If left untreated, anxiety may worsen to the point at which the person's life is seriously affected by panic attacks and by attempts to avoid or conceal them. In fact, many people have had problems with friends and family, failed in school, and/or lost jobs while struggling to cope with this condition. There may be periods of spontaneous improvement in the episodes, but panic attacks do not usually go away unless the person receives treatments designed specifically to help people with these symptoms.
Panic attacks and panic disorder are treatable once the underlying cause of is identified. “Usually medical conditions and other factors (substance use or withdrawal from substances) are ruled out before making the diagnosis,” says Flo Leighton, psychiatric nurse practitioner, and therapist with Union Square Practice in Manhattan. Getting to the root cause typically takes a couple of sessions, says Leighton. Here are some options that may be recommended to you :
Yes, panic attacks are real and potentially quite emotionally disabling. Fortunately, they can be controlled with specific treatments. Because of the disturbing physical signs and symptoms that accompany panic attacks, they may be mistaken for heart attacks or some other life-threatening medical problem. In fact, up to 25% of people who visit emergency rooms because of chest pain are actually experiencing panic. This can lead to people with this symptom often undergoing extensive medical testing to rule out physical conditions. Sadly, sometimes more than 90% of these individuals are not appropriately diagnosed as suffering from panic.

Acupuncture is a treatment derived from traditional Chinese medicine. It consists of inserting very thin needles into the body in targeted areas. To date there is very little evidence that acupuncture can significantly treat generalized anxiety, although there are currently ongoing research trials for PTSD. One study did find that acupuncture can reduce pre-operative anxiety.
People with panic disorder may also experience comorbid bipolar disorder, alcohol or substance use disorder, or medical problems that accompany their panic. It is common for individuals with panic disorder to have thyroid problems, respiratory issues, heart problems, or feelings of dizziness (APA, 2013). In general, it has been reported that 93.7% of people with panic disorder meet criteria for at least one other medical or mental disorder (Arch, Kirk, & Craske, 2017). That being said, comorbidity is not inevitable with panic disorder and it is important to discuss your symptoms thoroughly with a medical professional. Additionally, the causality of the link between panic disorders and medical problems remains unclear.

