“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.
Yes, anxiety attacks and their signs and symptoms can feel awful, intense, and threatening. But they aren’t harmful. They pass when the anxiety attack subsides. Getting the right information, help, and support is the best way to treat anxiety attacks and their signs and symptoms. We provide more detailed information in the Recovery Support area of our website.
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]
Those who experience panic attacks are often nervous about having additional episodes. To avoid having a panic attack in a public space, they may avoid places like shopping malls or other crowded spots where previous incidents may have occurred or places that they fear will not allow them immediate access to help, such as an airplane or movie theater. This avoidance when severe may lead to agoraphobia, the inability to leave familiar, safe surroundings because of intense fear and anxiety about having a panic attack outside the home.
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.
Meditation may also be helpful in the treatment of panic disorders.[54] There was a meta-analysis of the comorbidity of panic disorders and agoraphobia. It used exposure therapy to treat the patients over a period. Hundreds of patients were used in these studies and they all met the DSM-IV criteria for both of these disorders.[55] A result was that thirty-two percent of patients had a panic episode after treatment. They concluded that the use of exposure therapy has lasting efficacy for a client who is living with a panic disorder and agoraphobia.[55]

Panic disorder is a condition that causes many disturbing mental, physical, and emotional symptoms. Despite these intense symptoms, panic disorder, panic attacks, and agoraphobia are all treatable conditions. Given that agoraphobia typically develops within the first year a person begins to have abrupt panic attacks, it is important to seek out help early on. However, treatment can provide much improvement, even for those with long-term symptoms.


Anxiety disorders reflect disorders that share a general feature of excessive fear (i.e. emotional response to perceived or real threat) and/or anxiety (i.e. anticipation of future threat) and demonstrate behavioral and functional disturbances as a result. Panic attacks are a feature that can occur in the context of many anxiety disorders and reflect a type of fear response.


Research demonstrates that the most effective treatments for anxiety are behavioral. Such treatments often involve gradually exposing sufferers to the situations they fear. Anxiety therapy may also focus on changing distorted thought patterns that underlie the condition. Drugs may help patients control their anxiety, but they are typically effective only during treatment and do not usually cure the condition. Increasingly, researchers are finding that mindfulness meditation can be a successful technique that helps lessen anxiety.

The condition of steady, pervasive anxiety is called Generalized Anxiety Disorder. Yet there are numerous anxiety-related disorders. One is panic disorder—severe episodes of anxiety that occur in response to specific triggers. Another is obsessive-compulsive disorder, marked by persistent intrusive thoughts or compulsions to carry out specific behaviors, such as hand-washing. Post-traumatic stress disorder may develop after exposure to a terrifying event in which severe physical harm occurred or was threatened. Anxiety so frequently co-occurs with depression that the two are thought to be twin faces of one disorder. Like depression, anxiety strikes twice as many adult females as males.

An anxiety or panic attack often comes on suddenly, with symptoms peaking within 10 minutes. For doctors to diagnose a panic attack, they look for at least four of the following signs: sweating, trembling, shortness of breath, a choking sensation, chest pain, nausea, dizziness, fear of losing your mind, fear of dying, feeling hot or cold, numbness or tingling, a racing heart (heart palpitations), and feeling unusually detached from yourself.


Depression is a condition in which a person feels discouraged, sad, hopeless, unmotivated, or disinterested in life in general for more than two weeks and when the feelings interfere with daily activities. Major depression is a treatable illness that affects the way a person thinks, feels, behaves, and functions. At any point in time, 3 to 5 percent of people suffer from major depression; the lifetime risk is about 17 percent.

