While separation anxiety is a normal stage of development, if anxieties intensify or are persistent enough to get in the way of school or other activities, your child may have separation anxiety disorder. Children with separation anxiety disorder may become agitated at just the thought of being away from mom or dad and complain of sickness to avoid playing with friends or going to school.
The mutism must also include impairment in social, academic, or occupational achievement or functioning to qualify as a diagnosis. Selective mutism is not present if it is related to lack of knowledge or comfort with the spoken language required of the situation or is due to embarrassment from a communication or developmental disorder. The symptoms cannot be better accounted for by another mental disorder or be caused by substances, medications, or medical illness.
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. 
Psychologically, people who develop panic attacks or another anxiety disorder are more likely to have a history of what is called anxiety sensitivity. Anxiety sensitivity is the tendency for a person to fear that anxiety-related bodily sensations (like brief chest pain or stomach upset) have dire personal consequences (for example, believing that it automatically means their heart will stop or they will throw up, respectively). From a social standpoint, a risk factor for developing panic disorder as an adolescent or adult is a history of being physically or sexually abused as a child. This is even more the case for panic disorder when compared to other anxiety disorders. Often, the first attacks are triggered by physical illnesses, another major life stress, or perhaps medications that increase activity in the part of the brain involved in fear reactions.
Panic attacks may also occur due to short-term stressors. Significant personal loss, including an emotional attachment to a romantic partner, life transitions, and significant life changes may all trigger a panic attack to occur. A person with an anxious temperament, excessive need for reassurance, hypochondriacal fears,[14] overcautious view of the world,[9] and cumulative stress have been correlated with panic attacks. In adolescents, social transitions may also be a cause.[15]

Without treatment, panic attacks tend to occur repeatedly for months or years. While they typically begin in young adulthood, the symptoms may arise earlier or later in life in some people. Complications, which are symptoms that can develop as a result of continued panic attacks and develop into other mental illnesses, may include specific irrational fears (phobias), especially of leaving home (agoraphobia) and avoidance of social situations. Other possible complications can include depression, work or school problems, suicidal thoughts or actions, financial problems, and alcohol or other substance abuse. For children and adolescents, panic disorder can even interfere with normal development. Panic disorder and other anxiety disorders also predispose sufferers to developing heart or gastrointestinal diseases, high blood pressure or diabetes, having more severe symptoms if they have a respiratory disease, and of dying prematurely.
Phobic avoidance – You begin to avoid certain situations or environments. This avoidance may be based on the belief that the situation you’re avoiding caused a previous panic attack. Or you may avoid places where escape would be difficult or help would be unavailable if you had a panic attack. Taken to its extreme, phobic avoidance becomes agoraphobia.
Those who experience panic attacks are often nervous about having additional episodes. To avoid having a panic attack in a public space, they may avoid places like shopping malls or other crowded spots where previous incidents may have occurred or places that they fear will not allow them immediate access to help, such as an airplane or movie theater. This avoidance when severe may lead to agoraphobia, the inability to leave familiar, safe surroundings because of intense fear and anxiety about having a panic attack outside the home.
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.
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.
Anyone can learn how to stop and prevent anxiety attacks. It’s a matter of learning more about them and knowing how to control and prevent them. Most people struggle with problematic anxiety attacks because they don’t understand them, and therefore, fear them…which is a common catalyst into Panic Attack Disorder. The more you know, the better off you’ll be.
Medications — most often antidepressants and anti-anxiety drugs — can also be used to help treat panic disorder. Your doctor may initially prescribe you an anti-anxiety drug, such as Xanax (alprazolam), and then add an antidepressant, such as Effexor XR (venlafaxine). After a month or sooner, your doctor may stop the Xanax and have you remain on the antidepressant.
Yes, panic attacks can feel awful, intense, and threatening. But they aren’t harmful and generally pass when the body calms down. And yes, they can range in number, intensity, and frequency with each person experiencing a unique set of panic attack symptoms. But panic attacks and their symptoms can be overcome for good by getting the right information, help, and support. We provide more detailed information in the Recovery Support area of our website.
Exercises to replace negative thoughts with positive ones: Make a list of the negative thoughts that might be cycling as a result of anxiety, and write down another list next to it containing positive, believable thoughts to replace them. Creating a mental image of successfully facing and conquering a specific fear can also provide benefits if anxiety symptoms relate to a specific cause, such as in a phobia.

These physiological responses can actually help us to survive. However, sometimes we experience these physiological responses, like an increased heartbeat, that are not in the presence of danger at all, but something else entirely. In these cases, our bodies can misinterpret these physiological signals as being indicators of danger or a "true threat." For example, people may experience learned anxiety due to previous associations between elevated heart rate and panic attacks and may misinterpret bodily sensations as signs of imminent death or loss of control. In this way, one may start to fear these physiological responses, which is what we call "fear of fear" (Craske & Barlow, 2007). "Fear of fear" maintains or perpetuates panic attacks and panic symptoms, which becomes a vicious cycle. In other words, you experience an increased heart rate, which you interpret as negative, which makes you feel anxious, which further makes your heart rate increase and it often spirals from there. These associations may almost happen automatically, even without conscious thought, but this is what is likely going on behind the scenes.
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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