Everyone has probably experienced panic, or something like it, at least once in their lifetime: on a disturbingly turbulent plane, or before giving an important presentation, or after realizing you hit reply all when you really, really should not have. We all know the paralyzed feeling and the heightened physical sensations. But panic attacks and panic disorder take a different shape. Panic attacks have many physical symptoms and tend to peak around 10 minutes, and may last for 30. Panic disorder is diagnosed by the frequency of these attacks, and the presence of a fear of having them. 
In particular, the doctor will be concerned with the person's past medical history, past history of any mental illness, and any surgery the person may have had. In addition to exploring whether the person suffers from any other mental illness, the practitioner often explores whether the panic attack sufferer has a specific anxiety disorder in addition to or instead of panic disorder, like post traumatic stress disorder (PTSD), phobias, obsessive compulsive disorder, or generalized anxiety disorder.
Moreover, this hypocapnia and release of adrenaline during a panic attack cause vasoconstriction resulting in slightly less blood flow to the head which causes dizziness and lightheadedness.[28][29] A panic attack can cause blood sugar to be drawn away from the brain and toward the major muscles. Neuroimaging suggests heightened activity in the amygdala, thalamus, hypothalamus, and brainstem regions including the periaqueductal gray, parabrachial nucleus, and Locus coeruleus.[30] In particular, the amygdala has been suggested to have a critical role.[31] The combination of high arousal in the amygdala and brainstem along with decreased blood flow and blood sugar in the brain can lead to dramatically decreased activity in the prefrontal cortex region of the brain.[32] There is evidence that having an anxiety disorder increases the risk of cardiovascular disease (CVD).[33] Those affected also have a reduction in heart rate variability.[33]
As the result of years of research, there are a variety of treatments available to help people who suffer from panic attacks learn how to control the symptoms. This includes several effective medical treatments, and specific forms of psychotherapy. In terms of medications, specific members of the selective serotonin reuptake inhibitor (SSRI), the selective serotonin and norepinephrine reuptake inhibitors (SSNRI), and the benzodiazepine families of medications are approved by the U.S. Food and Drug Administration (FDA) for effective treatment of panic disorder. Examples of anti-anxiety medications include fluoxetine (Prozac), sertraline (Zoloft), paroxetine (Paxil), escitalopram (Lexapro), citalopram (Celexa), vortioxetine (Brintellix), and vilazodone (Viibryd) from the SSRI group, duloxetine (Cymbalta), venlafaxine (Effexor), desvenlafaxine (Pristiq), and levomilnacipran (Fetzima) from the SSNRI group, and clonazepam (Klonopin) and lorazepam (Ativan) from the benzodiazepine group. Although alprazolam (Xanax) is often used to treat panic attacks, its short duration of action can sometimes result in having to take it several times per day. Medications from the beta-blocker family (for example, propranolol [Inderal]) are sometimes used to treat the physical symptoms, like racing heart rate associated with a panic attack. Some individuals who suffer from severe panic attacks may benefit from treatment with gabapentin (Neurontin), which was initially found to treat seizures, or benefit from a neuroleptic medication like risperidone (Risperdal), olanzapine (Zyprexa), quetiapine (Seroquel), aripiprazole (Abilify), paliperidone (Invega), asenapine (Saphris), iloperidone (Fanapt), or lurasidone (Latuda).

The avoidance, anticipation of, or distress of the phobic object/situation must cause significant distress or interferes with the individual's daily life, occupational, academic, or social functioning to meet diagnosis. The symptoms cannot be better accounted for by another mental disorder or be caused by substances, medications, or medical illness.


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So I don’t know if I had a panic attack or anxiety attack. It happened last night after me and gf got into an argument and basically went to bed mad and angry. I woke up about 4am to her pushing the back of head to pulling towards her to give me a kiss. My heart was pounding really hard, I couldnt barely breath regularly like I should but couldn’t. I felt mildly nausea, and felt like throwing up but I never did and I was feeling a bit light-headed. This is my first time having this happen and I don’t thinks it’s happened before..at least not to my knowledge cause I never knew what the signs were for having an anxiety attack or a panic attack.
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 condition of steady, pervasive anxiety is called Generalized Anxiety Disorder. Yet there are numerous anxiety-related disorders. One is panic disorder—severe episodes of anxiety that occur in response to specific triggers. Another is obsessive-compulsive disorder, marked by persistent intrusive thoughts or compulsions to carry out specific behaviors, such as hand-washing. Post-traumatic stress disorder may develop after exposure to a terrifying event in which severe physical harm occurred or was threatened. Anxiety so frequently co-occurs with depression that the two are thought to be twin faces of one disorder. Like depression, anxiety strikes twice as many adult females as males.
Some medical conditions, like thyroid abnormalities and anemia, as well as certain medications, can produce severe anxiety. Examples of such medications include stimulants like methylphenidate (Ritalin) or amphetamine salts (Adderall), diabetes medications like metformin (Glucophage) and insulin, antimalarial medications like quinine, as well as corticosteroid withdrawal, such as withdrawal from dexamethasone (Decadron). As individuals with panic disorder seem to be at higher risk of having a heart valve abnormality called mitral valve prolapse (MVP), this possibility should be investigated by a doctor since MVP may dictate the need for special precautions when the individual is being treated for any dental problem. While the development of panic attacks has been attributed to the use of food additives like aspartame, alone or in combination with food dyes, more research is needed to better understand the role such substances may have on this disorder.

