Anxiety disorders reflect disorders that share a general feature of excessive fear (i.e. emotional response to perceived or real threat) and/or anxiety (i.e. anticipation of future threat) and demonstrate behavioral and functional disturbances as a result. Panic attacks are a feature that can occur in the context of many anxiety disorders and reflect a type of fear response.


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.
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.
How do you know if you're having a panic or anxiety attack? Panic attacks and anxiety attacks share some symptoms, but they differ in intensity, duration, and whether or not there is a trigger. Some treatments are similar and include therapy, stress management, and breathing exercises. Learn more about the differences between a panic attack and an anxiety attack here. Read now

Anxiety disorders increase one's chances for suffering from other medical illness, such as cardiovascular disorders, including obesity, heart disease and diabetes. More specifically, increased body weight and abdominal fat, high blood pressure, and greater levels of cholesterol, triglycerides, and glucose have all been linked to anxiety. While it is still unclear what causes the high co-morbidity between anxiety and bad physical health outcomes, research suggests that changes in underlying biology that is characteristic of anxiety may also facilitate the emergence for these other physical health outcomes over time. For example, changes in stress hormones, autonomic responses, as well as heightened systemic inflammation are all associated with anxiety disorders and negative health outcomes. These shared physiological states suggest a shared underlying biology and that anxiety maybe a whole-body condition.


Poverty and low education level tend to be associated with anxiety, but it is unclear if those factors cause or are caused by anxiety. While some statistics suggest that disadvantaged ethnic minorities tend to suffer from internalizing disorders like panic disorder less often than the majority population in the United States, other research shows that may be the result of differences in how ethnic groups interpret and discuss signs and symptoms of intense fright, like panic attacks. Also, panic and other anxiety disorders are thought to persist more for some ethnic minorities in the United States. Difficulties the examiner may have in appropriately recognizing and understanding ethnic differences in symptom expression is also thought to play a role in ethnic differences in the reported frequency of panic and other internalizing disorders.
Generalized anxiety disorder involves persistent and excessive worry that interferes with daily activities. This ongoing worry and tension may be accompanied by physical symptoms, such as restlessness, feeling on edge or easily fatigued, difficulty concentrating, muscle tension or problems sleeping. Often the worries focus on everyday things such as job responsibilities, family health or minor matters such as chores, car repairs, or appointments.

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.

People with panic attacks often report a fear of dying or heart attack, flashing vision, faintness or nausea, numbness throughout the body, heavy breathing and hyperventilation, or loss of body control. Some people also suffer from tunnel vision, mostly due to blood flow leaving the head to more critical parts of the body in defense. These feelings may provoke a strong urge to escape or flee the place where the attack began (a consequence of the "fight-or-flight response", in which the hormone causing this response is released in significant amounts). This response floods the body with hormones, particularly epinephrine (adrenaline), which aid it in defending against harm.[9]
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.
Many people experience their first panic attack due a build up of chronic stress. Anxious personalities often then become afraid of them, which further stresses the body. As fear and stress increase, so does the likelihood of a subsequent panic attack. This scenario is a common catalyst into Panic Attack Disorder: becoming afraid of the feelings and symptoms of a panic attack, which causes further panic attacks.
Anxiety disorders are treated through medication and therapy. You might feel embarrassed talking about the things you are feeling and thinking, but talking about it, say experts, is the best treatment. A particular form of therapy is considered most effective: cognitive behavioral therapy, or CBT for short. Antidepressants — the types of medication most frequently used to treat depression — are the drugs that also work best for anxiety disorders.
In fact, some studies have suggested that people with chronic anxiety disorders have an increased prevalence of CAD—that is, chronic anxiety may be a risk factor for CAD. So doctors should not be too quick to simply write the chest pain off as being “simply” due to anxiety. They should at least entertain the possibility that both disorders may be present and should do an appropriate evaluation.
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.

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]
A panic attack begins suddenly and unexpectedly and most often peaks within 10 to 20 minutes. At times, the resulting anxiety may last a couple of hours. Panic attacks can occur whether the person is calm or anxious. Recalling a past attack may trigger a new one. The frequency of panic attacks can vary, and for some people the fear of having an additional attack may lead them to avoid situations where escape may be difficult, such as being in a crowd or traveling in a car or bus. 
Panic disorder affects 2-3% of people every year in the United States and Europe, with varying rates depending on race and ethnicity. On average, Native American Indian populations experience panic disorder at higher rates than non-Latino white Americans. In contrast, African Americans, Latinos, Caribbean Blacks, and Asian Americans all experience the disorder at lower rates than non-Latino white Americans. In addition, it has been well established than females are twice as likely to be diagnosed with panic disorder than males (Asnaani, Gutner, Hinton, & Hofmann, 2009; McLean, Asnaani, Litz, & Hofmann, 2011). A number of factors (e.g., biological influences, temperament, exposure to stressors and trauma, cognitive factors, and environmental factors) have been identified as possibly influencing sex differences in rates of panic disorder (McLean & Anderson, 2009). However, no one theory has been determined so the underlying reason for sex differences in rates of panic disorder remains unknown.

Expected panic attacks are those which occur when you are exposed to one of your triggers. For example, if you have a fear of flying you may have a panic attack when you board a plane. Expected panic attacks are again broken down into two categories: situationally bound (cued) in which a person is anticipating exposure to a particular trigger (as with our flying example), or situationally predisposed, in which a panic attack does not always occur when exposed to the feared situation.
Generally, panic attacks are treated with reassurance and relaxation techniques. By definition, panic attacks last less than an hour, so many times a person already feels much better by the time he or she makes it to the doctor's office. Nevertheless, because the diagnosis is made by excluding more dangerous causes, people may be given medications during their attack.

Paula had her first panic attack six months ago. She was in her office preparing for an important work presentation when, suddenly, she felt an intense wave of fear. Then the room started spinning and she felt like she was going to throw up. Her whole body was shaking, she couldn’t catch her breath, and her heart was pounding out of her chest. She gripped her desk until the episode passed, but it left her deeply shaken.


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.
Some of these symptoms will most likely be present in a panic attack. The attacks can be so disabling that the person is unable to express to others what is happening to them. A doctor might also note various signs of panic: The person may appear to be very afraid or shaky or be hyperventilating (deep, rapid breathing that causes dizziness). Anxiety attacks that take place while sleeping, also called nocturnal panic attacks, occur less often than do panic attacks during the daytime, but affect a large percentage of people who suffer from daytime panic attacks. Individuals with nocturnal panic attacks tend to have more respiratory symptoms associated with panic and have more symptoms of depression and of other psychiatric disorders compared to people who do not have panic attacks at night. Nocturnal panic attacks tend to result in sufferers waking suddenly from sleep in a state of sudden fright or dread for no known reason. As opposed to people with sleep apnea and other sleep disorders, sufferers of nocturnal panic can have all the other symptoms of a panic attack. Although nocturnal panic attacks usually last no more than 10 minutes, it can take much longer for the person to fully recover from the episode.
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.
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