Panic disorder is characterized by uncontrollable, recurrent episodes of panic and fear that peak within minutes. Panic attacks are accompanied by physical manifestations, such as heart palpitations, sweating, and dizziness as well as the fear of dying or becoming insane. Worry about having an attack may lead to additional anxiety and avoidance behaviors or to other problems in functioning.
Once you are under enough stress, almost anything can set off a panic attack. Suppose you are under a lot of stress, but still managing. If you add even more stress, your brain will begin to feel under siege. Your body will respond by releasing adrenaline as part of the fight or flight response. That will cause more anxiety, which will create a vicious feedback that will turn into a panic disorder.

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.
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.
Many patients first report symptoms to their primary care physician. Primary care physicians (PCPs) will administer a thorough physical exam to rule out hormonal imbalances, side effects of medications, and certain illnesses. If the symptoms are not due to other conditions, the physician may diagnose the patient with anxiety and therefore refer the patient to a psychologist or psychiatrist. Physicians practice in hospitals, clinics and private practices.
Medication does not cure anxiety disorders but can help relieve symptoms. Medication for anxiety is prescribed by doctors, such as a psychiatrist or primary care provider. Some states also allow psychologists who have received specialized training to prescribe psychiatric medications. The most common classes of medications used to combat anxiety disorders are anti-anxiety drugs (such as benzodiazepines), antidepressants, and beta-blockers.
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.
One of the most important things you can do is to listen to your family member or friend talk about the things in his/her life that are sources of stress. A first instinct might be to offer advice or ideas for a "quick fix". However, simply accepting your friend's stress levels can help them deal with their anxiety, knowing that they can rely on you as a source of support even when their symptoms might be tough to watch. Studies show that social support from family and friends can be one of the strongest protective factors against debilitating levels of anxiety.
Our experience has shown that the most effective treatment for anxiety attacks is the combination of good self-help information and Personal Coaching/Counseling/Therapy. Since the underlying factors that cause issues with anxiety are learned, generally a professional therapist is required to help uncover, identify, and successfully address them. Working with a professional therapist ensures that these underlying factors are effectively treated.[1]
If you're having lots of panic attacks at unpredictable times and there doesn't seem to be a particular trigger or cause, you might be given a diagnosis of panic disorder. It's common to experience panic disorder and agoraphobia (a type of phobia) together. People who experience panic disorder may have some periods with few or no panic attacks, but have lots at other times.

Practice relaxation techniques. When practiced regularly, activities such as yoga, meditation, and progressive muscle relaxation strengthen the body’s relaxation response—the opposite of the stress response involved in anxiety and panic. And not only do these relaxation practices promote relaxation, but they also increase feelings of joy and equanimity.
Fear and anxiety can be differentiated in four domains: (1) duration of emotional experience, (2) temporal focus, (3) specificity of the threat, and (4) motivated direction. Fear is short lived, present focused, geared towards a specific threat, and facilitating escape from threat; anxiety, on the other hand, is long-acting, future focused, broadly focused towards a diffuse threat, and promoting excessive caution while approaching a potential threat and interferes with constructive coping.[17]
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.
So, if anxiety has so many negative effects, why is it relatively common? Many scientists who study anxiety disorders believe that many of the symptoms of anxiety (e.g., being easily startled, worrying about having enough resources) helped humans survive under harsh and dangerous conditions. For instance, being afraid of a snake and having a "fight or flight" response is most likely a good idea! It can keep you from being injured or even killed. When humans lived in hunter-gatherer societies and couldn't pick up their next meal at a grocery store or drive-through, it was useful to worry about where the next meal, or food for the winter, would come from. Similarly avoiding an area because you know there might be a bear would keep you alive —worry can serve to motivate behaviors that help you survive. But in modern society, these anxiety-related responses often occur in response to events or concerns that are not linked to survival. For example, seeing a bear in the zoo does not put you at any physical risk, and how well-liked you are at work does not impact your health or safety. In short, most experts believe that anxiety works by taking responses that are appropriate when there are real risks to your physical wellbeing (e.g., a predator or a gun), and then activating those responses when there is no imminent physical risk (e.g., when you are safe at home or work).
It should be noted that finding the right strategy that works for you to control your anxiety is important. Maybe you feel that you do not have the time to schedule "me time" with your busy schedule or kids, and you need to find another way to reduce your anxiety. A friend or therapist could be a great resource to turn to if you believe you need help with finding the right strategies to reduce your anxiety.
Anxiety cannot increase forever and you cannot experience peak levels of anxiety forever. Physiologically there is a point at which our anxiety cannot become any higher and our bodies will not maintain that peak level of anxiety indefinitely. At that point, there is nowhere for anxiety to go but down. It is uncomfortable to reach that peak but it is important to remember this anxiety will even out and then go down with time.
The causes of anxiety attacks are not well understood. Some traumatic life events can set off anxiety attacks if the person is prone to depression or anxiety disorders. Also, medical conditions and some medications may trigger anxiety attacks. Many believe anxiety attacks run in families with a genetic predisposition. In other words, if your mom and her sister had anxiety attacks, it’s likely you will, too.
Persistent and excessive fear of a specific object or situation, such as flying, heights, animals, toilets, or seeing blood. Fear is cued by the presence or anticipation of the object/situation and exposure to the phobic stimulus results in an immediate fear response or panic attack. The fear is disproportionate to the actual danger posed by the object or situation. Commonly, adults with specific phobias will recognize that their fear is excessive or unreasonable.

