having and using access to care. Combating other social disparities, like educational, employment, housing, and criminal justice, is also seen as being important to improving the prognosis for recovering from panic attacks and other health problems.
Although how long a panic attack lasts can vary greatly, its duration is typically more than 10 minutes. A panic is one of the most distressing conditions that a person can endure, and its symptoms can closely mimic those of a heart attack. Typically, most people who have one panic attack will have others, and when someone has repeated attacks with no other apparent physical or emotional cause and it negatively changes their behavior due to the attacks or feels severe anxiety about having another attack, he or she is said to have panic disorder. A number of other emotional problems can have panic attacks as a symptom. Some of these illnesses include posttraumatic stress disorder (PTSD), obsessive-compulsive disorder, schizophrenia, and intoxication or withdrawal from alcohol and certain other drugs of abuse.
Some people with anxiety disorders might benefit from joining a self-help or support group and sharing their problems and achievements with others. Internet chat rooms might also be useful, but any advice received over the internet should be used with caution, as Internet acquaintances have usually never seen each other and what has helped one person is not necessarily what is best for another. You should always check with your doctor before following any treatment advice found on the internet. Talking with a trusted friend or member of the clergy can also provide support, but it is not necessarily a sufficient alternative to care from a doctor or other health professional.
Anxiety attacks can last anywhere between a few moments to 30 or more minutes. It’s also common for subsequent anxiety attacks to follow, causing the overall anxiety attack experience to last much longer as one episode is followed by another. Even though anxiety attacks eventually end, it’s common for the symptoms and after effects of an anxiety attack to linger for hours or even days, depending upon the severity of the attack and the level of stress your body is under.
Fortunately, panic disorder is a treatable condition. Psychotherapy and medications have both been used, either singly or in combination, for successful treatment of panic disorder. If medication is necessary, your doctor may prescribe anti-anxiety medications, certain antidepressants or sometimes certain anticonvulsant drugs that also have anti-anxiety properties, or a class of heart medications known as beta-blockers to help prevent or control the episodes in panic disorder.
For people who may be wondering how to avoid panic attacks using treatment without prescribed medication, natural remedies may be an option. While herbal supplements that contain kava have been found to be helpful for some people with mild to moderate panic disorder, the research data is still considered to be too limited for many physicians to recommend treatment with other natural remedies like valerian or passionflower. Also, care should be taken when taking any dietary supplements, since supplements are not regulated in terms of quality, content, or effectiveness.
Anxiety isn't always a bad thing. In fact, it can motivate you and help you to stay focused under pressure. But when worries, fears, or panic attacks start to get in the way of your life, you may be suffering from an anxiety disorder. Whatever form of anxiety you're dealing with, there are many things you can do to gain peace of mind and take back control of your life.

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Everyone has probably experienced panic, or something like it, at least once in their lifetime: on a disturbingly turbulent plane, or before giving an important presentation, or after realizing you hit reply all when you really, really should not have. We all know the paralyzed feeling and the heightened physical sensations. But panic attacks and panic disorder take a different shape. Panic attacks have many physical symptoms and tend to peak around 10 minutes, and may last for 30. Panic disorder is diagnosed by the frequency of these attacks, and the presence of a fear of having them. 


Panic attacks can occur due to number of disorders including panic disorder, social anxiety disorder, post traumatic stress disorder, drug use disorder, depression, and medical problems.[2][4] They can either be triggered or occur unexpectedly.[2] Smoking, caffeine, and psychological stress increase the risk of having a panic attack.[2] Before diagnosis, conditions that produce similar symptoms should be ruled out, such as hyperthyroidism, hyperparathyroidism, heart disease, lung disease, and drug use.[2]

Anxiety attacks that occur while sleeping, also called nocturnal panic attacks, occur less often than panic attacks during the daytime but affect about 40%-70% of those who suffer from daytime panic attacks. This symptom is also important because people who suffer from panic symptoms during sleep tend to have more respiratory distress associated with their panic. They also tend to experience more symptoms of depression and other psychiatric disorders compared to people who do not have panic attacks at night. Nocturnal panic attacks tend to cause sufferers to wake suddenly from sleep in a state of sudden fear or dread for no apparent reason. In contrast to people with sleep apnea and other sleep disorders, sufferers of nocturnal panic can have all the other symptoms of a panic attack. The duration of nocturnal panic attacks tends to be less than 10 minutes, but it can take much longer to fully calm down for those who experience them.
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.
Panic disorder is a separate but related diagnosis to panic attacks. People experiencing repeated panic attacks and who meet other diagnostic criteria may be diagnosed with this illness. Panic disorder is thought to have more of an inherited component than panic attacks that are not a part of panic disorder. Certain medical conditions, like asthma and heart disease, as well as certain medications, like steroids and some asthma medications, can cause anxiety attacks as a symptom or side effect. As individuals with panic disorder are at higher risk of having a heart-valve abnormality called mitral valve prolapse (MVP), that should be evaluated by a doctor since MVP may indicate that specific precautions be taken when the person is treated for a dental problem.
Your heart beats fast, and your breathing speeds up. Your chest may feel tight, and you might start to sweat. If you've ever felt it, you know that anxiety is just as much a physical state as a mental state. That's because there's a very strong biological chain reaction that occurs when we encounter a stressful event or begin to worry about potential stressors or dangers in the future. Other physical symptoms include sweating, headaches, and insomnia. Psychological symptoms may include feeling restless or irritable, feeling tense, having a feeling of dread, or experiencing ruminative or obsessive thoughts.

