Meditation may also be helpful in the treatment of panic disorders.[54] There was a meta-analysis of the comorbidity of panic disorders and agoraphobia. It used exposure therapy to treat the patients over a period. Hundreds of patients were used in these studies and they all met the DSM-IV criteria for both of these disorders.[55] A result was that thirty-two percent of patients had a panic episode after treatment. They concluded that the use of exposure therapy has lasting efficacy for a client who is living with a panic disorder and agoraphobia.[55]
Medications options for panic attacks typically include benzodiazepines and antidepressants. Benzodiazepines are being prescribed less often because of their potential side effects, such as dependence, fatigue, slurred speech, and memory loss.[57] Antidepressant treatments for panic attacks include selective serotonin reuptake inhibitors (SSRIs), serotonin noradrenaline reuptake inhibitors (SNRIs), tricyclic antidepressants (TCAs), and MAO inhibitors (MAOIs). SSRIs in particular tend to be the first drug treatment used to treat panic attacks. Selective serotonin reuptake inhibitors (SSRIs) and tricyclic antidepressants appear similar for short-term efficacy.[58] SSRIs carry a relatively low risk due to the fact that they are not associated with much of a tolerance or dependence, and are difficult to overdose with. TCAs are similar to SSRIs in their many advantages, but come with more common side effects such as weight gain and cognitive disturbances. They are also easier to overdose on. MAOIs are generally suggested for patients who have not responded to other forms of treatment.[59]

Until recently, panic disorder was not distinguished from agoraphobia (distressing anxiety resulting from being outside the home, travelling via public transit, being in open or claustrophobic environments, or being in crowds that generally leads to extreme avoidance due to fear of not being able to escape in those situations; APA, 2013). As it stands in the current Diagnostic and Statistical Manual of Mental Disorders - 5 agoraphobia is one of the most common disorders to co-occur with panic disorder. Current estimates contend that just under 2% of teens and adults have agoraphobia (Kessler et al., 2012). Often, people associate panic attacks or their panic disorder with certain places, people, or events and the fear of another attack occurring can lead to comorbid fears of the location or idea that there is no escape, which leads to extreme avoidance. Panic disorder can also occur simultaneously with other anxiety disorders, such as Generalized Anxiety Disorder (GAD) and/or Social Anxiety Disorder (SAD), for example.
A healthy diet is also important to reduce and prevent anxiety. It seems counterintuitive that you can "eat your way to calm" but sustaining a healthy diet can really help you to feel more at ease on a regular basis, despite stressors. Some foods that are particularly helpful for reducing anxiety include foods with omega 3 fatty acids (i.e., salmon, walnuts, and flaxseed) and probiotics. Avoid greasy, sugary, high-fat, and processed foods. Additionally, avoiding caffeine when feeling anxious as well as unhealthy substances (i.e., alcohol) could be beneficial. Drinking alcohol might seem like a good way to calm down, but it can lead to sustained anxious symptoms. Incorporating a healthy diet into your lifestyle is fundamental to preventing and reducing anxiety.
Often, a combination of psychotherapy and medications produces good results in the treatment of panic disorder. Improvement is usually noticed in about two to three months. Thus, appropriate treatment for panic disorder can prevent panic attacks or at least substantially reduce their severity and frequency, bringing significant relief to 70%-90% of people with the illness. More than 18% of people who are assessed but not treated for this condition tend to relapse in less than two years. As these statistics indicate, access to appropriate mental health care is key to a positive prognosis for people who suffer from panic attacks. Therefore, it is imperative to alleviate the well documented economic and racial disparities that exist in having and using access to care. Combating other social disparities, like educational, employment, housing, and criminal justice, is also seen as being important to improving the prognosis for recovering from panic attacks and other health problems.

When we’re anxious, the body produces a stress response. The stress response is designed to give us an extra ‘boost’ of awareness and energy when we think we could be in danger. The stress response causes a number of physiological, psychological, and emotional changes in the body that enhance the body’s ability to deal with a perceived threat – to either fight or flee, which is the reason the stress response is often referred to as the ‘fight or flight response.’