An evolutionary psychology explanation is that increased anxiety serves the purpose of increased vigilance regarding potential threats in the environment as well as increased tendency to take proactive actions regarding such possible threats. This may cause false positive reactions but an individual suffering from anxiety may also avoid real threats. This may explain why anxious people are less likely to die due to accidents.[86]


Anxiety cannot increase forever and you cannot experience peak levels of anxiety forever. Physiologically there is a point at which our anxiety cannot become any higher and our bodies will not maintain that peak level of anxiety indefinitely. At that point, there is nowhere for anxiety to go but down. It is uncomfortable to reach that peak but it is important to remember this anxiety will even out and then go down with time.
Almost everyone experiencing symptoms of a panic attack needs evaluation. Unless the person has a history of having panic attacks, is otherwise healthy, and is experiencing a typical attack, they must be evaluated promptly by a doctor. The level of evaluation depends on many factors. Err on the side of safety when deciding whether to go to a hospital's emergency department.

Panic Disorder: People with panic disorder have panic attacks with feelings of terror that strike suddenly and repeatedly with no warning. During the attacks, individuals may feel like they can't breathe, have lost control, are having a heart attack or even that they are dying. Physical symptoms may include chest pain, dizziness, nausea, sweating, tingling or numbness, and a racing heartbeat. Some people will have one isolated attack, while others will develop a long term panic disorder; either way, there is often high anxiety between attacks because there is no way of knowing when the next one will occur. Panic disorders often begin early in adulthood. Many people with panic disorder also suffer from agoraphobia (abnormal fear of open or public places.). See more on Panic Attacks.


Panic attacks may also be caused by substances. Discontinuation or marked reduction in the dose of a substance such as a drug (drug withdrawal), for example an antidepressant (antidepressant discontinuation syndrome), can cause a panic attack. According to the Harvard Mental Health Letter, "the most commonly reported side effects of smoking marijuana are anxiety and panic attacks. Studies report that about 20% to 30% of recreational users experience such problems after smoking marijuana."[16]

Some research suggests that your body's natural fight-or-flight response to danger is involved in panic attacks. For example, if a grizzly bear came after you, your body would react instinctively. Your heart rate and breathing would speed up as your body prepared for a life-threatening situation. Many of the same reactions occur in a panic attack. But it's unknown why a panic attack occurs when there's no obvious danger present.

We all experience anxiety. For example, speaking in front of a group can make us anxious, but that anxiety also motivates us to prepare and practice. Driving in heavy traffic is another common source of anxiety, but it helps keep us alert and cautious to avoid accidents. However, when feelings of intense fear and distress become overwhelming and prevent us from doing everyday activities, an anxiety disorder may be the cause.


