Your health care provider can determine if your panic disorder is caused by an underlying medical condition, such as heart disease or thyroid problems. This may require blood tests and an electrocardiogram (ECG). A complete assessment should also include questions about your caffeine and alcohol consumption, and any substance use, which can contribute to an anxiety disorder.
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.

“Panic disorder is diagnosed if the individual has recurrent panic attacks (minimum four in a four-week period), and at least one of the attacks is accompanied by one or more physical symptoms, including persistent concern about having another attack, worry about the implication or consequences of the attack (i.e., having a heart attack), and/or a significant change in behaviour due to the attacks, such as quitting a job.7 In addition, the panic attacks cannot be due to the physiological effects of a substance or another general medical condition.”[1]


During the day if she was out, the attack felt “like my head suddenly weighed a thousand pounds and my chest would get really heavy. It literally felt like something was pulling me down. I would usually have to head home immediately.  I would then experience foggy vision where it …actually looked like there was fog in the air. I also experienced double vision and parts of my body—like my neck or one arm or one entire side of my face– would go totally numb.”
It is 3:00 in the morning. I wake up from a dead sleep, sit straight up, and immediately know something is wrong. I am sweating, nauseous, and feel as if someone has dumped a bucket of ice water onto my chest. I feel it spill down my abdomen and through my arms and legs. My chest feels as though a giant’s hand is squeezing it with the intention of taking my life.
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.
We have all felt anxiety—the nervousness before a date, test, competition, presentation—but what exactly is it? Anxiety is our body's way of preparing to face a challenge. Our heart pumps more blood and oxygen so we are ready for action. We are alert and perform physical and emotional tasks more efficiently. (See also Test Anxiety for tips on dealing with tests.)

When people are confronted with unpleasant and potentially harmful stimuli such as foul odors or tastes, PET-scans show increased bloodflow in the amygdala.[87][88] In these studies, the participants also reported moderate anxiety. This might indicate that anxiety is a protective mechanism designed to prevent the organism from engaging in potentially harmful behaviors.
Medications are also a common form of treatment for Generalized Anxiety Disorder. The most common types of medications prescribed to individuals living with this form of anxiety include anti-depressants, anti-anxiety drugs, and in some cases, sedatives. Antidepressants are used to treat depression, but have been found effective in the treatment of anxiety as well. They commonly take a couple of weeks to start taking effect and may cause some mild side effects, including headache, nausea, or difficulty sleeping. Most of the side effects are mild and tend to subside within a few weeks. Anti-anxiety medication is also often prescribed to help individuals cope with Generalized Anxiety Disorder. These types of drugs are powerful in their treatment of this type of anxiety; one of the most commonly prescribed types is a drug called buspirone often under the brand nane Buspar.
Generally, anxiety arises first, often during childhood. Evidence suggests that both biology and environment can contribute to the disorder. Some people may have a genetic predisposition to anxiety; however, even so, development of the condition is not inevitable. Early traumatic experiences can also reset the body’s normal fear-processing system so that it is hyper-reactive.
Obsessive-compulsive and related disorders are characterized by obsessive, intrusive thoughts (e.g. constantly worrying about staying clean, or about one's body size) that trigger related, compulsive behaviors (e.g. repeated hand-washing, or excessive exercise). These behaviors are performed to alleviate the anxiety associated with the obsessive thoughts. These types of disorders can restrict participation in everyday life and/or generate significant distress, for instance, by making it difficult to leave the house without many repetitions of a compulsive behavior (e.g. checking that the doors are locked). Periodically experiencing worry or having a few "idiosyncratic" habits does not constitute an obsessive-compulsive or related disorder. Instead, these disorders are characterized by unusually high levels of worry and related compulsive behaviors, in comparison with a typical range of individuals.
My grandparents, who I lived with my entire life, just passed away. One in june and the other in september. My girlfriend wants to spend the night with her sister and the thought of it scares me. I fear that I am pushing her away, thus for sending me into a state of anger at myself followed by a heavy cold sadness, panic and fear. Then I start to get a small headache, clammy feeling overcomea my body, I start feeling naucious and then the next thing I know, my girlfriend is waking me up trying to pick me up off the floor. Is this a simple anxiety attack that will go away?
Anxiety disorders respond very well to therapy—and often in a relatively short amount of time. The specific treatment approach depends on the type of anxiety disorder and its severity. But in general, most anxiety disorders are treated with therapy, medication, or some combination of the two. Cognitive-behavioral therapy and exposure therapy are types of behavioral therapy, meaning they focus on behavior rather than on underlying psychological conflicts or issues from the past. They can help with issues such as panic attacks, generalized anxiety, and phobias.
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“Panic disorder is diagnosed if the individual has recurrent panic attacks (minimum four in a four-week period), and at least one of the attacks is accompanied by one or more physical symptoms, including persistent concern about having another attack, worry about the implication or consequences of the attack (i.e., having a heart attack), and/or a significant change in behaviour due to the attacks, such as quitting a job.7 In addition, the panic attacks cannot be due to the physiological effects of a substance or another general medical condition.”[1]
There are dozens of drugs that can be prescribed to treat anxiety. Since each person responds to medication differently, there's no one drug that works perfectly for everyone. You may have to work a little with a psychiatrist to find the right medication, or the right combination of medicines, that’s most beneficial to you. The drugs that are used to treat anxiety over a long period of time are antidepressants, which affect serotonin, norepinephrine, and other neurotransmitters in the brain.
Disclaimer: Anxiety.org does not endorse or provide any medical advice, diagnosis, or treatment. The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition and cannot be substituted for the advice of physicians, licensed professionals, or therapists who are familiar with your specific situation. Consult a licensed medical professional or call 911, if you are in need of immediate assistance. Furthermore, the information reflects the opinions of the author alone and not those of the author’s employer or Anxiety.org. For more information, please carefully read our Privacy Policy and the Terms and Conditions of Use.
The Substance Abuse and Mental Health Services Administration (SAMHSA) provides this online resource for locating mental health treatment facilities and programs. The Mental Health Treatment Locator section of the Behavioral Health Treatment Services Locator lists facilities providing mental health services to persons with mental illness. Find a facility in your state at https://findtreatment.samhsa.gov/. For additional resources, visit www.nimh.nih.gov/findhelp.
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.
Because symptoms are so severe, many people who experience a panic attack may believe they are having a heart attack or other life-threatening illness and may go to a hospital ER. Panic attacks may be expected, such as a response to a feared object, or unexpected, apparently occurring for no reason. The mean age for onset of panic disorder is 22-23. Panic attacks may occur with other mental disorders such as depression or PTSD.
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.

