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 :
Benzodiazepines, including alprazolam (Xanax) and lorazepam (Ativan), may be prescribed for patients to help with more acute symptoms of panic disorder. These drugs alleviate symptoms quickly and have fewer side effects other than drowsiness, but frequent use may lead to dependence on the medication. They are not recommended for patients who have alcohol or substance abuse issues.

This may sound counter-intuitive but trying to accept one's emotional experience can be very helpful during panic attacks. Remind yourself that anxiety is like a wave, what goes up must come down. Fighting against the experience engages the "fear of fear" cycle that can make you feel even worse. If you notice panic symptoms creeping up, label your experience and you remind yourself, "I will be okay. This will pass in time." Accepting your experience, rather than fighting against it, will likely help your panic symptoms reduce more quickly and will feel easier along the way.

Signs of mental health difficulty can be different in the workplace than in other settings. The Harvard Mental Health Letter outlines signs that you may notice in your co-workers, which could indicate a significant problem. For anxiety disorders, these can include restlessness, fatigue, difficulty concentrating, excess worrying, and a general impairment in quality of work.


I had the biggest panic attack to date today, managed to get into the car with my friends to take my son for a hospital appointment, felt very unsafe and thought I was going to fall out of the car when it went around a corner. Talked to myself all through the journey telling myself I’d been round hundreds of corners and never fallen out out a car yet…got the hospital, got out the car, got half way across the carpark and had what I can only describe as the most hysterical panic/anxiety attack I have ever had. I,d dropped to the floor by now as I was with my friend Kay and I knew she wouldnt be able to run after me….I was screaming, pleading for help for what felt like forever, 2 paramedics came over and it took them a good 10 minutes to convince me I should stand up and go into A&E, I can only explain the whole thing as being hysterical, a Crisis nurse and doctor came to see my and gave me 4 diazepam, even after taking one – 5mg – I was hysterical and wouldnt then leave the hospital…I,m now at home and a lot calmer, the Crisis team are coming to see me between 10am and 1pm tomorrow to discuss meds, even the nurse said to the doctor ‘this isnt depression, this is severe anxiety..’ all I need is a tiny pinprick of light to look at to keep me hopeful. I honestly thought I could handle today but I didnt, I,m angry and disappointed with myself as this time a month ago I was fine
I almost had a breakdown yesterday, I got mad at my sister. She told me we’d hang out then later she bailed me. I was so mad I poured all her body lotion in the sink, I was looking for her Victoria’s Secret perfume so I could break it into pieces but couldn’t find it. (Yes, I think I have anger issues too, might need anger management). I was already frustrated with my new job. I am slightly a perfectionist and I’m having a hard time with work I’m not too familiar with. I almost broke down or did broke down but hid it very well. My heart can’t stop pounding the whole day, whole night. I went to sleep since I was so tired but I woke up in the middle of the night with my heart beating so loud and fast. Until in the morning I can’t control it. I have a feeling I need to visit my psychiatrist again. I miss talking to her though. But the medications are so expensive it makes me depress more.

Cognitive behavioral therapy (CBT), is based on the idea that our thoughts cause our feelings and behaviors, not external things, like people, situations, and events. According to the National Association of Cognitive Behavioral Therapists the benefit of this therapy is that we can change the way we think to feel and act better even if the situation does not change. CBT focuses on determining the thought and behavior patterns responsible for sustaining or causing the panic attacks. CBT is a time-limited process (treatment goals—and the number of sessions expected to achieve them—are established at the start) that employs a variety of cognitive and behavioral techniques to affect change.
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.
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.
Behavioral choices can also significantly impact risk, as excessive tobacco or caffeine use can increase anxiety, whereas regular exercise can decrease anxiety. Specific temperament and personality traits also may confer risk of having an anxiety disorder. With regards to temperament, shyness and behavioral inhibition in childhood can increase risk of developing an anxiety disorder later in life. With regard to personality traits, the Five Factor Model of Personality consists of five broad trait domains including Neuroticism, Extraversion, Openness to Experience, Agreeableness, and Conscientiousness. An individual higher on trait Neuroticism or low on Conscientiousness is at a higher risk for all anxiety disorders, and an individual low on trait Extraversion is at a higher risk of developing social phobia and agoraphobia. Some more narrow personality traits have also been found to relate to risk for anxiety, including anxiety sensitivity, a negative or hostile attributional style, and self-criticism. Personality disorders have also been shown to relate to increased risk for anxiety disorders.

Panic disorder is diagnosed in people who experience spontaneous seemingly out-of-the-blue panic attacks and are very preoccupied with the fear of a recurring attack. Panic attacks occur unexpectedly, sometimes even when waking up from sleep. Panic disorder usually begins in adulthood (after age 20), but children can also have panic disorder and many children experience panic-like symptoms (“fearful spells”).
All human beings experience anxiety. In many cases, anxiety can have some beneficial and adaptive qualities such as pushing one to study for an upcoming difficult exam or propelling a person to flee from danger. Although experiencing some anxiety with life stressors and worries is normal, sometimes it can be difficult to manage and can feel overwhelming. Below we provide a list of tips and strategies to help individuals prevent anxiety from reaching a diagnosable level. Even though not everyone will struggle with a diagnosable anxiety disorder, learning strategies to aid in relief from anxiety and to manage the "normal" anxiety experienced in everyday life can help you live the life you desire.