But over time, you may find yourself experiencing more panic attacks, in a variety of circumstances. Most of these will not be entirely unexpected. Most subsequent attacks occur in response to various cues such as entering a crowded area; a traffic jam; or simply worrying about having a panic attack. But there may still be some surprises: for instance, you might have a nocturnal panic attack, which wakes you out of a sound sleep. Or you might find yourself experiencing odd feelings of depersonalization as you kill some time with friends or colleagues.
Medications are also a common form of treatment for Generalized Anxiety Disorder. The most common types of medications prescribed to individuals living with this form of anxiety include anti-depressants, anti-anxiety drugs, and in some cases, sedatives. Antidepressants are used to treat depression, but have been found effective in the treatment of anxiety as well. They commonly take a couple of weeks to start taking effect and may cause some mild side effects, including headache, nausea, or difficulty sleeping. Most of the side effects are mild and tend to subside within a few weeks. Anti-anxiety medication is also often prescribed to help individuals cope with Generalized Anxiety Disorder. These types of drugs are powerful in their treatment of this type of anxiety; one of the most commonly prescribed types is a drug called buspirone often under the brand nane Buspar.

Antidepressants are used to treat depression, but they can also be helpful for treating anxiety disorders. They may help improve the way your brain uses certain chemicals that control mood or stress. You may need to try several different antidepressant medicines before finding the one that improves your symptoms and has manageable side effects. A medication that has helped you or a close family member in the past will often be considered.
A panic attack? I thought panic attacks were reserved for women who were overly emotional and struggled with a mood disorder. The picture I had of these women from after-school movies and health class worksheets hadn’t prepared me for the idea that a relatively happy wife, mother, teacher, writer, and friend could be suffering from a panic attack. This had to be wrong.
Approximately one-third of people with panic disorder will also develop agoraphobia. People with agoraphobia are afraid that they will have some anxiety symptoms or a full-blown panic attack in a place where it would be very challenging or embarrassing for them to flee. This condition can lead to avoidance behaviors, in which they try to stay away from all places or situations in which they may have a panic attack.
A licensed mental health professional that has earned a Master’s degree from a variety of educational backgrounds (e.g. general counseling background, social work, marriage and family counseling).  Once their formal education is completed, these clinicians are supervised in the field 1-2 years and pass a State exam to become fully licensed in the state in which they practice.  These mental health professionals are licensed to diagnose emotional, mental health and behavioral health problems.  They can provide mental health treatment in the form of counseling and psychotherapy, or work in other capacities as patient advocates or care managers. Licensed Master’s level clinicians work in many settings, including hospitals, community mental health clinics, private practice, school settings, nursing homes, and other social service agencies.  Titles and licensing requirements may vary from state to state.
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Biological causes may include obsessive compulsive disorder, Postural Orthostatic Tachycardia Syndrome, post traumatic stress disorder, hypoglycemia, hyperthyroidism, Wilson's disease, mitral valve prolapse, pheochromocytoma, and inner ear disturbances (labyrinthitis). Dysregulation of the norepinephrine system in the locus ceruleus, an area of the brain stem, has been linked to panic attacks.[13]
Desperate for help, he reached out to the Anxiety and Depression Association of America, which sent him a list of therapists experienced in treating panic attacks and anxiety. “This is how I got better," Sideman says. "I found a therapist who understood what panic disorder was, understood agoraphobia, and knew cognitive behavioral therapy, which I had not known about.” He also started practicing meditation.
The causes of anxiety attacks are not well understood. Some traumatic life events can set off anxiety attacks if the person is prone to depression or anxiety disorders. Also, medical conditions and some medications may trigger anxiety attacks. Many believe anxiety attacks run in families with a genetic predisposition. In other words, if your mom and her sister had anxiety attacks, it’s likely you will, too.

"This tends to make the individual vulnerable to developing an anxiety disorder, rather than cause them to directly inherit one," she says. Environmental factors, she adds, interact with genetic predispositions to trigger the onset of anxiety disorders. A study published in August 2017 in the journal Emotion may offer clues as to how both genes and environment combine to make anxiety take root. (4)
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.
More than shyness, this disorder causes intense fear about social interaction, often driven by irrational worries about humiliation (e.g. saying something stupid or not knowing what to say). Someone with social anxiety disorder may not take part in conversations, contribute to class discussions or offer their ideas, and may become isolated. Panic attacks are a common reaction to anticipated or forced social interaction.