Post-traumatic stress disorder -- or PTSD -- was considered to be a type of anxiety disorder in earlier versions of the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders. But in 2013, PTSD was reclassified as its own condition. It describes a range of emotional reactions caused by exposure to either death or near-death circumstances (such as fires, floods, earthquakes, shootings, assault, automobile accidents, or wars) or to events that threaten one's own or another person's physical well-being. The traumatic event is re-experienced with fear of feelings of helplessness or horror and may appear in thoughts and dreams. Common behaviors include the following:

Exercise regularly. Exercise is a natural stress buster and anxiety reliever. To achieve the maximum benefit, aim for at least 30 minutes of aerobic exercise on most days (broken up into short periods if that’s easier). Rhythmic activities that require moving both your arms and legs are especially effective. Try walking, running, swimming, martial arts, or dancing.
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

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.
Genetic risk factors have been documented for all anxiety disorders. Clinical genetic studies indicate that heritability estimates for anxiety disorders range from 30-67%. Many studies, past and present, have focused on identifying specific genetic factors that increase one's risk for an anxiety disorder. To date, an array of single nucleotide polymorphisms (SNPs) or small variations in genetic code, that confer heightened risk for anxiety have been discovered. For the most part, the variants that have been associated with risk for anxiety are located within genes that are critical for the expression and regulation of neurotransmitter systems or stress hormones.

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.


Panic disorder involves repeated episodes of sudden feelings of intense anxiety and fear or terror that reach a peak within minutes (panic attacks). You may have feelings of impending doom, shortness of breath, chest pain, or a rapid, fluttering or pounding heart (heart palpitations). These panic attacks may lead to worrying about them happening again or avoiding situations in which they've occurred.
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.
A collection of activities focused in which an individual consciously produces the relaxation response in their body. This response consists of slower breathing, resulting in lower blood pressure and overall feeling of well-being. These activities include: progressive relaxation, guided imagery, biofeedback, and self-hypnosis and deep-breathing exercises.
Not everyone understands is that someone with an anxiety disorder cannot "just let things go". This makes the struggle with an anxiety disorder even harder, and may prevent one from looking for help. However, it is very important to talk about these anxieties with someone and preferably find a health care professional as soon as you experience these symptoms. Anxiety should be considered as severe as a physical disease; however, most people in society do not appreciate the severity of this disorder. Some people may consider anxiety a fault or a weakness; however, it may help if people realize that many research studies have demonstrated biological explanations for (some of) the symptoms observed in anxiety disorders. Brain scans have demonstrated brain abnormalities in certain anxiety disorders, and also altered brain functioning has been demonstrated for individuals with anxiety disorders. Furthermore, there is some evidence that anxiety disorders might be linked to chemical imbalances in the brain.
Panic attacks and panic disorder are treatable once the underlying cause of is identified. “Usually medical conditions and other factors (substance use or withdrawal from substances) are ruled out before making the diagnosis,” says Flo Leighton, psychiatric nurse practitioner, and therapist with Union Square Practice in Manhattan. Getting to the root cause typically takes a couple of sessions, says Leighton. Here are some options that may be recommended to you :

Not everyone who worries a lot has an anxiety disorder. You may be anxious because of an overly demanding schedule, lack of exercise or sleep, pressure at home or work, or even from too much caffeine. The bottom line is that if your lifestyle is unhealthy and stressful, you’re more likely to feel anxious—whether or not you actually have an anxiety disorder. These tips can help to lower anxiety and manage symptoms of an anxiety disorder:
A key component to the prevention of anxiety is awareness. Learning to recognize your anxious thinking patterns when they arise can help you manage and reduce them quickly. Awareness of anxiety begins with trying to identify the cause and/or trigger of anxiety and gaining an understanding of how it affects your mood and behaviors. Is it that your boss recently gave you negative feedback at work and you are worried each day that you are not doing well enough for their standards? Is it that you waited until the last minute to study for a test and are feeling anxious that you will not perform well? Awareness of the source of your anxiety is the first step to finding out the best way to relieve it.
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."[22]
Have you ever worried about your health? Money? The well-being of your family? Who hasn’t, right? These are common issues we all deal with and worry about from time to time. However, if you find yourself in constant worry over anything and everything in your life, even when there should be no cause for concern, you might be suffering from Generalized Anxiety Disorder. People with this condition often recognize they are “over-worrying” about a lot of issues, but have no control over the worry and associated anxiety. It is constant and can interfere with your ability to relax or sleep well and can cause you to startle easily.
Although beta-blockers are most often used to treat high blood pressure, they can also be used to help relieve the physical symptoms of anxiety, such as rapid heartbeat, shaking, trembling, and blushing. These medications, when taken for a short period of time, can help people keep physical symptoms under control. They can also be used “as needed” to reduce acute anxiety, including as a preventive intervention for some predictable forms of performance anxieties.
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