There are two very important guidelines to think about, aside from symptoms. These are duration of symptoms and level of impairment. Anxiety is a normal reaction to stressful situations, and even high levels of anxiety can be healthy and beneficial at times. Disorders are only present when anxiety symptoms last for several weeks to months and significantly interfere with every day function or cause long-lasting distress.
CBT is a short-term treatment designed to help patients identify inaccurate and negative thinking in situations that cause anxiety like panic attacks. CBT can be used in one-on-one therapy or in a group therapy session with people facing similar problems. CBT primarily focuses on the ongoing problems in a patient's life and helps them develop new ways of processing their feelings, thoughts and behaviors to develop more effective ways of coping with their life. In patients who suffer from PTSD, CBT can take on a trauma-focused approach, where the goal is to process and reframe the traumatic experience that lead to the symptoms. On average, the length of treatment is around 10-15 weekly one-hour sessions depending on the type and severity of symptoms.
Persistent and excessive fear of a specific object or situation, such as flying, heights, animals, toilets, or seeing blood. Fear is cued by the presence or anticipation of the object/situation and exposure to the phobic stimulus results in an immediate fear response or panic attack. The fear is disproportionate to the actual danger posed by the object or situation. Commonly, adults with specific phobias will recognize that their fear is excessive or unreasonable.
Warren: With anxiety to the point where it’s part of a disorder — let’s say generalized anxiety disorder, mostly characterized by anxiety and worry about a whole bunch of different situations — we would treat it by teaching a patient about the role of worry in creating the symptoms and how to manage the worry. That sometimes involves challenging unrealistic thoughts or working to increase one’s ability to tolerate uncertainty, which is a big part of anxiety.
Your brain focuses on some alleged thread, for instance, a very scary thought that was floating somewhere at your subconscious.  Your thalamus – the part of the brain responsible for regulating consciousness, sleep and alertness – transfers that information to your amygdala – the part of the brain responsible for emotional reactions, decision-making and memory – which marks it as “danger” and sends a signal to your sympathetic nervous system, activating the fight-or-flight response.

Warren: So if you’re walking down a dark alley, you are probably thinking that there could be potential danger; that anxiety of anticipation, the feeling in your stomach, the elevated heart rate. But if you’re walking down that alley and somebody jumps out with a knife, then you’re likely to have a panic attack — an overwhelming urge to escape a situation that is dangerous.


We all tend to avoid certain things or situations that make us uncomfortable or even fearful. But for someone with a phobia, certain places, events or objects create powerful reactions of strong, irrational fear. Most people with specific phobias have several things that can trigger those reactions; to avoid panic, they will work hard to avoid their triggers. Depending on the type and number of triggers, attempts to control fear can take over a person’s life.

Panic attacks are generally brief, lasting less than 10 minutes, although some of the symptoms may persist for a longer time. People who have had one panic attack are at greater risk for having subsequent panic attacks than those who have never experienced a panic attack. When the attacks occur repeatedly, and there is worry about having more episodes, a person is considered to have a condition known as panic disorder.
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. 

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.
Many people experience their first panic attack due a build up of chronic stress. Anxious personalities often then become afraid of them, which further stresses the body. As fear and stress increase, so does the likelihood of a subsequent panic attack. This scenario is a common catalyst into Panic Attack Disorder: becoming afraid of the feelings and symptoms of a panic attack, which causes further panic attacks.

A panic attack is a response of the sympathetic nervous system (SNS). The most common symptoms include trembling, dyspnea (shortness of breath), heart palpitations, chest pain (or chest tightness), hot flashes, cold flashes, burning sensations (particularly in the facial or neck area), sweating, nausea, dizziness (or slight vertigo), light-headedness, hyperventilation, paresthesias (tingling sensations), sensations of choking or smothering, difficulty moving, and derealization. These physical symptoms are interpreted with alarm in people prone to panic attacks. This results in increased anxiety and forms a positive feedback loop.[10]


