Although there are not specific causes for panic attacks in adults, teens, or children, like most other emotional symptoms, panic is understood to be the result of a combination of biological vulnerabilities, ways of thinking, and environmental factors like social stressors. According to one theory of panic disorder, the body's normal "alarm system," also described as the body's fight or flight system, the set of mental and physical mechanisms that allows a person to respond to a threat, tends to be triggered when there is no danger. Scientists don't know specifically why this happens or why some people are more susceptible to the problem than others. Panic disorder has been found to run in families, and this may mean that inheritance (genetics) plays a role in determining who will develop the condition. However, many people who have no family history of the disorder develop it. Studies differ as to whether drugs like marijuana or nutritional deficiencies like zinc or magnesium deficiencies may also be risk factors for developing panic disorder.
But over time, you may find yourself experiencing more panic attacks, in a variety of circumstances. Most of these will not be entirely unexpected. Most subsequent attacks occur in response to various cues such as entering a crowded area; a traffic jam; or simply worrying about having a panic attack. But there may still be some surprises: for instance, you might have a nocturnal panic attack, which wakes you out of a sound sleep. Or you might find yourself experiencing odd feelings of depersonalization as you kill some time with friends or colleagues.
Complementary and Alternative Therapies can be used in conjunction with conventional therapies to reduce the symptoms of anxiety. There is a growing interest in these types of alternative therapies, since they are non-invasive and can be useful to patients. They are typically not intended to replace conventional therapies but rather can be an adjunct therapy that can improve the overall quality of life of patients.
Characterized by a suite of symptoms that persist for at least three days and up to one month after a traumatic experience (same diagnostic criteria for "trauma" as listed above). The specific symptoms of the disorder vary across individuals, but a common feature is intense anxiety in response to re-experiencing symptoms (e.g., recurrent intrusive recollections of traumatic event) of the trauma.
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.

If you think a friend or colleague at work is experiencing an anxiety disorder or other mental health difficulty, you should carefully consider how you react. Your actions in the workplace can have work-related and legal consequences. However, intervening early before an emergency situation arises can help prevent greater consequences for your colleague's career, health, and safety.


The psychotherapy component of treatment for panic disorder is at least as important as medication. In fact, research shows that psychotherapy alone or the combination of medication and psychotherapy treatment are more effective than medication alone in the long-term management of panic attacks. In overcoming anxiety, cognitive behavioral therapy is widely accepted as an effective form of psychotherapy treatment, for both adults and children. This form of psychotherapy seeks to help those with panic disorder identify and decrease the irrational thoughts and behaviors that reinforce panic symptoms and can be done either individually, in group therapy, in partner-assisted therapy, and even over the Internet. Behavioral techniques that are often used to decrease anxiety include relaxation techniques (like breathing techniques or guided imagery) and gradually increasing exposure to situations that may have previously triggered anxiety in the panic disorder sufferer. Helping the person with anxiety understand how to handle the emotional forces that may have contributed to developing symptoms (panic-focused psychodynamic psychotherapy) has also been found to be effective in teaching an individual with panic disorder how to prevent an anxiety attack or how to calm down in order to decrease or stop a panic attack once it starts.
The cause of anxiety disorders is a combination of genetic and environmental factors.[47] Anxiety can stem itself from certain factors: genetics, medicinal side-effects, shortness of oxygen.[48] Risk factors include a history of child abuse, family history of mental disorders, and poverty. Anxiety disorders often occur with other mental disorders, particularly major depressive disorder, personality disorder, and substance use disorder.[49] To be diagnosed symptoms typically need to be present at least six months, be more than would be expected for the situation, and decrease functioning.[10][49] Other problems that may result in similar symptoms including hyperthyroidism, heart disease, caffeine, alcohol, or cannabis use, and withdrawal from certain drugs, among others.[49][7]
People who have repeated, persistent attacks or feel severe anxiety about having another attack are said to have panic disorder. Panic disorder is strikingly different from other types of anxiety disorders in that panic attacks are often sudden and unprovoked.[18] However, panic attacks experienced by those with panic disorder may also be linked to or heightened by certain places or situations, making daily life difficult.[19]
Why stress happens and how to manage it Stress is essential for survival; the chemicals it triggers help the body prepare to face danger and cope with difficulty. Long-term stress is linked to various health conditions and can cause physical and psychological symptoms. How is it diagnosed, what types of stress are there, and how is it treated or managed? Read now
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.

