Treatment of anxiety focuses on a two-pronged approach for most people, that focuses on using psychotherapy combined with occasional use of anti-anxiety medications on an as-needed basis. Most types of anxiety can be successfully treated with psychotherapy alone — cognitive-behavioral and behavioral techniques have been shown to be very effective. Anti-anxiety medications tend to be fast-acting and have a short-life, meaning they leave a person’s system fairly quickly (compared to other psychiatric medications, which can take weeks or even months to completely leave).
Cognitive behavioral therapy focuses on the thinking patterns and behaviors that are sustaining or triggering your panic attacks and helps you look at your fears in a more realistic light. For example, if you had a panic attack while driving, what is the worst thing that would really happen? While you might have to pull over to the side of the road, you are not likely to crash your car or have a heart attack. Once you learn that nothing truly disastrous is going to happen, the experience of panic becomes less terrifying.

We all tend to avoid certain things or situations that make us uncomfortable or even fearful. But for someone with a phobia, certain places, events or objects create powerful reactions of strong, irrational fear. Most people with specific phobias have several things that can trigger those reactions; to avoid panic, they will work hard to avoid their triggers. Depending on the type and number of triggers, attempts to control fear can take over a person’s life.
Prolonged exposure therapy is a specific type of CBT used to treat PTSD and phobias. The goal of this therapy is to help patients overcome the overwhelming disstress they experience when reminded of past traumas or in confronting their fears. With the guidance of a licensed therapist, the patient is carefully reintroduced to the trauma memories or reminders. During the exposure, the therapist guides the patient to use coping techniques such as mindfulness or relaxation therapy/imagery. The goal of this therapy is to help patients realize that trauma-related memories (or phobias) are no longer dangerous and do not need to be avoided. This type of treatment usually lasts 8-16 weekly sessions.
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.

To receive a diagnosis of panic disorder, the panic attacks must be unexpected and during the attack four or more of the above symptoms must occur. For panic attacks that are expected, meaning they might not be expected by the individual but are expected in relation to any phobia, anxiety or other mental health disorder, four or more symptoms must also occur.
Characterized by the development of certain trauma-related symptoms following exposure to a traumatic event (see "Diagnostic criteria" below). While most people experience negative, upsetting, and/or anxious reactions following a traumatic event, a diagnosis of PTSD is made when symptoms and negative reactions persist for more than a month and disrupt daily life and functioning. Symptoms are separated into four main groups: re-experiencing, avoidance, negative cognitions and mood, and hyperarousal. The specific symptoms experienced can vary substantially by individuals; for instance, some individuals with PTSD are irritable and have angry outbursts, while others are not. In addition to the symptoms listed below, some individuals with PTSD feel detached from their own mind and body, or from their surroundings (i.e., PTSD dissociative subtype).
Most people experience feelings of anxiety before an important event such as a big exam, business presentation or first date. Anxiety disorders, however, are illnesses that cause people to feel frightened, distressed and uneasy for no apparent reason. Left untreated, these disorders can dramatically reduce productivity and significantly diminish an individual's quality of life.

We all tend to avoid certain things or situations that make us uncomfortable or even fearful. But for someone with a phobia, certain places, events or objects create powerful reactions of strong, irrational fear. Most people with specific phobias have several things that can trigger those reactions; to avoid panic, they will work hard to avoid their triggers. Depending on the type and number of triggers, attempts to control fear can take over a person’s life.
Obsessive-compulsive Disorder (OCD): In OCD, a person becomes trapped in a pattern of repetitive thoughts and behaviors that are senseless and distressing but extremely difficult to overcome. Such rituals as counting, prolonged handwashing, and repeatedly checking for danger may occupy much of the person’s time and interfere with other activities. Like panic disorder, OCD can be treated effectively with medication and/or psychotherapy.
These attacks are a symptom of panic disorder, a type of anxiety disorder that affects some 2.4 million U.S. adults. The disorder most often begins during the late teens and early adulthood and strikes twice as many American women as men. No one knows what causes panic disorder, though researchers suspect a combination of biological and environmental factors, including family history (panic disorder seems to run in families), stressful life events, drug and alcohol abuse, and thinking patterns that exaggerate normal physical reactions.
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]

Exposure therapy has been around for a long time. It involves exposing the patient in a safe and controlled environment to physical sensations they experience during a panic attack much the same way you‘d expose in small increments a person with a fear of trains or puppies or snakes to the things that scares them. With panic disorder, there’s often a heightened sensitivity to ordinary physical sensations such as racing heart, stomach ache or feeling faint. In exposure therapy, the therapist will ask you to mimic activities—like running around or doing jumping jacks or holding your breath—to cause panic symptoms. The idea is that by repeating the things that may trigger a panic attack those triggers will eventually lose their power.
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.
Anxiety disorders are a group of mental disorders characterized by exaggerated feelings of anxiety and fear responses.[10] Anxiety is a worry about future events and fear is a reaction to current events. These feelings may cause physical symptoms, such as a fast heart rate and shakiness. There are a number of anxiety disorders: including generalized anxiety disorder, specific phobia, social anxiety disorder, separation anxiety disorder, agoraphobia, panic disorder, and selective mutism. The disorder differs by what results in the symptoms. People often have more than one anxiety disorder.[10]
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.
People who have had a panic attack in certain situations may develop irrational fears, called phobias, of these situations and begin to avoid them. Eventually, the pattern of avoidance and level of anxiety about another attack may reach the point where individuals with panic disorder are unable to drive or even step out of the house. At this stage, the person is said to have panic disorder with agoraphobia.
Anxiety attacks symptoms and heart attack symptoms can seem similar because their signs and symptoms can be similar. But most medical professionals can quickly tell the difference as heart attacks have distinct symptoms that aren’t anxiety-like. If you are unsure of which is an anxiety attack symptom and which is a heart attack symptom, seek immediate medical advice. If the doctor diagnoses your symptoms as anxiety attack symptoms, you can feel confident the doctor’s diagnosis is correct. Therefore, there is no need to worry about a heart attack.

Panic attacks are generally brief, lasting less than 10 minutes, although some of the symptoms may persist for a longer time. People who have had one panic attack are at greater risk for having subsequent panic attacks than those who have never experienced a panic attack. When the attacks occur repeatedly, and there is worry about having more episodes, a person is considered to have a condition known as panic disorder.
Your brain focuses on some alleged thread, for instance, a very scary thought that was floating somewhere at your subconscious.  Your thalamus – the part of the brain responsible for regulating consciousness, sleep and alertness – transfers that information to your amygdala – the part of the brain responsible for emotional reactions, decision-making and memory – which marks it as “danger” and sends a signal to your sympathetic nervous system, activating the fight-or-flight response.
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.
Generally, anxiety arises first, often during childhood. Evidence suggests that both biology and environment can contribute to the disorder. Some people may have a genetic predisposition to anxiety; however, even so, development of the condition is not inevitable. Early traumatic experiences can also reset the body’s normal fear-processing system so that it is hyper-reactive.
Antidepressants called selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs) are commonly used as first-line treatments for anxiety. Less-commonly used — but effective — treatments for anxiety disorders are older classes of antidepressants, such as tricyclic antidepressants and monoamine oxidase inhibitors (MAOIs).
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