Poverty and low education level tend to be associated with anxiety, but it is unclear if those factors cause or are caused by anxiety. While some statistics suggest that disadvantaged ethnic minorities tend to suffer from internalizing disorders like panic disorder less often than the majority population in the United States, other research shows that may be the result of differences in how ethnic groups interpret and discuss signs and symptoms of intense fright, like panic attacks. Also, panic and other anxiety disorders are thought to persist more for some ethnic minorities in the United States. Difficulties the examiner may have in appropriately recognizing and understanding ethnic differences in symptom expression is also thought to play a role in ethnic differences in the reported frequency of panic and other internalizing disorders.
I was 34 before I knew anxiety was real. I had lived my life with these feelings, never knowing that everyone else wasn’t experiencing the same thing. I was 35 when I reached out to a friend, who is a nurse practitioner, to ask about my symptoms. That is when I began taking medication. I am on the lowest dose of anxiety medication and I have been taking it for six months. It has changed my life.
A large brief current is passed through a wire coil that is placed on the front of the head which is near the areas that regulate mood. The transient current creates a magnetic field that produces an electric current in the brain and stimulates nerve cells in the targeted region. The current typically only affects brain regions that are 5 centimeters deep into the brain which allows doctors to selectively target which brain regions to treat. Typical sessions lasts 30-60 minutes and do not require anesthesia. Sessions are administered 4-5 times a week for about 6 weeks. Although the procedure is painless, patients may experience a gentle tapping in the area of the head where the current is being administered. Neuromodulation has very few side effects but they may include headaches, slight tingling or discomfort in the area in which the coil is placed. rTMS may be administered alone or in combination with medication and/or psychotherapy.
While obsessive-compulsive disorder is not officially classified by the American Psychological Association as an anxiety disorder, it shares many traits with common anxiety disorders, such as generalized anxiety disorder. In both conditions, you may know that your thoughts are irrational, but you feel unable to stop thinking them. Often, but not always, these thoughts may concern cleanliness, sex, or religion.

The buildup phase of a panic attack is the most important phase, because it is when you can prevent it. If you are under chronic stress, you become worn down and have no reserve left. Anything can push you over the edge. But if you regularly reduce your stress through a combination of cognitive behavioral therapy and mind-body relaxation, you will have enough reserve left to handle life’s surprises.

If you can identify that after a long day of parenting you often feel exhausted and overcome with anxiety by all of the things you need to do, you can work to schedule in "me time" where you can make sure that you have time to relax, exercise or engage in an enjoyable activity that you know helps to reduce your anxiety. Taking care of yourself is important to be able to take care of others.
I don’t clearly know if it’s a panic attack. Sometimes I feel left out or secluded and then the feelings come over. Sometimes if I feel things are being unfair, it triggers again. I am diabetic patient suffering from fights to take medicines regualry. If this feeling of loneliness or being left out occurs, then i just can’t help but feel a lump in my throat, as if I can’t breathe. I get very frustrated, restless and often feel like crying but no voice will come out. Sometimes, heck no one ever understands my feelings and pain and it just gets worse. Mood swings, Shivering, body pain, restlessness dizzyness, headache, are few symptoms. And then I start thinking of how useless I am and there is a reason why I am not chosen for things thus making me feel like even more shit.
Post-traumatic stress disorder (PTSD) is an extreme anxiety disorder that can occur in the aftermath of a traumatic or life-threatening event. PTSD can be thought of as a panic attack that rarely, if ever, lets up. Symptoms of PTSD include flashbacks or nightmares about what happened, hypervigilance, startling easily, withdrawing from others, and avoiding situations that remind you of the event.
Obsessive-Compulsive Disorder (OCD) is characterized by uncontrollable anxious thoughts or behaviors. Individuals with OCD are plagued by persistent, unwelcome thoughts and images or by the urgent need to engage in certain rituals. Some OCD sufferers may only have obsessive thoughts without the related rituals. The disturbing thoughts or images (e.g., fear of germs) are called obsessions, and the rituals performed to try to get rid of them (e.g., hand washing) are called compulsions. For example, people who are obsessed with germs may wash their hands excessively. The individual is not happy to be performing the ritual behaviors but finds this to be the only way to get temporary relief from the obsessive thought.

No matter what your plan is, having one in place is the most important thing. You can think of your plan as your go-to set of instructions for yourself when you feel a panic attack coming on. One plan might be to take yourself out of your current environment, sit down, and call a friend or family member that can help distract you from your symptoms and help you to calm down. Then you can incorporate the following techniques.
Additionally, there is some evidence that Acceptance and Commitment Therapy (ACT), Mindfulness-based Stress Reduction treatment (MBSR), as well as online and computerized treatments are effective in treating panic disorder (Arch et al., 2017). However, the overwhelming majority of research supports the long-term success of CBT for treating panic disorder. More research is needed to explore the extent to which MBSR and ACT work when compared to CBT and other treatments, but preliminary results are positive. In general, empirically-supported treatments that are founded on the basis of research within the psychological and medical fields are recommended for treating panic disorder.