Antidepressants are widely used to treat anxiety disorders, such as generalized anxiety disorder, panic disorder, agoraphobia and social anxiety disorder. The most commonly prescribed medications are from the selective serotonin reuptake inhibitor (SSRI) class. They are generally effective and have few side-effects, although they do not provide immediate relief. More
Anxiety can be either a short-term 'state' or a long-term personality "trait". Trait anxiety reflects a stable tendency across the lifespan of responding with acute, state anxiety in the anticipation of threatening situations (whether they are actually deemed threatening or not).[40] A meta-analysis showed that a high level of neuroticism is a risk factor for development of anxiety symptoms and disorders.[41] Such anxiety may be conscious or unconscious.[42]
Palpitations are uncomfortable sensations of the heart beating hard, rapidly, or irregularly. Some types of palpitations are benign, while others are more serious. Palpitations are diagnosed by taking the patient history and by performing an EKG or heart monitoring along with blood tests. An electrophysiology study may also be performed. Treatment of palpitations may include lifestyle changes, medication, ablation, or implantation of a pacemaker. The prognosis if palpitations depends on the underlying cause.
Characterized by a preoccupation with the belief that one's body or appearance are unattractive, ugly, abnormal or deformed. This preoccupation can be directed towards one or many physical attributes (e.g., acne, hair loss, facial features). Muscle dysmorphia is a subtype of this disorder that is characterized by belief that one's body is too small or insufficiently muscular.
Panic disorder is diagnosed as occurring with or without agoraphobia. Agoraphobia involves a fear of having one of these intense panic attacks in a place or situation where it would be very difficult or embarrassing to escape. Often times, the fear associated with agoraphobia can lead to many avoidance behaviors. By limiting one’s ability to be in certain situations, people with agoraphobia often experience feelings of loneliness as well as an overall diminished quality of life.
There are many highly effective treatment options available for anxiety and anxiety-related disorders. These treatments can be broadly categorized as: 1) Psychotherapy; 2) Medications; and 3) Complementary and Alternative Therapies. Patients diagnosed with anxiety can benefit from one or a combination of these various therapies. Discussions of emerging therapies and types of care providers are also included.
The philosopher Søren Kierkegaard, in The Concept of Anxiety (1844), described anxiety or dread associated with the "dizziness of freedom" and suggested the possibility for positive resolution of anxiety through the self-conscious exercise of responsibility and choosing. In Art and Artist (1932), the psychologist Otto Rank wrote that the psychological trauma of birth was the pre-eminent human symbol of existential anxiety and encompasses the creative person's simultaneous fear of – and desire for – separation, individuation, and differentiation.
Agoraphobia is often comorbid with panic disorder — meaning people often suffer from both conditions at the same time. It's an intense fear of not being able to escape whatever place you're in, and can often lead to an avoidance of leaving the house. People with agoraphobia can fear situations where this anxiety might flare up, and typically don't feel comfortable or safe in public, crowded places. 
According to a study published in Psychology Medicine1, people who suffer from panic attacks and panic disorder may be at higher risk of heart attack and heart disease later in life. While the link between panic disorder and heart disease remains controversial, the study found that compared to individuals without panic disorder, sufferers were found to have up to a 36% higher risk of heart attack and up to 47% higher risk of heart disease. If you suffer from panic attacks, seek attention for any chest pain symptoms in order to rule out any issues with heart health.
When used in the appropriate person with close monitoring, medications can be quite effective as part of treatment for panic disorder. However, as anything that is ingested carries a risk of side effects, it is important for the individual who has panic attacks to work closely with the prescribing health care professional to decide whether treatment with medications is an appropriate intervention and, if so, which medication should be administered. The person being treated should be closely monitored for the possibility of side effects that can vary from minor to severe, and in some cases, even be life-threatening. Due to the possible risks to the fetus of a mother being treated for panic attacks with medication, psychotherapy should be the first treatment tried when possible during pregnancy and the risk of medication treatment should be weighed against the risk of continued panic attacks in regard to the impact of a developing fetus.
But some think that nature isn’t as much of an influence as nurture. People theorize that women tend to be socialized in a way that gives them permission to openly discuss emotion. So women may feel more comfortable admitting to feelings than men, who tend to be socialized to keep their feelings to themselves and are less likely to confess to emotional problems. Women may therefore get diagnosed with anxiety disorders more often than men. (9)
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