Expected panic attacks are those which occur when you are exposed to one of your triggers. For example, if you have a fear of flying you may have a panic attack when you board a plane. Expected panic attacks are again broken down into two categories: situationally bound (cued) in which a person is anticipating exposure to a particular trigger (as with our flying example), or situationally predisposed, in which a panic attack does not always occur when exposed to the feared situation.


Anxiety can be caused by numerous factors, ranging from external stimuli, emotional abandonment, shame, to experiencing an extreme reaction when first exposed to something potentially anxiety-provoking. Research has not yet explained why some people will experience a panic attack or develop a phobia, while others growing up in the same family and shared experiences do not. It is likely that anxiety disorders, like all mental illness, is caused by a complex combination of factors not yet fully understood. These factors likely include childhood development, genetics, neurobiology, psychological factors, personality development, and social and environmental cues.


The emotional effects of anxiety may include "feelings of apprehension or dread, trouble concentrating, feeling tense or jumpy, anticipating the worst, irritability, restlessness, watching (and waiting) for signs (and occurrences) of danger, and, feeling like your mind's gone blank"[20] as well as "nightmares/bad dreams, obsessions about sensations, déjà vu, a trapped-in-your-mind feeling, and feeling like everything is scary."[21]

Although many people breathe into a paper bag in an attempt to alleviate the hyperventilation that can be associated with panic, the benefit received may be the result of the individual thinking it will help (a placebo effect). Unfortunately, breathing into a paper bag while having trouble breathing can worsen symptoms when the hyperventilation is caused by a condition associated with oxygen deprivation, like an asthma attack or a heart attack.

Anxiety disorders are a group of mental disorders characterized by exaggerated feelings of anxiety and fear responses.[10] Anxiety is a worry about future events and fear is a reaction to current events. These feelings may cause physical symptoms, such as a fast heart rate and shakiness. There are a number of anxiety disorders: including generalized anxiety disorder, specific phobia, social anxiety disorder, separation anxiety disorder, agoraphobia, panic disorder, and selective mutism. The disorder differs by what results in the symptoms. People often have more than one anxiety disorder.[10]
^ Anxiety: management of anxiety (panic disorder, with or without agoraphobia, and generalised anxiety disorder) in adults in primary, secondary and community care. National Institute for Health and Clinical Excellence. Clinical Guideline 22. Issue date: April 2007 "Archived copy" (PDF). Archived from the original (PDF) on 24 August 2009. Retrieved 2009-07-21. ISBN 1-84629-400-2
The mutism must also include impairment in social, academic, or occupational achievement or functioning to qualify as a diagnosis. Selective mutism is not present if it is related to lack of knowledge or comfort with the spoken language required of the situation or is due to embarrassment from a communication or developmental disorder. The symptoms cannot be better accounted for by another mental disorder or be caused by substances, medications, or medical illness.
Moreover, this hypocapnia and release of adrenaline during a panic attack cause vasoconstriction resulting in slightly less blood flow to the head which causes dizziness and lightheadedness.[28][29] A panic attack can cause blood sugar to be drawn away from the brain and toward the major muscles. Neuroimaging suggests heightened activity in the amygdala, thalamus, hypothalamus, and brainstem regions including the periaqueductal gray, parabrachial nucleus, and Locus coeruleus.[30] In particular, the amygdala has been suggested to have a critical role.[31] The combination of high arousal in the amygdala and brainstem along with decreased blood flow and blood sugar in the brain can lead to dramatically decreased activity in the prefrontal cortex region of the brain.[32] There is evidence that having an anxiety disorder increases the risk of cardiovascular disease (CVD).[33] Those affected also have a reduction in heart rate variability.[33]
Generally, panic attacks are treated with reassurance and relaxation techniques. By definition, panic attacks last less than an hour, so many times a person already feels much better by the time he or she makes it to the doctor's office. Nevertheless, because the diagnosis is made by excluding more dangerous causes, people may be given medications during their attack.
Social Anxiety Disorder;Fear of social situations in which the person is exposed to unfamiliar people or to possible scrutiny by others. The individual fears that he or she will act in a way (or show anxiety symptoms) that will be embarrassing and humiliating, often times leading to avoidance of social situations and severe distress when participation in social situations can't be avoided. [2]

