Panic attacks are often confusing for the sufferer. They are usually sudden and are accompanied by extremely intense physical sensations, leaving one to believe they may have a serious medical condition. Because the physical symptoms associated with a panic attack are similar to certain serious medical conditions, it is important to rule out any medical causes.

^ Anxiety: management of anxiety (panic disorder, with or without agoraphobia, and generalised anxiety disorder) in adults in primary, secondary and community care. National Institute for Health and Clinical Excellence. Clinical Guideline 22. Issue date: April 2007 "Archived copy" (PDF). Archived from the original (PDF) on 24 August 2009. Retrieved 2009-07-21. ISBN 1-84629-400-2
Facing Panic:Self Help for People with Panic Attacks. Learn seven self-help steps to break the cycle of panic and regain control of your life. This book includes techniques and exercises to manage and overcome panic attacks and panic disorder. The disorder often occurs with other mental and physical disorders, including other anxiety disorders, depression, irritable bowel syndrome, asthma, or substance abuse. This may complicate of getting a correct diagnosis.
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
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.
A nurse with a master's or doctoral degree in mental health disorders. A psychiatric nurse can diagnose and treat mental health disorders. They mainly provide psychotherapy but in some states that can also prescribe medications. Psychiatric nurses also serve as patient advocates and provide case-management services. They often work in private practices, hospitals and schools.
Cognitive distortions such as overgeneralizing, catastrophizing, mind reading, emotional reasoning, binocular trick, and mental filter can result in anxiety. For example, an overgeneralized belief that something bad "always" happens may lead someone to have excessive fears of even minimally risky situations and to avoid benign social situations due to anticipatory anxiety of embarrassment. In addition, those who have high anxiety can also create future stressful life events.[85] Together, these findings suggest that anxious thoughts can lead to anticipatory anxiety as well stressful events, which in turn cause more anxiety. Such unhealthy thoughts can be targets for successful treatment with cognitive therapy.

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.

Panic disorder is characterized by unexpected and repeated episodes of intense fear accompanied by physical symptoms that may include chest pain, heart palpitations, shortness of breath, dizziness, or abdominal distress. These sensations often mimic symptoms of a heart attack or other life-threatening medical conditions. As a result, the diagnosis of panic disorder is frequently not made until extensive and costly medical procedures fail to provide a correct diagnosis or relief.
These episodes are a serious health problem in the U.S. At least 20% of adult Americans, or about 60 million people, will suffer from panic at some point in their lives. About 1.7% of adult Americans, or about 3 million people, will have full-blown panic disorder at some time in their lives, women twice as often as men. The most common age at which people have their first panic attack (onset) is between 15 and 19 years of age. Panic attacks are significantly different from other types of anxiety, in that panic attacks are very sudden and often unexpected, appear to be unprovoked, and are often disabling.
I think I had an anxiety attack the other day, but I’m not sure. I was at the movies and felt scared, like something or someone was going to attack me. I drove home and felt like I was scared of the dark and was having trouble breathing and focusing on driving. After dropping off my bf and driving home, I started crying and hyperventilating, and felt detached from the world, like nothing mattered, and felt like I was going to die. It took me two hours to fall asleep and I had nightmares. The episode was over by morning, but I’m concerned that it will happen again.
Mindfulness involves spending time focusing on the present moment and using a nonjudgmental stance (things are not good or bad, they just are). This may sound straightforward but it can be tricky as our mind often wanders. Try to spend some time each day focusing on a single activity for 10 minutes. For example, focus on the experience of breathing: noticing the physical sensations that you have, the sound of your breath, the feeling of your chest rising and falling as you breathe, the feeling of air entering and leaving your lungs, etc. Try your best to keep your mind focused on these sensations. If you notice your mind wandering, gently redirect it back to the exercise. Engaging in these exercises on a regular basis can help you to feel emotionally centered. Check out websites, apps, and books for more information on mindfulness and guided mindfulness exercises.
Biological causes may include obsessive compulsive disorder, Postural Orthostatic Tachycardia Syndrome, post traumatic stress disorder, hypoglycemia, hyperthyroidism, Wilson's disease, mitral valve prolapse, pheochromocytoma, and inner ear disturbances (labyrinthitis). Dysregulation of the norepinephrine system in the locus ceruleus, an area of the brain stem, has been linked to panic attacks.[13]