Our experience has shown that the most effective treatment for anxiety attacks is the combination of good self-help information and Personal Coaching/Counseling/Therapy. Since the underlying factors that cause issues with anxiety are learned, generally a professional therapist is required to help uncover, identify, and successfully address them. Working with a professional therapist ensures that these underlying factors are effectively treated.[1]
Anxiety disorders are associated with chronic life stress. Unpredictable, unrelenting, unresolvable stressors chronically stimulate the stress hormone system and cardiovascular system, and lead to states of constant increased activity. Biologically, the body has evolved to deal with imminent and concrete danger in the environment, rather than continuous stressors. Under normal conditions where chronic stress is low, exposure to a sudden threat activates the autonomic nervous system, i.e. increased levels of adrenaline and faster breathing, and racing heart rate. These reactions in turn trigger activation of stress hormones, such as cortisol. One of the effects of these stress hormones is to increase glucose levels in the bloodstream in order to respond to the imminent threat, so that muscles can be activated for the flight or fight response. Another effect of stress hormones is to supress the immune system, since processes such as healing and repair can wait until after the threat subsides. However, in someone with an anxiety disorder, where there is constant activation of these responses to everyday stressors, the stress hormone system loses its ability to control immune function, thus contributing to heightened systemic inflammation that increases risk for cardiovascular and even autoimmune disorders. Neuroscience and clinical research continues to investigate how anxiety disorders increase individual risk for developing physical health co-morbidities in hopes of identifying new treatments that may alleviate suffering from and prevent the development of these whole-body disorders.
How do you know if you're having a panic or anxiety attack? Panic attacks and anxiety attacks share some symptoms, but they differ in intensity, duration, and whether or not there is a trigger. Some treatments are similar and include therapy, stress management, and breathing exercises. Learn more about the differences between a panic attack and an anxiety attack here. Read now
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.
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]
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.
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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.
^ Leicht, Gregor; Mulert, Christoph; Eser, Daniela; Sämann, Philipp G.; Ertl, Matthias; Laenger, Anna; Karch, Susanne; Pogarell, Oliver; Meindl, Thomas; Czisch, Michael; Rupprecht, Rainer (2013). "Benzodiazepines Counteract Rostral Anterior Cingulate Cortex Activation Induced by Cholecystokinin-Tetrapeptide in Humans". Biological Psychiatry. 73 (4): 337–44. doi:10.1016/j.biopsych.2012.09.004. PMID 23059050.
Cognitive behavioral therapy (CBT), is based on the idea that our thoughts cause our feelings and behaviors, not external things, like people, situations, and events. According to the National Association of Cognitive Behavioral Therapists the benefit of this therapy is that we can change the way we think to feel and act better even if the situation does not change. CBT focuses on determining the thought and behavior patterns responsible for sustaining or causing the panic attacks. CBT is a time-limited process (treatment goals—and the number of sessions expected to achieve them—are established at the start) that employs a variety of cognitive and behavioral techniques to affect change.
Paula had her first panic attack six months ago. She was in her office preparing for an important work presentation when, suddenly, she felt an intense wave of fear. Then the room started spinning and she felt like she was going to throw up. Her whole body was shaking, she couldn’t catch her breath, and her heart was pounding out of her chest. She gripped her desk until the episode passed, but it left her deeply shaken.
Panic attacks (or anxiety attacks - the terms are interchangeable) are intense episodes of fear which are so powerful that they trick you into fearing that you are dying, going crazy, about to faint, or losing control of yourself in some vital way. The symptoms of a panic attack feel so powerful and threatening that they convince you that you're in terrible danger.
A phobia is an unrealistic or exaggerated fear of a specific object, activity, or situation that in reality presents little to no danger. Common phobias include fear of animals (such as snakes and spiders), fear of flying, and fear of heights. In the case of a severe phobia, you might go to extreme lengths to avoid the thing you fear. Unfortunately, avoidance only strengthens the phobia.
While everyone experiences brief episodes of intense anxiety from time to time, and a great many people experience one or two anxiety attacks over the course of their lifetime, anxiety attack disorder occurs when these attacks become frequent or persistent, begin interfering with or restricting normal lifestyle, or when the individual becomes afraid of them. Once established, anxiety attack disorder can be very debilitating.
Anxiety can be either a short-term "state" or a long-term "trait". Whereas trait anxiety represents worrying about future events, anxiety disorders are a group of mental disorders characterized by feelings of anxiety and fear.[10] Anxiety disorders are partly genetic but may also be due to drug use, including alcohol, caffeine, and benzodiazepines (which are often prescribed to treat anxiety), as well as withdrawal from drugs of abuse. They often occur with other mental disorders, particularly bipolar disorder, eating disorders, major depressive disorder, or certain personality disorders. Common treatment options include lifestyle changes, medication, and therapy. Metacognitive therapy seeks to diminish anxiety through reducing worry, which is seen[by whom?] as a consequence of metacognitive beliefs.[11]
A panic attack is an abrupt surge of intense fear or discomfort that reaches a peak within minutes, and during which time a variety of psychological and physical symptoms occur. These symptoms include rapid heart rate, sweating, shaking, shortness of breath, hot flashes, and lightheadedness—as well as a sense of impending doom, chills, nausea, abdominal pain, chest pain, headache, and numbness or tingling.
With panic attacks, we might show them a diagram and explain the fight-or-flight response; their mind or body is trying to help them. If you’ve had a panic attack that came out of the blue, you might become afraid of lightheadedness and avoid activities that spur adrenaline. So we might hyperventilate for a minute in a controlled way to get to the point where they’re not afraid of their own bodily sensation. We work on internal avoidance of those cues that become scary, and desensitize them.
A panic attack begins suddenly and unexpectedly and most often peaks within 10 to 20 minutes. At times, the resulting anxiety may last a couple of hours. Panic attacks can occur whether the person is calm or anxious. Recalling a past attack may trigger a new one. The frequency of panic attacks can vary, and for some people the fear of having an additional attack may lead them to avoid situations where escape may be difficult, such as being in a crowd or traveling in a car or bus. 