Adoration Aesthetic emotions Affection Agitation Agony Amusement Anger Anguish Annoyance Anxiety Apathy Arousal Attraction Awe Boredom Calmness Compassion Contempt Contentment Defeat Depression Desire Disappointment Disgust Ecstasy Embarrassment Vicarious Empathy Enthrallment Enthusiasm Envy Euphoria Excitement Fear Flow (psychology) Frustration Gratitude Grief Guilt Happiness Hatred Hiraeth Homesickness Hope Horror Hostility Humiliation Hygge Hysteria Infatuation Insecurity Insult Interest Irritation Isolation Jealousy Joy Limerence Loneliness Longing Love Lust Melancholy Mono no aware Neglect Nostalgia Panic Passion Pity Pleasure Pride hubris Rage Regret Rejection Remorse Resentment Sadness Saudade Schadenfreude Sehnsucht Sentimentality Shame Shock Shyness Sorrow Spite Stress Suffering Surprise Sympathy Tenseness Wonder Worry
Demographic factors also impact risk for anxiety disorders. While there is not a strong consensus, research suggests that risk for anxiety disorders decreases over the lifespan with lower risk being demonstrated later in life. Women are significantly more likely to experience anxiety disorders. Another robust biological and sociodemographic risk factor for anxiety disorders is gender, as women are twice as likely as men to suffer from anxiety. Overall symptom severity has also been shown to be more severe in women compared to men, and women with anxiety disorders typically report a lower quality of life than men. This sex difference in the prevalence and severity of anxiety disorders that puts women at a disadvantage over men is not specific to anxiety disorders, but is also found in depression and other stress-related adverse health outcomes (i.e. obesity and cardiometabolic disease). Basic science and clinical studies suggest that ovarian hormones, such as estrogen and progesterone, and their fluctuations may play an important role in this sex difference in anxiety disorder prevalence and severity. While changes in estrogen and progesterone, over the month as well as over the lifetime, are linked to change in anxiety symptom severity and have been shown to impact systems implicated in the etiology of anxiety disorders (i.e. the stress axis), it still remains unclear how these hormones and their fluctuations increase women's vulnerability to anxiety.

There are many highly effective treatment options available for anxiety and anxiety-related disorders. These treatments can be broadly categorized as: 1) Psychotherapy; 2) Medications; and 3) Complementary and Alternative Therapies. Patients diagnosed with anxiety can benefit from one or a combination of these various therapies. Discussions of emerging therapies and types of care providers are also included.
The symptoms of a panic attack may cause the person to feel that their body is failing. The symptoms can be understood as follows. First, there is frequently the sudden onset of fear with little provoking stimulus. This leads to a release of adrenaline (epinephrine) which brings about the fight-or-flight response when the 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. 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 or hypocapnia), causing compensatory metabolic acidosis activating chemosensing mechanisms which translate this pH shift into autonomic and respiratory responses.[25][26] The person him/herself may overlook the hyperventilation, having become preoccupied with the associated somatic symptoms.[27]
Many people use the terms anxiety attack and panic attack interchangeable, but in reality, they represent two different experiences. The DSM-5 uses the term panic attack to describe the hallmark features of panic disorder or panic attacks that occur as a result of another mental disorder. To be considered a panic attack, four or more of the symptoms outlined in the DSM-5 must be present.
Seeing a friend or loved one suffering a panic attack can be frightening. Their breathing may become abnormally fast and shallow, they could become dizzy or light-headed, tremble, sweat, feel nauseous, or think they’re having a heart attack. No matter how irrational you think their panicked response to a situation is, it’s important to remember that the danger seems very real to your loved one. Simply telling them to calm down or minimizing their fear won’t help. But by helping your loved one ride out a panic attack, you can help them feel less fearful of any future attacks.
Antidepressants can take time to work, so it’s important to give the medication a chance before reaching a conclusion about its effectiveness. If you begin taking antidepressants, do not stop taking them without the help of a doctor. When you and your doctor have decided it is time to stop the medication, the doctor will help you slowly and safely decrease your dose. Stopping them abruptly can cause withdrawal symptoms.
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