Nevertheless, if you are struggling with symptoms of an anxiety disorder it is not uncommon to feel alone and misunderstood. Because the fear that people with an anxiety disorder have is not experienced by others, they may not understand why, for example, being in a crowd of people, not being able to wash your hands after meeting a new person, or driving through the street where you got in a car accident can be really anxiety-provoking for someone with an anxiety disorder. People may comment that "there is no reason to worry about it" or that you "should just let it go".
As the result of years of research, there are a variety of treatments available to help people who suffer from panic attacks learn how to control the symptoms. This includes several effective medical treatments, and specific forms of psychotherapy. In terms of medications, specific members of the selective serotonin reuptake inhibitor (SSRI), the selective serotonin and norepinephrine reuptake inhibitors (SSNRI), and the benzodiazepine families of medications are approved by the U.S. Food and Drug Administration (FDA) for effective treatment of panic disorder. Examples of anti-anxiety medications include fluoxetine (Prozac), sertraline (Zoloft), paroxetine (Paxil), escitalopram (Lexapro), citalopram (Celexa), vortioxetine (Brintellix), and vilazodone (Viibryd) from the SSRI group, duloxetine (Cymbalta), venlafaxine (Effexor), desvenlafaxine (Pristiq), and levomilnacipran (Fetzima) from the SSNRI group, and clonazepam (Klonopin) and lorazepam (Ativan) from the benzodiazepine group. Although alprazolam (Xanax) is often used to treat panic attacks, its short duration of action can sometimes result in having to take it several times per day. Medications from the beta-blocker family (for example, propranolol [Inderal]) are sometimes used to treat the physical symptoms, like racing heart rate associated with a panic attack. Some individuals who suffer from severe panic attacks may benefit from treatment with gabapentin (Neurontin), which was initially found to treat seizures, or benefit from a neuroleptic medication like risperidone (Risperdal), olanzapine (Zyprexa), quetiapine (Seroquel), aripiprazole (Abilify), paliperidone (Invega), asenapine (Saphris), iloperidone (Fanapt), or lurasidone (Latuda).
Medications — most often antidepressants and anti-anxiety drugs — can also be used to help treat panic disorder. Your doctor may initially prescribe you an anti-anxiety drug, such as Xanax (alprazolam), and then add an antidepressant, such as Effexor XR (venlafaxine). After a month or sooner, your doctor may stop the Xanax and have you remain on the antidepressant.
As with most behavioral illnesses, the causes of panic attacks are many. Certainly there is evidence that the tendency to have panic attacks can sometimes be inherited. However, there is also evidence that panic may be a learned response and that the attacks can be initiated in otherwise healthy people simply given the right set of circumstances. Research into the causes of panic attacks is ongoing.
These physiological responses can actually help us to survive. However, sometimes we experience these physiological responses, like an increased heartbeat, that are not in the presence of danger at all, but something else entirely. In these cases, our bodies can misinterpret these physiological signals as being indicators of danger or a "true threat." For example, people may experience learned anxiety due to previous associations between elevated heart rate and panic attacks and may misinterpret bodily sensations as signs of imminent death or loss of control. In this way, one may start to fear these physiological responses, which is what we call "fear of fear" (Craske & Barlow, 2007). "Fear of fear" maintains or perpetuates panic attacks and panic symptoms, which becomes a vicious cycle. In other words, you experience an increased heart rate, which you interpret as negative, which makes you feel anxious, which further makes your heart rate increase and it often spirals from there. These associations may almost happen automatically, even without conscious thought, but this is what is likely going on behind the scenes.
Have you ever experienced an intense feeling of terror, fear or apprehension, for no apparent reason? If you have, you may have experienced a panic attack. If you experience recurrent panic attacks, you may have a condition called panic disorder. Panic attacks can also be the sign of other underlying medical or mental health conditions, including sleep disorders, post-traumatic stress disorder (PTSD), or depression.
Generalized Anxiety Disorder is one of the most common anxiety disorders and affects approximately 3.1% of the American adult population. With 6.8 million reported cases among American adults aged 18 and older, the average age of onset is 31 years old. While it can occur at any point of life, the most common points of onset occur between childhood and middle age. If you are a woman, you are twice as likely to suffer from Generalized Anxiety Disorder than men.