Obsessive-compulsive disorder (OCD) is characterized by unwanted thoughts or behaviors that seem impossible to stop or control. If you have OCD, you may be troubled by obsessions, such as a recurring worry that you forgot to turn off the oven or that you might hurt someone. You may also suffer from uncontrollable compulsions, such as washing your hands over and over.
Mindfulness practice, meditation, and mindfulness yoga can increase one's awareness of the world around you and increase your control over how you experience situations and how you respond. Loss of feelings of control is often a symptom of anxiety when a person is feeling overwhelmed and stressed. Practicing these strategies can help you live life in the present moment and enjoy the present things in your life that bring you joy.
A form of psychotherapy called cognitive behavioural therapy (CBT) has been found by several studies to be the most effective treatment for panic attacks and panic disorder. During CBT, you will work with a therapist on relaxation training, restructuring your thoughts and behaviors, mindfulness, exposure treatment, and stress reduction. Many people that suffer from panic attacks start to notice a reduction within weeks, and symptoms often decrease significantly or go away completely within several months.
I almost had a breakdown yesterday, I got mad at my sister. She told me we’d hang out then later she bailed me. I was so mad I poured all her body lotion in the sink, I was looking for her Victoria’s Secret perfume so I could break it into pieces but couldn’t find it. (Yes, I think I have anger issues too, might need anger management). I was already frustrated with my new job. I am slightly a perfectionist and I’m having a hard time with work I’m not too familiar with. I almost broke down or did broke down but hid it very well. My heart can’t stop pounding the whole day, whole night. I went to sleep since I was so tired but I woke up in the middle of the night with my heart beating so loud and fast. Until in the morning I can’t control it. I have a feeling I need to visit my psychiatrist again. I miss talking to her though. But the medications are so expensive it makes me depress more.
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Experiencing a chronic medical condition or severe or frequent illness can also increase risk for anxiety disorders, as well as dealing with significant illness of a family member or loved one. Given that several medical conditions have been linked to significant anxiety, in some cases a physician may perform medical tests to rule out an underlying medical condition. For instance, thyroid disease is often characterized by experiencing significant symptoms of anxiety. Menopause, heart disease, and diabetes have also been linked to anxiety symptoms. Additionally, drug abuse or withdrawal for many substances is characterized by acute anxiety, and chronic substance abuse can increase risk for developing an anxiety disorder. Anxiety can also be a side effect of certain medications. Experiencing significant sleep disturbances, such as difficulty falling asleep or staying asleep, may also be a risk factor for developing an anxiety disorder.
EMDR is a psychotherapy that alleviates the distress and emotional disturbances that are elicited from the memories of traumatic events. It is primarily administered to treat PTSD, and is very similar to exposure therapy. This therapy helps patients to process the trauma so that they can heal. During the therapy, patients pay attention to a back and forth movement or sound while recounting their traumatic memories. Patients continue these sessions until the memory becomes less distressing. EMDR sessions typically last 50-90 minutes and are administered weekly for 1-3 months, although many patients report experiencing a reduction of symptoms after a few sessions of EMDR.
Because there are many medical conditions that can cause anxiety attack signs and symptoms, such as the strong sensations and feelings associated with anxiety attacks, it’s wise to discuss them with your doctor. If your doctor has attributed your anxiety attacks to stress and anxiety, you can feel confident that your doctor’s diagnosis is correct. Anxiety attacks and their signs and symptoms are relatively easy to diagnose and aren’t easily confused with other medical conditions.
2) If you suddenly feel your heart pounding or experience other physical clues that a panic attack is barreling for you, try this distraction suggested by Rob Cole, LHMC, clinical director of mental health services at Banyan Treatment Centers. Start counting backward from 100 by 3s. The act of counting at random intervals helps you to focus and override the anxious thoughts that are trying to sneak into your psyche. Better still keep loose change in your pocket. Add a dime to a nickel, then add two pennies and so on. By controlling your thoughts and focusing on something outside yourself you will being to feel calmer.
You do not need to be officially diagnosed with panic disorder to have an attack. Some people have only one or two panic attacks in their life and don't have panic disorder. Panic attacks are actually much more common than panic disorder. According to one Harvard Medical School survey, about 23 percent of people interviewed experienced at least one panic attack in their lifetime, while only about 3 percent of people experienced panic disorder in their lifetime. (1)
Because involuntary panic attacks can be caused by other medical conditions, such as mitral valve prolapse, thyroid problems, hyperglycemia, side effects from certain types of medications, recreational drug use (such as marijuana), stimulants, etc., it’s best to discuss your panic attacks and symptoms with your doctor to rule out any medical cause.
iv suffered with severe anxiety since i suffered a massive panic attack 2 years ago on holiday in spain . i have battled with it and im still fighting now i go through times were im fine but other times like now im still fighting the anxiety attacks . the above advice has helped me so much :)one thing i wanted to ask does anxiety attacks cause headaches (pressure type) ? xxx
So how do you know if your anxiety is “normal” or “excessive?” It’s normal to be worried about an upcoming test or wondering how you are going to cope financially when you unexpectedly find out you need major repairs done to your house. If you are suffering from the type of excessive worry that accompanies Generalized Anxiety Disorder, you may see a report on the local news about a new health scare in a different country and stay awake at night worrying about you or your family being affected, even though risks are minimal at best. You will likely spend the next few days and weeks in a constant state of worry about the well-being of your family and experience anxiety that is debilitating, intrusive, excessive, and persistent.
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.
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.
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]