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.
Many neurotransmitters are affected when the body is under the increased stress and anxiety that accompany a panic attack. Some include serotonin, GABA (gamma-aminobutyric acid), dopamine, norepinephrine and glutamate. More research into how these neurotransmitters interact with one another during a panic attack is needed to make any solid conclusions, however.
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 is a normal reaction to danger, the body’s automatic fight-or-flight response that is triggered when you feel threatened, under pressure, or are facing a stressful situation. In moderation, anxiety isn’t necessarily a bad thing. It can help you to stay alert and focused, spur you to action, and motivate you to solve problems. But when anxiety is constant or overwhelming—when it interferes with your relationships and daily activities—you’ve likely crossed the line from normal anxiety into the territory of an anxiety 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.
Physical symptoms of an anxiety disorder can be easily confused with other medical conditions, like heart disease or hyperthyroidism. Therefore, a doctor will likely perform an evaluation involving a physical examination, an interview and lab tests. After ruling out an underlying physical illness, a doctor may refer a person to a mental health professional for evaluation.
Anxiety attacks that occur while sleeping, also called nocturnal panic attacks, occur less often than panic attacks during the daytime but affect about 40%-70% of those who suffer from daytime panic attacks. This symptom is also important because people who suffer from panic symptoms during sleep tend to have more respiratory distress associated with their panic. They also tend to experience more symptoms of depression and other psychiatric disorders compared to people who do not have panic attacks at night. Nocturnal panic attacks tend to cause sufferers to wake suddenly from sleep in a state of sudden fear or dread for no apparent reason. In contrast to people with sleep apnea and other sleep disorders, sufferers of nocturnal panic can have all the other symptoms of a panic attack. The duration of nocturnal panic attacks tends to be less than 10 minutes, but it can take much longer to fully calm down for those who experience them.
People with panic disorder have sudden and repeated attacks of fear that last for several minutes or longer. These are called panic attacks. Panic attacks are characterized by a fear of disaster or of losing control even when there is no real danger. A person may also have a strong physical reaction during a panic attack. It may feel like having a heart attack. Panic attacks can occur at any time, and many people with panic disorder worry about and dread the possibility of having another attack.

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).

Characterized by a preoccupation with the belief that one's body or appearance are unattractive, ugly, abnormal or deformed. This preoccupation can be directed towards one or many physical attributes (e.g., acne, hair loss, facial features). Muscle dysmorphia is a subtype of this disorder that is characterized by belief that one's body is too small or insufficiently muscular.
If you’ve ever had a panic attack, you’ll know it can be both a terrifying experience and exhausting experience. Panic disorder is a diagnosis given to people who experience recurrent unexpected panic attacks—that is, the attack appears to occur from out of the blue. Panic attack symptoms include sweating, shaking, shortness of breath, feelings of choking, chest pain, and a fear of dying.
If you can identify that after a long day of parenting you often feel exhausted and overcome with anxiety by all of the things you need to do, you can work to schedule in "me time" where you can make sure that you have time to relax, exercise or engage in an enjoyable activity that you know helps to reduce your anxiety. Taking care of yourself is important to be able to take care of others.
There are also things that people with panic disorder can do to learn how to handle it and to make treatment more effective. Since substances like drinking alcohol or caffeinated beverages, or using illicit drugs can worsen panic attacks, those things should be avoided. Other tips to prevent or manage panic attacks include engaging in aerobic exercise and stress-management techniques like deep breathing, massage therapy, and yoga, since these self-help activities have also been found to help decrease the frequency and severity of panic attacks. Although many people use home remedies like breathing into a paper bag when afflicted by the hyperventilation that can be associated with panic, the benefit received may be the result of the individual believing it will remedy the symptoms (placebo effect). Also, breathing into a paper bag when one is already having trouble breathing can make matters worse when the hyperventilation is the result of conditions of oxygen deprivation, like an asthma attack or a heart attack.
Almost everyone experiencing symptoms of a panic attack needs evaluation. Unless the person has a history of having panic attacks, is otherwise healthy, and is experiencing a typical attack, they must be evaluated promptly by a doctor. The level of evaluation depends on many factors. Err on the side of safety when deciding whether to go to a hospital's emergency department.
Some research suggests that your body's natural fight-or-flight response to danger is involved in panic attacks. For example, if a grizzly bear came after you, your body would react instinctively. Your heart rate and breathing would speed up as your body prepared for a life-threatening situation. Many of the same reactions occur in a panic attack. But it's unknown why a panic attack occurs when there's no obvious danger present.
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
David D. Burns recommends breathing exercises for those suffering from anxiety. One such breathing exercise is a 5-2-5 count. Using the stomach (or diaphragm)—and not the chest—inhale (feel the stomach come out, as opposed to the chest expanding) for 5 seconds. As the maximal point at inhalation is reached, hold the breath for 2 seconds. Then slowly exhale, over 5 seconds. Repeat this cycle twice and then breathe 'normally' for 5 cycles (1 cycle = 1 inhale + 1 exhale). The point is to focus on the breathing and relax the heart rate. Regular diaphragmatic breathing may be achieved by extending the outbreath by counting or humming.
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).
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