4) Ice, Ice Baby. For nighttime panic attacks, Kirstie Craine Ruiz keeps about 4 ready-to-go ice packs—2 big and 2 small– in her freezer.  When she feels panic coming she puts two small ones in her hand and the 2 large ones on my lower back.  “If your heart is really racing and your breathing is bad, I would suggest taking the one on your belly and rubbing it from the middle of your chest down to the bottom of your belly, slowly, and over and over until your heart rate starts to mellow (over your shirt, of course- you don’t want to make yourself freezing!).  I feel like when I do this, it literally moves the hyper energy down from my chest and alleviates any chest pain. This method always helps me when it feels like my heart is in my throat.  Once you feel as though you can breathe again, place the packs on your lower belly or lower back, and in the palms of your hands. I don’t know if it’s pressure points but holding small smooth ice packs in both hands with palms up, does wonders for my panic, to this day.”
The philosopher Søren Kierkegaard, in The Concept of Anxiety (1844), described anxiety or dread associated with the "dizziness of freedom" and suggested the possibility for positive resolution of anxiety through the self-conscious exercise of responsibility and choosing. In Art and Artist (1932), the psychologist Otto Rank wrote that the psychological trauma of birth was the pre-eminent human symbol of existential anxiety and encompasses the creative person's simultaneous fear of – and desire for – separation, individuation, and differentiation.
Exposure therapy for panic disorder allows you to experience the physical sensations of panic in a safe and controlled environment, giving you the opportunity to learn healthier ways of coping. You may be asked to hyperventilate, shake your head from side to side, or hold your breath. These different exercises cause sensations similar to the symptoms of panic. With each exposure, you become less afraid of these internal bodily sensations and feel a greater sense of control over your panic.

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.
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