Once the panic attack is over and the person has returned to a calm state, encourage them to seek help from a mental health professional at their earliest convenience, if they haven’t already. You can help them further by assisting with the search for a licensed professional, researching coping techniques online, and looking for self-help books that might be useful.
Everyone experiences anxiety from time to time. Perhaps the person has watched a scary move, or seen something upsetting on TV. Or, more ominous, perhaps the person has experienced or witnessed a crime. Anyone might get anxious in these situations, but the person with an anxiety disorder has persistent or recurrent anxiety that prevents him or her from full participation in life. Anxiety can range from relatively mild (occasional “butterflies,” jitteriness, accompanied by a sense of unease) to severe (frequent, disabling panic attacks). Severe anxiety disorders can lead the person to alter his lifestyle to accommodate the anxiety, for example not leaving home. More

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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.
Secondly, the psychobiological conceptualization of panic disorder emphasizes the influence of psychological factors (Meuret, White, Ritz, Roth, Hofmann, & Brown, 2006). This psychological factor refers to a fear of bodily sensations, or a certain set of beliefs that lead individuals to be especially afraid of physical symptoms, such as believing that a racing heart could mean heart disease. Sometimes this is discussed as anxiety sensitivity or a belief that anxiety is harmful. Again, having the belief that physical symptoms are harmful may increase the likelihood of experiencing a panic attack, but it does not make having a panic attack inevitable. Instead, panic attacks can seem abnormal if they occur at the wrong time, when there is no real reason to be afraid. It is important to consider, however, that anxiety can also be adaptive or helpful in contexts where there is true threat.

Over time, many who suffer panic attacks develop an on-going fear of having another attack. This fear can severely hamper daily activities and overall quality of life. Some people refuse to leave their houses or to put themselves in situations that remind them of their previous attacks. Agoraphobia (a fear of being outside of known and safe surroundings) or other mental problems may follow.
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Dr. Roxanne Dryden-Edwards is an adult, child, and adolescent psychiatrist. She is a former Chair of the Committee on Developmental Disabilities for the American Psychiatric Association, Assistant Professor of Psychiatry at Johns Hopkins Hospital in Baltimore, Maryland, and Medical Director of the National Center for Children and Families in Bethesda, Maryland.
Hyperventilation syndrome may occur when a person breathes from the chest, which can lead to overbreathing (exhaling excessive carbon dioxide in relation to the amount of oxygen in one's bloodstream). Hyperventilation syndrome can cause respiratory alkalosis and hypocapnia. This syndrome often involves prominent mouth breathing as well. This causes a cluster of symptoms, including rapid heart beat, dizziness, and lightheadedness, which can trigger panic attacks.[12]
Humor and laughter, in addition to being fun and enjoyable, have many health benefits. Laughter can help people cope with stress, reduce anxiety and tension and serve as a coping mechanism. Humor may allow a person to feel in control of a situation and make it seem more manageable. By helping to reduce fear, anger and stress, humor can help minimize the potential harm they can have on the body over time.
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.
Given that anxiety attacks aren’t specifically outlined as a diagnosis in the DSM-5, the usage of the word is open to interpretation and different individuals may use it in varying ways and circumstances. For one person, an anxiety attack might be overthinking about a specific worry to the extent that they are unable to concentrate on anything else; for another, anxiety attack might refer to sweating and shortness of breath when faced with a certain situation.
Panic attacks can occur unexpectedly during a calm state or in an anxious state. Although panic attacks are a defining characteristic of panic disorder, it is not uncommon for individuals to experience panic attacks in the context of other psychological disorders. For example, someone with social anxiety disorder might have a panic attack before giving a talk at a conference and someone with obsessive-compulsive disorder might have a panic attack when prevented from engaging in a ritual or compulsion.  

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.
Anxiety can be either a short-term 'state' or a long-term personality "trait". Trait anxiety reflects a stable tendency across the lifespan of responding with acute, state anxiety in the anticipation of threatening situations (whether they are actually deemed threatening or not).[40] A meta-analysis showed that a high level of neuroticism is a risk factor for development of anxiety symptoms and disorders.[41] Such anxiety may be conscious or unconscious.[42]
A helpful approach to distinguishing normal anxiety from an anxiety disorder is to identify the cause of the anxiety, and then assess whether the anxiety symptoms are a proportional response to it. Worries, fears, and intrusive thoughts that are extreme, unrealistic, or exaggerated and interfere with normal life and functioning could constitute an anxiety disorder. For instance, being concerned about getting sick and taking steps to avoid germs, like using hand sanitizer and avoiding touching door handles, does not necessarily constitute an anxiety disorder; however, if the concern about sickness makes it difficult to leave the house, then it is possible that the person suffers from an anxiety or anxiety-related disorder.
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