Panic attacks can happen during the day or night. Some people have one panic attack then don't ever experience another, or you might find that you have them regularly, or several in a short space of time. You might notice that particular places, situations or activities seem to trigger panic attacks. For example, they might happen before a stressful appointment.
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.

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.
We have all felt anxiety—the nervousness before a date, test, competition, presentation—but what exactly is it? Anxiety is our body's way of preparing to face a challenge. Our heart pumps more blood and oxygen so we are ready for action. We are alert and perform physical and emotional tasks more efficiently. (See also Test Anxiety for tips on dealing with tests.)
"The fight-or-flight system is hardwired for us humans to manage dangerous situations, and those of us with anxiety have an activated fight-or-flight response when the trigger is not really dangerous," says Beth Salcedo, MD, the medical director of The Ross Center for Anxiety & Related Disorders and board president of the Anxiety and Depression Association of America.
This may sound counter-intuitive but trying to accept one's emotional experience can be very helpful during panic attacks. Remind yourself that anxiety is like a wave, what goes up must come down. Fighting against the experience engages the "fear of fear" cycle that can make you feel even worse. If you notice panic symptoms creeping up, label your experience and you remind yourself, "I will be okay. This will pass in time." Accepting your experience, rather than fighting against it, will likely help your panic symptoms reduce more quickly and will feel easier along the way.

Try your best not to avoid or push away feelings of panic. Instead, breathe into the experience and practice your acceptance (as described above). Avoiding situations or bodily sensations associated with panic attacks may seem helpful in the short-term because it helps to immediately make our anxiety decrease. But in the long-term, it is not helpful because it teaches our brains that those physical sensations were a "true alarm" or something to really be afraid of. Instead, if we approach the sensations and situations that make us anxious, perhaps a little bit at a time, we can rewire our brains over time to learn that these things are not so scary after all. By repeating this approach process over and over, you can begin to see that these physical sensations you are having are not so scary and this can help reduce panic symptoms in the future or at least make them much more manageable in the moment. Remember the saying, "avoidance is anxiety's best friend" because the more we avoid, the more anxious we tend to feel. So, try out approaching the things that make you anxious with an "I can do this!" attitude.
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.
Heredity, other biological factors, stressful life events, and thinking in a way that exaggerates relatively normal bodily reactions are all believed to play a role in the onset of panic disorder. Some research suggests panic attacks occur when a “suffocation alarm mechanism” in the brain is activated, falsely reporting that death is imminent. The exact cause or causes of panic disorder are unknown and are the subject of intense scientific investigation.
In a decision context, unpredictability or uncertainty may trigger emotional responses in anxious individuals that systematically alter decision-making.[46] There are primarily two forms of this anxiety type. The first form refers to a choice in which there are multiple potential outcomes with known or calculable probabilities. The second form refers to the uncertainty and ambiguity related to a decision context in which there are multiple possible outcomes with unknown probabilities.[46]
Butterflies in your stomach before an important event? Worried about how you will meet a deadline? Nervous about a medical or dental procedure? If so, you are like most people, for whom some worry about major events (like having a child, taking an exam, or buying a house), and/or practical issues (like money or health conditions), is a normal part of life. Similarly, it is not uncommon to have fears about certain things (like spiders, injections, or heights) that cause you to feel some fear, worry, and/or apprehension. For example, many people get startled and feel nervous when they see a snake or a large insect. People can differ in what causes them to feel anxious, but almost everyone experiences some anxiety in the course of their life.
What’s it like to live with an anxiety disorder on a daily basis? Is it always overwhelming, or are there specific strategies that can be used to make it easier to get through the day and manage anxiety successfully? Anxiety disorders are so common that we might take for granted that a person can live their lives and still suffer from occasional bouts of anxiety (or anxiety-provoking situations). These articles explore the challenges of living with and managing this condition.
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.
Had my first panic attack today and wanted to be sure about what I was experiencing. I sat there crying hysterically, hyperventilating, chest shaking, my hands went very numb. Took me about 10 minutes to get sort of calm, sat in the shower for about half an hour afterwards to fully calm myself down. Every time I tried to focus on my breathing and taking longer breaths I would start hyperventilating again. Felt like I was choking, awful awful experience.
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.
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