Panic disorder is a type of anxiety disorder that is characterized by fear and worry. One of the most salient symptoms is the experience of persistent and often unanticipated panic attacks. Panic attacks are typically experienced through a combination of frightening physical sensations and distressing thoughts and emotions. These attacks bring on severe apprehension and discomfort, despite a lack of actual threat or danger.
There is a long list of signs and symptoms of an anxiety attack. But because each body is somewhat chemically unique, anxiety attacks can affect each person differently. Consequently, anxiety attack symptoms can vary from person to person in type or kind, number, intensity, duration, and frequency. If your symptoms don’t exactly match this list, that doesn’t mean you don’t have anxiety attacks. It simply means that your body is responding to them slightly differently.
The last strategy — learning what triggers your anxiety — is important. Sometimes you can take small steps to conquer your anxiety instead of letting the trigger conquer you. For example, if meeting new people causes you high anxiety, consider going with a friend to meet the new neighbors. Once you do this with ease, you can move forward and meet people on your own. All the pent-up fear and anxiety attacks will start to resolve as you become accustomed to reaching out in your community.
Anxiety during social interactions, particularly between strangers, is common among young people. It may persist into adulthood and become social anxiety or social phobia. "Stranger anxiety" in small children is not considered a phobia. In adults, an excessive fear of other people is not a developmentally common stage; it is called social anxiety. According to Cutting,[32] social phobics do not fear the crowd but the fact that they may be judged negatively.
While the term "test anxiety" refers specifically to students,[29] many workers share the same experience with regard to their career or profession. The fear of failing at a task and being negatively evaluated for failure can have a similarly negative effect on the adult.[30] Management of test anxiety focuses on achieving relaxation and developing mechanisms to manage anxiety.[29]
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).
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.
Anxiety is associated with abnormal patterns of activity in the brain. One way to treat anxiety is to directly target abnormal nerve cell activity. Neuromodulation or brain stimulation therapy is a non-invasive and painless therapy that stimulates the human brain. In some recent clinical trials, patients that did not respond to more traditional forms of treatment (i.e. medication) showed a reduction in symptoms of depression and anxiety. There are two main types of neuromodulation:

Anxiety disorders are characterized by a general feature of excessive fear (i.e. emotional response to perceived or real threat) and/or anxiety (i.e. worrying about a future threat) and can have negative behavioral and emotional consequences. 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. Trauma- and stressor- related anxiety disorders are related to the experience of a trauma (e.g., unexpected death of a loved one, a car accident, or a violent incident) or stressor (e.g., divorce, beginning college, moving).

What happens, exactly? "We all physically respond to stress," says Barbara O. Rothbaum, PhD, psychiatry professor and director, Trauma and Anxiety Recovery Program, at Atlanta's Emory University School of Medicine. "You might feel anxious about work-related problems, taking a big exam, or making an important decision. But someone who suffers from panic disorder may react to those same moderate pressures with an exaggerated physical reaction-as if he or she were about to be attacked by a wild tiger or fall from a great height. It's full-on, adrenaline-pumping, fight-or-flight response."

For me it’s knowing or believing I don’t have enough time to finish an assignment, and then I feel like a failure. Right now, I’m doing the most difficult assignment of my life, and if I don’t finish it on time, my graduation will be delayed. This is on top of all my other responsibilities. And to think that I’m supposed to have an accommodation for extra time. Ha! The university and the state don’t care. They just want me to fail so I have to dish out more money to line the pockets of the corporation that assigned this required project.
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.

Some benefits of benzodiazepines are that they are effective in relieving anxiety and take effect more quickly than antidepressant medications often prescribed for anxiety. Some drawbacks of benzodiazepines are that people can build up a tolerance to them if they are taken over a long period of time and they may need higher and higher doses to get the same effect. Some people may even become dependent on them.

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