It is common for a person with one anxiety disorder to also have another anxiety disorder. Anxiety disorders are also frequently accompanied by depression or substance abuse. Anxiety disorders can coexist with physical health conditions as well. In such instances, these physical health conditions will also need to be treated. Before undergoing any treatment, it is important to have a thorough medical exam to rule out other possible causes.

Anxiety disorders fall into a set of distinct diagnoses, depending upon the symptoms and severity of the anxiety the person experiences. Anxiety disorders share the anticipation of a future threat, but differ in the types of situations or objects that induce fear or avoidance behavior. Different types of anxiety disorder also have different types of unhealthy thoughts associated with them.

Panic attacks are common among all anxiety disorders but what sets panic disorder apart is that panic attacks are unexpected and occur "out of the blue" without an obvious trigger (American Psychiatric Association, 2013; Craske & Barlow, 2007). These unexpected panic attacks must be associated with a significant change in behavior or be followed by at least one month of persistent worry about having another attack or about what will happen if you have another panic attack.


According to a study published in Psychology Medicine1, people who suffer from panic attacks and panic disorder may be at higher risk of heart attack and heart disease later in life. While the link between panic disorder and heart disease remains controversial, the study found that compared to individuals without panic disorder, sufferers were found to have up to a 36% higher risk of heart attack and up to 47% higher risk of heart disease. If you suffer from panic attacks, seek attention for any chest pain symptoms in order to rule out any issues with heart health.
Post-Traumatic Stress Disorder affects people after terrifying events such as physical or sexual abuse, car accidents, war or natural disasters. Individuals with PTSD may experience depression, flashbacks, nightmares, sleep difficulties, irritability, aggression, violence, and a feeling of detachment or numbness. Symptoms can be triggered by anything that reminds the individual of their trauma.
Prolonged exposure therapy is a specific type of CBT used to treat PTSD and phobias. The goal of this therapy is to help patients overcome the overwhelming disstress they experience when reminded of past traumas or in confronting their fears. With the guidance of a licensed therapist, the patient is carefully reintroduced to the trauma memories or reminders. During the exposure, the therapist guides the patient to use coping techniques such as mindfulness or relaxation therapy/imagery. The goal of this therapy is to help patients realize that trauma-related memories (or phobias) are no longer dangerous and do not need to be avoided. This type of treatment usually lasts 8-16 weekly sessions.
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“Anxiety attack” is not a formal, clinical term, but one that is used by many people to describe all sorts of things, from feeling worried about an upcoming event to intense feelings of terror or fear that would meet the diagnostic criteria for a panic attack. In order to understand what someone means by “anxiety attack,” it is necessary to consider the context in which the symptoms occur.
Panic attacks are a symptom of an anxiety disorder and affect a significant number of adult Americans. Other facts about panic include that many people in the United States will have full-blown panic disorder at some time in their lives, usually beginning between 15-19 years of age. Panic attacks occur suddenly and often unexpectedly, are unprovoked, and can be disabling.
Signs of mental health difficulty can be different in the workplace than in other settings. The Harvard Mental Health Letter outlines signs that you may notice in your co-workers, which could indicate a significant problem. For anxiety disorders, these can include restlessness, fatigue, difficulty concentrating, excess worrying, and a general impairment in quality of work.
A key component to the prevention of anxiety is awareness. Learning to recognize your anxious thinking patterns when they arise can help you manage and reduce them quickly. Awareness of anxiety begins with trying to identify the cause and/or trigger of anxiety and gaining an understanding of how it affects your mood and behaviors. Is it that your boss recently gave you negative feedback at work and you are worried each day that you are not doing well enough for their standards? Is it that you waited until the last minute to study for a test and are feeling anxious that you will not perform well? Awareness of the source of your anxiety is the first step to finding out the best way to relieve it.
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Cognitive-behavioral therapy, or CBT, teaches patients to see the links between the their thoughts, beliefs, and actions. By changing distorted thought patterns that maintain the anxiety and by exposing the person to anxiety-provoking symptoms or situations in a gradual manner, CBT can help create mastery over the anxiety and panic symptoms. Therapy may help those with panic disorder to
Panic attack symptoms and heart attack symptoms can seem similar because their signs and symptoms can be similar. Most medical professionals, however, can quickly tell the difference between their symptoms as heart attacks have distinct symptoms that aren’t panic attack like. If you are unsure of which is panic attack symptoms and which is heart attack symptoms, seek immediate medical advice. If the doctor believes your symptoms are those of a panic attack, you can feel confident his or her diagnosis is correct. Therefore, there is no need to worry about a heart attack.
Paula had her next panic attack three weeks later, and since then, they’ve been occurring with increasing frequency. She never knows when or where she’ll suffer an attack, but she’s afraid of having one in public. Consequently, she’s been staying home after work, rather than going out with friends. She also refuses to ride the elevator up to her 12th floor office out of fear of being trapped if she has a panic attack.
While the use of drugs in treating panic attacks can be very successful, it is generally recommended that people also be in some form of therapy, such as cognitive behavioral therapy. Drug treatments are usually used throughout the duration of panic attack symptoms, and discontinued after the patient has been free of symptoms for at least six months. It is usually safest to withdraw from these drugs gradually while undergoing therapy.[14] While drug treatment seems promising for children and adolescents, they are at an increased risk of suicide while taking these medications and their well-being should be monitored closely.[59]
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.
In deeper level psychoanalytic approaches, in particular object relations theory, panic attacks are frequently associated with splitting (psychology), paranoid-schizoid and depressive positions, and paranoid anxiety. They are often found comorbid with borderline personality disorder and child sexual abuse. Paranoid anxiety may reach the level of a persecutory anxiety state.[53]
Anxiety is distinguished from fear, which is an appropriate cognitive and emotional response to a perceived threat.[12] Anxiety is related to the specific behaviors of fight-or-flight responses, defensive behavior or escape. It occurs in situations only perceived as uncontrollable or unavoidable, but not realistically so.[13] David Barlow defines anxiety as "a future-oriented mood state in which one is not ready or prepared to attempt to cope with upcoming negative events,"[14] and that it is a distinction between future and present dangers which divides anxiety and fear. Another description of anxiety is agony, dread, terror, or even apprehension.[15] In positive psychology, anxiety is described as the mental state that results from a difficult challenge for which the subject has insufficient coping skills.[16]
Panic attacks, on the other hand, are short bursts of intense fear often marked by increased heart rate, brief chest pain or shortness of breath. Typically lasting fewer than 30 minutes, they could occur once or repeatedly — sometimes without reason. These episodes can send patients to the emergency room, as they are sometimes mistaken for a heart attack.
[3]DISCLAIMER: Because each body is somewhat chemically unique, and because each person will have a unique mix of symptoms and underlying factors, recovery results may vary. Variances can occur for many reasons, including due to the severity of the condition, the ability of the person to apply the recovery concepts, and the commitment to making behavioral change.
Panic attacks and panic disorder are not the same thing. Panic disorder involves recurrent panic attacks along with constant fears about having future attacks and, often, avoiding situations that may trigger or remind someone of previous attacks. Not all panic attacks are caused by panic disorder; other conditions may trigger a panic attack. They might include:

