In an anxiety-related disorder, your fear or worry does not go away and can get worse over time. It can influence your life to the extent that it can interfere with daily activities like school, work and/or relationships. Fear, stress, and anxiety are "normal feelings and experiences" but they are completely different than suffering from any of the seven diagnosable disorders plus substance-induced anxiety, obsessive-compulsive disorders, and trauma- or stressor-related disorders.
The cognitive effects of anxiety may include thoughts about suspected dangers, such as fear of dying. "You may ... fear that the chest pains are a deadly heart attack or that the shooting pains in your head are the result of a tumor or an aneurysm. You feel an intense fear when you think of dying, or you may think of it more often than normal, or can't get it out of your mind."
Psychotherapy. A type of psychotherapy called cognitive behavioral therapy (CBT) is especially useful as a first-line treatment for panic disorder. CBT teaches you different ways of thinking, behaving, and reacting to the feelings that come on with a panic attack. The attacks can begin to disappear once you learn to react differently to the physical sensations of anxiety and fear that occur during panic attacks.
A panic attack is an abrupt surge of intense fear or discomfort that reaches a peak within minutes, and during which time a variety of psychological and physical symptoms occur. These symptoms include rapid heart rate, sweating, shaking, shortness of breath, hot flashes, and lightheadedness—as well as a sense of impending doom, chills, nausea, abdominal pain, chest pain, headache, and numbness or tingling.
People with panic disorder may also experience comorbid bipolar disorder, alcohol or substance use disorder, or medical problems that accompany their panic. It is common for individuals with panic disorder to have thyroid problems, respiratory issues, heart problems, or feelings of dizziness (APA, 2013). In general, it has been reported that 93.7% of people with panic disorder meet criteria for at least one other medical or mental disorder (Arch, Kirk, & Craske, 2017). That being said, comorbidity is not inevitable with panic disorder and it is important to discuss your symptoms thoroughly with a medical professional. Additionally, the causality of the link between panic disorders and medical problems remains unclear.
According to the American Psychological Association, "most specialists agree that a combination of cognitive and behavioral therapies are the best treatment for panic disorder. Medication might also be appropriate in some cases." The first part of therapy is largely informational; many people are greatly helped by simply understanding exactly what panic disorder is and how many others suffer from it. Many people who suffer from panic disorder are worried that their panic attacks mean they are "going crazy" or that the panic might induce a heart attack. Cognitive restructuring helps people replace those thoughts with more realistic, positive ways of viewing the attacks. Avoidance behavior is one of the key aspects that prevent people with frequent panic attacks from functioning healthily. Exposure therapy, which includes repeated and prolonged confrontation with feared situations and body sensations, helps weaken anxiety responses to these external and internal stimuli and reinforce realistic ways of viewing panic symptoms.
“One day, without any warning or reason, a feeling of terrible anxiety came crashing down on me. I felt like I couldn’t get enough air, no matter how hard I breathed. My heart was pounding out of my chest, and I thought I might die. I was sweating and felt dizzy. I felt like I had no control over these feelings and like I was drowning and couldn’t think straight.
Foster the development of a strong peer network. It's probably no surprise to hear that peer relationships become a major source of support during adolescence. Encourage your child to engage in interests (like arts, music, and sports) that will help them develop and maintain friendships. If your child already has a very busy and structured schedule, try to carve out some time for more relaxed socializing. However, note that sometimes peers can be the source of anxiety, whether through peer pressure or bullying. Check in with your child about the nature of their relationships with others in their social circle (school or class).
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 medications are prescribed, several options are available. Selective serotonin reuptake inhibitors (SSRIs), selective serotonin and norepinephrine reuptake inhibitors (SSNRIs), and the benzodiazepine families of medications are considered to be effective treatment of panic disorder. SSRIs include sertraline (Zoloft), fluoxetine (Prozac), paroxetine (Paxil), citalopram (Celexa), escitalopram (Lexapro), and fluvoxamine (Luvox). SSNRIs include duloxetine (Cymbalta) and venlafaxine (Effexor). Clinical trials have shown SSRIs reduce the frequency of panic attack up to 75%-85%. SSRIs must be taken three to six weeks before they are effective in reducing panic attacks and are taken once daily.
The combination of good self-help information and working with an experienced anxiety disorder coach, counselor, or therapist is the most effective way to address anxiety disorder and its many symptoms. Until the core causes of anxiety are addressed - the underlying factors that motivate apprehensive behavior - a struggle with anxiety disorder can return again and again. Identifying and successfully addressing anxiety's underlying factors is the best way to overcome problematic anxiety.
Vertigo is the sensation of spinning or rocking, even when someone is at rest. Vertigo may be caused by a problem in the brain or spinal cord or a problem within in the inner ear. Head injuries, certain medications, and female gender are associated with a higher risk of vertigo. Medical history, a physical exam, and sometimes an MRI or CT scan are required to diagnose vertigo. The treatment of vertigo may include:
There has been recent interest in using psychoactive substances in conjunction with psychotherapy; the two that have received increased attention have been cannabis (marijuana) and methylenedioxymethamfetamine (MDMA, known as ecstasy or molly). These drugs are somewhat controversial, given that they also have psychoactive, i.e. "feeling high" effects. However, with increasing legalization of marijuana it is important to address whether these substances could be used to alleviate clinical symptoms of anxiety. While there have been only a few randomized clinical trials for these drugs, certain forms of cannabis have demonstrated positive effects on anxiety. Specifically, cannabidiol, a component of cannabis has been effective for Social Anxiety Disoder, and tetrahydrocannabinol (THC) has helped PTSD patients. However, the plant form of cannabis has not shown great efficacy and has potential to worsen symptoms, so should be used with caution and only under supervision of a provider. MDMA has shown some positive effects for PTSD, but should only be used as an adjunct to psychotherapy, again under clinical care.
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 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.
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".
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.
So I can tell you that panic attacks aren't dangerous, but I recognize that this is "easy for me to say". If you're having anxiety attacks, especially if they're a relatively new occurrence for you, you might not be able to believe this right now. That's entirely understandable when you feel that your life is threatened! You don't need to take anything here on faith. Instead, check it all out. Test everything I say against your own experience, as you work your way through this site.
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.
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.
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.
Dialectical Behavior Therapy (DBT) is form of Cognitive therapy that emphasizes individual psychotherapy as well as group skills training to help people learns new skills and strategies—including mindfulness and distress tolerance– to manage their anxiety and panic. According to the American Psychological Association therapists who practicing DBT aim to strike a balance between validation and change by clearly communicating acceptance of who the client is and the challenges the client faces, while at the same time helping the client to learn new skills to improve emotion regulation, interpersonal communication skills and how to participate in life and cope with problems without defaulting to impulsive behavior.
Although the exact causes of panic attacks and panic disorder are unclear, the tendency to have panic attacks runs in families. There also appears to be a connection with major life transitions such as graduating from college and entering the workplace, getting married, or having a baby. Severe stress, such as the death of a loved one, divorce, or job loss can also trigger panic attacks.
Panic attacks are a symptom of an anxiety disorder and affect a significant number of adult Americans. Other facts about panic include that many people in the United States will have full-blown panic disorder at some time in their lives, usually beginning between 15-19 years of age. Panic attacks occur suddenly and often unexpectedly, are unprovoked, and can be disabling.
Antidepressants are used to treat depression, but they can also be helpful for treating anxiety disorders. They may help improve the way your brain uses certain chemicals that control mood or stress. You may need to try several different antidepressant medicines before finding the one that improves your symptoms and has manageable side effects. A medication that has helped you or a close family member in the past will often be considered.