Anxiety disorders are the most common mental health disorder in the U.S., affecting more than 18% of the population. They are even more common among children, affecting an estimated 25% of children between the ages of 13 and 18. The most common anxiety disorders are Specific Phobias, affecting 8.7% of the population, and Social Anxiety, affecting 6.8% of the population.
If the person has a family history of seizures or symptoms that are not typical for panic attack, a neurologist may be asked to evaluate the person. There is some overlap between the symptoms of panic attack and what is known as "partial seizures." Distinguishing between the two is important because the treatment for each is quite different. A neurologist, if consulted, will order an EEG (electroencephalogram) to check for seizure activity in the brain. This is a painless test but does require some time to complete (typically overnight).
There is evidence for panic disorder-like diagnoses across cultures, such as ataque de nervios in Latin American communities. Research has shown that African Americans experience more functional impairment (i.e., impact on one's ability to complete daily activities) than non-Latino white Americans. This is not an exhaustive list of cultural factors related to panic disorder, but it does highlight cultural differences that may affect the presentation of panic disorder as well as individual differences in the interpretation of panic symptoms (Asnaani, Gutner, Hinton, & Hofmann, 2009; Hofmann & Hinton, 2014; Lewis-Fernández, et al., 2010).

Some people find that medication alone can be helpful in the treatment of Generalized Anxiety Disorder, while others are more likely to benefit from psychotherapy. Some find that the combination of psychotherapy and medication is the best course of action. Engaging in certain behaviors may also ease your anxiety and promote a healthier lifestyle. These include:
In the past it might have taken months or years and lots of frustration before getting a proper diagnosis. Some people are afraid or embarrassed to tell anyone, including their doctors or loved ones about what they are experiencing for fear of being seen as a hypochondriac. Instead they suffer in silence, distancing themselves from friends, family, and others who could be helpful. Other people suffering from panic attacks don't know they have a real and highly treatable disorder. It is our hope that through increased education, people will feel more empowered to discuss their symptoms with a healthcare professional and seek appropriate treatment.
Although anxiety is often accompanied by physical symptoms, such as a racing heart or knots in your stomach, what differentiates a panic attack from other anxiety symptoms is the intensity and duration of the symptoms. Panic attacks typically reach their peak level of intensity in 10 minutes or less and then begin to subside. Due to the intensity of the symptoms and their tendency to mimic those of heart disease, thyroid problems, breathing disorders, and other illnesses, people with panic disorder often make many visits to emergency rooms or doctors' offices, convinced they have a life-threatening issue.
The effects of anxiety on the body Anxiety is a common condition that impacts a person's mental health, and it can also have short- and long-term effects on the body. Anxiety can change the function of the cardiovascular, urinary, and respiratory systems. It can also lead to digestive issues and an increased risk of infection. Learn more here. Read now
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 person with separation anxiety disorder is excessively fearful or anxious about separation from those with whom he or she is attached. The feeling is beyond what is appropriate for the person’s age, persists (at least four weeks in children and six months in adults) and causes problems functioning. A person with separation anxiety disorder may be persistently worried about losing the person closest to him or her, may be reluctant or refuse to go out or sleep away from home or without that person, or may experience nightmares about separation. Physical symptoms of distress often develop in childhood, but symptoms can carry though adulthood.
There are long-term, biological, environmental, and social causes of panic attacks. In 1993, Fava et al. proposed a staging method of understanding the origins of disorders. The first stage in developing a disorder involves predisposing factors, such as genetics, personality, and a lack of wellbeing.[11] Panic disorder often occurs in early adulthood, although it may appear at any age. It occurs more frequently in women and more often in people with above-average intelligence. Various twin studies where one identical twin has an anxiety disorder have reported a 31–88% incidence of the other twin also having an anxiety disorder diagnosis.[12]
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.
There remains a chance of panic symptoms becoming triggered or being made worse due to increased respiration rate that occurs during aerobic exercise. This increased respiration rate can lead to hyperventilation and hyperventilation syndrome, which mimics symptoms of a heart attack, thus inducing a panic attack.[42] Benefits of incorporating an exercise regimen have shown best results when paced accordingly.[43]
Many people don't know that their disorder is real and highly responsive to treatment. Some are afraid or embarrassed to tell anyone, including their doctors and loved ones, about what they experience for fear of being considered a hypochondriac. Instead they suffer in silence, distancing themselves from friends, family, and others who could be helpful or supportive.
Says Clyman: "You might start to consider your emotions as changing experiences that are always fluctuating. When we feel distressed, it can seem like the distress is going to go on and on forever until we emotionally combust. But instead, emotions act more like a wave, at times increasing and becoming more intense. But inevitably they'll reach a plateau, subsiding and finally passing."
Mitral valve prolapse (MVP), also called "click murmur syndrome" and "Barlow's syndrome," is the most common type of heart valve abnormality. Usually, people with mitral valve prolapse have no signs and symptoms; however, if the prolapsed valve is severe, symptoms may appear. When symptoms of severe mitral valve prolapse do appear, they may include, fatigue, palpitations, chest pain, anxiety, migraine headaches, and pulmonary edema. Echocardiography is the most useful test for mitral valve prolapse. Most people with mitral valve need no treatment. However, if the valve prolapse is severe, treatment medications or surgery may be necessary to repair the heart valve.

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.

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.
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.
People with generalized anxiety disorder (GAD) display excessive anxiety or worry, most days for at least 6 months, about a number of things such as personal health, work, social interactions, and everyday routine life circumstances. The fear and anxiety can cause significant problems in areas of their life, such as social interactions, school, and work.
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