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.
In deeper level psychoanalytic approaches, in particular object relations theory, panic attacks are frequently associated with splitting (psychology), paranoid-schizoid and depressive positions, and paranoid anxiety. They are often found comorbid with borderline personality disorder and child sexual abuse. Paranoid anxiety may reach the level of a persecutory anxiety state.
“Anxiety attack” is not a formal, clinical term, but one that is used by many people to describe all sorts of things, from feeling worried about an upcoming event to intense feelings of terror or fear that would meet the diagnostic criteria for a panic attack. In order to understand what someone means by “anxiety attack,” it is necessary to consider the context in which the symptoms occur.
“Panic disorder is diagnosed if the individual has recurrent panic attacks (minimum four in a four-week period), and at least one of the attacks is accompanied by one or more physical symptoms, including persistent concern about having another attack, worry about the implication or consequences of the attack (i.e., having a heart attack), and/or a significant change in behaviour due to the attacks, such as quitting a job.7 In addition, the panic attacks cannot be due to the physiological effects of a substance or another general medical condition.”
For example, a person with obsessive-compulsive disorder may experience a panic attack when their schedule or compulsions are interrupted. Individuals who struggle with specific phobias are also susceptible to panic attacks. A person with an extreme fear of heights (acrophobia) may experience a panic attack in a penthouse apartment. And for someone with generalized anxiety disorder (GAD), a condition characterized by extreme fear or worry, the unending anxiety can escalate to a panic attack. People with post-traumatic stress disorder (PTSD) have a higher incidence of panic disorder than the general population. Illness or traumatic events increase the chances of panic attacks.
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.
My dad passed away in November and I went back to work after a month, a month later I was given another client to work on. I felt really stressed out. I found myself feeling irrationally angry about things at work, build things up in my head to be really bad and then I would need to cry to release it, I have had two recent experiences of what I think are panic/anxiety attacks- feeling overwhelmed/stressed/negative thoughts and then hyperventilating with non-stop crying. I am seeing a psychiatrist who I think is helping. But short-term I think I need to tell work about how I am feeling. I want to quit and have time off but get worried about money.
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).
"These techniques take some getting used to,” says Dave Carbonell, PhD, an anxiety therapist in Chicago, but learning how to cope with anxiety attacks is important so that fear of having another won't keep you at home or limit your activities. A study in Alternative Therapies in Health and Medicine in 2013 found that multiple approaches to managing anxiety, including strategies like breathing and journaling, can help.
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.
Exposure therapy for panic disorder with agoraphobia includes exposure to the situations you fear and avoid is also included in treatment. As in exposure therapy for specific phobias, you face the feared situation until the panic begins to go away. Through this experience, you learn that the situation isn’t harmful and that you have control over your emotions.
I think I also be having anxiety attacks! I’m 20yrs old and just lost my baby boy while pregnant at 8months! It’s very sad and depressing to think about it! I went to the doctor and was prescribed xanx! They work but sometimes it takes a while for the anxiety to go away/slow down! Hot/cold feeling! Fast heart beat! The feeling of going in and out! Can hardly breathe! I’m just trying to cope with it, being that I am so young!
Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
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.
Selective mutism: A somewhat rare disorder associated with anxiety is selective mutism. Selective mutism occurs when people fail to speak in specific social situations despite having normal language skills. Selective mutism usually occurs before the age of 5 and is often associated with extreme shyness, fear of social embarrassment, compulsive traits, withdrawal, clinging behavior, and temper tantrums. People diagnosed with selective mutism are often also diagnosed with other anxiety disorders.