I’ve had a lot of these symptoms and I know I also have depression. These anxiety attack’s come at the worst of times, when I work and I can’t get my mind focused back into what I need to do. I’m only 19 years old, but I’ve been to hell & back. Serving in the U.S.Marines to now, back home not doing anything I love after I got discharged. I feel lost and I haven’t got my life back together yet. I don’t have anyone to depend on besides my brother who is a Marine now, stationed 1000 miles away. I haven’t been able to establish myself well, since. I do have a wonderful girlfriend I love dearly and we have been together 2-years, traveling with me and moving near me. I’ve come home and things just feel like they’re slipping away. I was trained to not stress and be calm in the worst situations. But, even as a Marine, things can get very hard and wear on my mind. I thought nothing would be worse than Parris Island, but I am wrong. Life has been beating me down. I lost my car because someone sold me a stolen car and I feel like I’ve lost motivation to do my job; Walking and hitching rides to work to make best I can do. If there’s anyone that’s older that can give me some advice, that would be great. Because I don’t have a lot of people, my brother is not here, and I just need something. I want to do nothing but great things in this life. It’s just been hard to deal with lately and I’m losing hope. These anxiety attacks are slowly killing me. It’s every second of every-single-day.
Generalized Anxiety Disorder is different than having a phobia about something. People with phobias are fearful of something in particular – for example, spiders, heights, or speaking in public. If you have Generalized Anxiety Disorder, you have an uneasy feeling about life in general. Often associated with feelings of dread or unease, you are in a state of constant worry over everything. If a friend doesn’t call you back within an hour, you may start to worry you did something wrong and the friend is upset with you. If you are waiting for someone to pick you up and he is a few minutes late – you may start to fear the worst – that he was in an accident, instead of thinking something more minor, like he got stuck in traffic. The feelings are not as intense as those that occur during a panic attack episode; however, the feelings are long-lasting. This results in having anxiety toward your life in general and the inability to relax – what some may consider far more debilitating than a specific phobia to a certain thing or situation, which you could possible avoid. There is no “off” switch. If you are suffering from Generalized Anxiety Disorder, you are experiencing a constant state of worry – and you cannot avoid it, because life, in general, is causing you anxiety.
Learn how to control your breathing. Hyperventilation brings on many sensations (such as lightheadedness and tightness of the chest) that occur during a panic attack. Deep breathing, on the other hand, can relieve the symptoms of panic. By learning to control your breathing, you can calm yourself down when you begin to feel anxious. And if you know how to control your breathing, you’re also less likely to create the very sensations that you’re afraid of.
In the central nervous system (CNS), the major mediators of the symptoms of anxiety disorders appear to be norepinephrine, serotonin, dopamine, and gamma-aminobutyric acid (GABA). Other neurotransmitters and peptides, such as corticotropin-releasing factor, may be involved. Peripherally, the autonomic nervous system, especially the sympathetic nervous system, mediates many of the symptoms. Increased flow in the right parahippocampal region and reduced serotonin type 1A receptor binding in the anterior and posterior cingulate and raphe of patients are the diagnostic factors for prevalence of anxiety disorder.
The theologian Paul Tillich characterized existential anxiety[23] as "the state in which a being is aware of its possible nonbeing" and he listed three categories for the nonbeing and resulting anxiety: ontic (fate and death), moral (guilt and condemnation), and spiritual (emptiness and meaninglessness). According to Tillich, the last of these three types of existential anxiety, i.e. spiritual anxiety, is predominant in modern times while the others were predominant in earlier periods. Tillich argues that this anxiety can be accepted as part of the human condition or it can be resisted but with negative consequences. In its pathological form, spiritual anxiety may tend to "drive the person toward the creation of certitude in systems of meaning which are supported by tradition and authority" even though such "undoubted certitude is not built on the rock of reality".[23]
A panic attack may be a one-time occurrence, although many people experience repeat episodes. Recurrent panic attacks are often triggered by a specific situation, such as crossing a bridge or speaking in public—especially if that situation has caused a panic attack before. Usually, the panic-inducing situation is one in which you feel endangered and unable to escape, triggering the body’s fight-or-flight response.
Poor coping skills (e.g., rigidity/inflexible problem solving, denial, avoidance, impulsivity, extreme self-expectation, negative thoughts, affective instability, and inability to focus on problems) are associated with anxiety. Anxiety is also linked and perpetuated by the person's own pessimistic outcome expectancy and how they cope with feedback negativity.[83] Temperament (e.g., neuroticism)[41] and attitudes (e.g. pessimism) have been found to be risk factors for anxiety.[57][84]
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.
Characterized by the development of certain trauma-related symptoms following exposure to a traumatic event (see "Diagnostic criteria" below). While most people experience negative, upsetting, and/or anxious reactions following a traumatic event, a diagnosis of PTSD is made when symptoms and negative reactions persist for more than a month and disrupt daily life and functioning. Symptoms are separated into four main groups: re-experiencing, avoidance, negative cognitions and mood, and hyperarousal. The specific symptoms experienced can vary substantially by individuals; for instance, some individuals with PTSD are irritable and have angry outbursts, while others are not. In addition to the symptoms listed below, some individuals with PTSD feel detached from their own mind and body, or from their surroundings (i.e., PTSD dissociative subtype).
Buspirone is a drug indicated for the treatment of anxiety. This drug has high efficacy for Generalized Anxiety Disorder and is particularly effective at reducing the cognitive and interpersonal problems associated with anxiety. Unlike benzodiazepines, buspirone does not have a sedative effect or interact with alcohol. Most importantly there is a very low risk of developing a dependence on buspirone. Its side effects are minimal but can include dizziness, nervousness, and headaches. BuSpar and Vanspar are brand names associated with buspirone.
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.
Although breathing into a paper bag was a common recommendation for short-term treatment of symptoms of an acute panic attack,[45] it has been criticized as inferior to measured breathing, potentially worsening the panic attack and possibly reducing needed blood oxygen.[46][47] While the paper bag technique increases needed carbon dioxide and so reduces symptoms, it may excessively lower oxygen levels in the blood stream.
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.

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.


For more information, please visit Mental Health Medications Health Topic webpage. Please note that any information on this website regarding medications is provided for educational purposes only and may be outdated. Diagnosis and treatment decisions should be made in consultation with your doctor. Information about medications changes frequently. Please visit the U.S. Food and Drug Administration website for the latest information on warnings, patient medication guides, or newly approved medications.
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