If medications are prescribed, several options are available. Selective serotonin reuptake inhibitors (SSRIs), selective serotonin and norepinephrine reuptake inhibitors (SSNRIs), and the benzodiazepine families of medications are considered to be effective treatment of panic disorder. SSRIs include sertraline (Zoloft), fluoxetine (Prozac), paroxetine (Paxil), citalopram (Celexa), escitalopram (Lexapro), and fluvoxamine (Luvox). SSNRIs include duloxetine (Cymbalta) and venlafaxine (Effexor). Clinical trials have shown SSRIs reduce the frequency of panic attack up to 75%-85%. SSRIs must be taken three to six weeks before they are effective in reducing panic attacks and are taken once daily.

People often fear the worst when they're having an anxiety attack. Most of the time, there’s no underlying physical problem, such as a real heart attack. But you should get the medical all clear if you have repeat anxiety attacks, just to be sure you don’t need additional treatment. Then find a cognitive behavioral therapist with experience treating anxiety to help you through.
It is important to note that genetic factors can also bestow resilience to anxiety disorders, and the field continues to pursue large-scale genomics studies to identify novel genetic factors that are associated with anxiety disorders in hopes of better understanding biological pathways that: 1) contribute to the development and maintenance of anxiety; and 2) may lead to better treatment for these disorders. Most people are not aware of what specific genetic markers they may have that confer risk for anxiety disorders, so a straightforward way to approximate genetic risk is if an individual has a history of anxiety disorders in their family. While both nature and nurture can be at play with family history, if several people have anxiety disorders it is likely that a genetic vulnerability to anxiety exists in that family.
Experiencing a chronic medical condition or severe or frequent illness can also increase risk for anxiety disorders, as well as dealing with significant illness of a family member or loved one. Given that several medical conditions have been linked to significant anxiety, in some cases a physician may perform medical tests to rule out an underlying medical condition. For instance, thyroid disease is often characterized by experiencing significant symptoms of anxiety. Menopause, heart disease, and diabetes have also been linked to anxiety symptoms. Additionally, drug abuse or withdrawal for many substances is characterized by acute anxiety, and chronic substance abuse can increase risk for developing an anxiety disorder. Anxiety can also be a side effect of certain medications. Experiencing significant sleep disturbances, such as difficulty falling asleep or staying asleep, may also be a risk factor for developing an anxiety disorder.
I have occasional panic attacks, typically around one or two of what I consider minor panic attacks per month. A minor panic attack is one that I catch and manage to head off before it grows full-blown. I just have so much experience having and handling panic attacks that I’ve learned the curb them…usually. Sometimes, my coping mechanisms don’t work and I’m left suffering a full-blown panic attack and, of course, they’re terrible. I’m always on the lookout for new and better coping mechanisms to minimize the chances of one slipping through like that.

The cause of anxiety disorders is a combination of genetic and environmental factors.[47] Anxiety can stem itself from certain factors: genetics, medicinal side-effects, shortness of oxygen.[48] Risk factors include a history of child abuse, family history of mental disorders, and poverty. Anxiety disorders often occur with other mental disorders, particularly major depressive disorder, personality disorder, and substance use disorder.[49] To be diagnosed symptoms typically need to be present at least six months, be more than would be expected for the situation, and decrease functioning.[10][49] Other problems that may result in similar symptoms including hyperthyroidism, heart disease, caffeine, alcohol, or cannabis use, and withdrawal from certain drugs, among others.[49][7]
Anxiety isn't always a bad thing. In fact, it can motivate you and help you to stay focused under pressure. But when worries, fears, or panic attacks start to get in the way of your life, you may be suffering from an anxiety disorder. Whatever form of anxiety you're dealing with, there are many things you can do to gain peace of mind and take back control of your life.

Because symptoms are so severe, many people who experience a panic attack may believe they are having a heart attack or other life-threatening illness and may go to a hospital ER. Panic attacks may be expected, such as a response to a feared object, or unexpected, apparently occurring for no reason. The mean age for onset of panic disorder is 22-23. Panic attacks may occur with other mental disorders such as depression or PTSD.


Guys, I am 23 and this might sound very stupid but i recently broke up with my boyfriend of 7 months(yes quite a less time to experience anxiety issues but yes..) One fine day he just comes over and says its done between us.. I have fell out of love and thats why I cant pretend to be with you. It happened on 17th of this month i.e. 17th july and for over a week i couldnt sleep, eat food and I was nauseaic and I am still in a bad state.. I am forcing myself to sleep, to not think about it but my attacks starts early in the morning and get suffocated and want to just run out of the space. I get urges to calling him, speak to him, tell him how much I love him and miss him but its all like I am speaking to a wall. And i dont trouble my parents with this problem. should i visit a counsellor or should I give myself some time to heal ?


Social risk factors for anxiety include a history of trauma (e.g., physical, sexual or emotional abuse or assault), early life experiences and parenting factors (e.g., rejection, lack of warmth, high hostility, harsh discipline, high parental negative affect, anxious childrearing, modelling of dysfunctional and drug-abusing behaviour, discouragement of emotions, poor socialization, poor attachment, and child abuse and neglect), cultural factors (e.g., stoic families/cultures, persecuted minorities including the disabled), and socioeconomics (e.g., uneducated, unemployed, impoverished although developed countries have higher rates of anxiety disorders than developing countries).[57][89]
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.
Physical Symptoms: People with panic disorder may also have irritable bowel syndrome, characterized by intermittent bouts of gastrointestinal cramps and diarrhea or constipation, or a relatively minor heart problem called mitral valve prolapse, which can trigger panic attacks in some people. In fact, panic disorder often coexists with unexplained medical problems, such as chest pain not associated with a heart attack or chronic fatigue.
Some benefits of benzodiazepines are that they are effective in relieving anxiety and take effect more quickly than antidepressant medications often prescribed for anxiety. Some drawbacks of benzodiazepines are that people can build up a tolerance to them if they are taken over a long period of time and they may need higher and higher doses to get the same effect. Some people may even become dependent on them.
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