Once the diagnosis of panic attack is made, however, the person may be surprised that no medicines are prescribed. Before medications are started, the person requires further evaluation by a mental-health professional to check for the presence of other mental-health disorders. These may include anxiety disorders, depression, or panic disorder (a different diagnosis than panic attack).
Post-traumatic stress disorder -- or PTSD -- was considered to be a type of anxiety disorder in earlier versions of the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders. But in 2013, PTSD was reclassified as its own condition. It describes a range of emotional reactions caused by exposure to either death or near-death circumstances (such as fires, floods, earthquakes, shootings, assault, automobile accidents, or wars) or to events that threaten one's own or another person's physical well-being. The traumatic event is re-experienced with fear of feelings of helplessness or horror and may appear in thoughts and dreams. Common behaviors include the following:
Many patients first report symptoms to their primary care physician. Primary care physicians (PCPs) will administer a thorough physical exam to rule out hormonal imbalances, side effects of medications, and certain illnesses. If the symptoms are not due to other conditions, the physician may diagnose the patient with anxiety and therefore refer the patient to a psychologist or psychiatrist. Physicians practice in hospitals, clinics and private practices.
If you're having lots of panic attacks at unpredictable times and there doesn't seem to be a particular trigger or cause, you might be given a diagnosis of panic disorder. It's common to experience panic disorder and agoraphobia (a type of phobia) together. People who experience panic disorder may have some periods with few or no panic attacks, but have lots at other times.

In people with anxiety disorders, the brain circuitry that controls the threat response goes awry. At the heart of the circuit is the amygdala, a structure that flags incoming signals as worrisome and communicates with other parts of the brain to put the body on alert for danger. Early life events, especially traumatic ones, can program the circuitry so that it is oversensitive and sends out alarms too frequently and with only minor provocations. Survival mandates a system for perceiving threats and taking quick, automatic action, but those with anxiety see threats where there are none, perhaps because emotional memories color their perceptions.
Characterized by a preoccupation with the belief that one's body or appearance are unattractive, ugly, abnormal or deformed. This preoccupation can be directed towards one or many physical attributes (e.g., acne, hair loss, facial features). Muscle dysmorphia is a subtype of this disorder that is characterized by belief that one's body is too small or insufficiently muscular.

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)
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