Panic attacks can occur due to number of disorders including panic disorder, social anxiety disorder, post traumatic stress disorder, drug use disorder, depression, and medical problems.[2][4] They can either be triggered or occur unexpectedly.[2] Smoking, caffeine, and psychological stress increase the risk of having a panic attack.[2] Before diagnosis, conditions that produce similar symptoms should be ruled out, such as hyperthyroidism, hyperparathyroidism, heart disease, lung disease, and drug use.[2]
Yes. There are many medications that have FDA approval to treat anxiety disorders. Several members of the benzodiazepine class are routinely used to provide relief from anxiety. These minor tranquillizers are safe and effective, but should be used for short-term relief. They have many side effects, including drowsiness, and can be habit forming at higher doses. People taking these medications should not use heavy machinery or drive until they understand how the medication might affect them.
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.
Simple Phobias and Agoraphobia: People with panic disorder often develop irrational fears of specific events or situations that they associate with the possibility of having a panic attack. Fear of heights and fear of crossing bridges are examples of simple phobias. As the frequency of panic attacks increases, the person often begins to avoid situations in which they fear another attack can occur or places where help would not be immediately available. This avoidance may eventually develop into agoraphobia, an inability to go beyond known and safe surroundings because of intense fear and anxiety. Generally, these fears can be resolved through repeated exposure to the dreaded situations, while practicing specific techniques to become less sensitive to them.
Please note that it is not a good idea to attempt to diagnose or label a friend or family member. Only a mental health professional can diagnose an anxiety disorder, as many disorders have overlapping features, and can go together with other types of mental health difficulties. However, if you notice signs of anxiety, or just feel that something is not quite right with someone that you care about, it's a good idea to reach out to ask the person how they are feeling. You could start with something neutral and supportive like, "It seems like you haven't been quite yourself lately. Is there something going on that you want to talk about?"

Medication: Many antidepressants can work for anxiety disorders. They include escitalopram (Lexapro) and fluoxetine (Prozac). Certain anticonvulsant medicines (typically taken for epilepsy) and low-dose antipsychotic drugs can be added to help make other treatments work better. Anxiolytics are also drugs that help lower anxiety. Examples are alprazolam (Xanax) and clonazepam (Klonopin). They’re prescribed for social or generalized anxiety disorder as well as for panic attacks.
Research demonstrates that the most effective treatments for anxiety are behavioral. Such treatments often involve gradually exposing sufferers to the situations they fear. Anxiety therapy may also focus on changing distorted thought patterns that underlie the condition. Drugs may help patients control their anxiety, but they are typically effective only during treatment and do not usually cure the condition. Increasingly, researchers are finding that mindfulness meditation can be a successful technique that helps lessen anxiety.
Paula had her next panic attack three weeks later, and since then, they’ve been occurring with increasing frequency. She never knows when or where she’ll suffer an attack, but she’s afraid of having one in public. Consequently, she’s been staying home after work, rather than going out with friends. She also refuses to ride the elevator up to her 12th floor office out of fear of being trapped if she has a panic attack.
People who have panic attacks typically spend a lot of time worrying about having more attacks and often make seemingly unreasonable lifestyle changes in an attempt to avoid circumstances that will trigger future attacks. They may avoid situations that, they feel, have precipitated previous episodes or environments where they would not be able to escape easily if another attack should occur.
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.

What’s it like to live with an anxiety disorder on a daily basis? Is it always overwhelming, or are there specific strategies that can be used to make it easier to get through the day and manage anxiety successfully? Anxiety disorders are so common that we might take for granted that a person can live their lives and still suffer from occasional bouts of anxiety (or anxiety-provoking situations). These articles explore the challenges of living with and managing this condition.


"Anxiety" is a general term that describes a variety of experiences, including nervousness, fear, apprehension, and worry, that are common in several mental health disorders. While most of us have anxiety at some time, this is completely different from an anxiety attack or anxiety disorder. Normal feelings of nervousness, worry, and fear often have a known trigger (a major exam, money issues, or seeing a bug). But when you're having a full blown panic attack or anxiety attack, the symptoms — chest pain, flushing skin, racing heart, and difficulty breathing — can make you feel as though you're going to faint, lose your mind, or die. The reality is, you won’t. The key to surviving is to learn all you can about anxiety attacks and practice the skills you need to get through them.
Comorbidity is more common than not with anxiety disorders, meaning that most individuals who experience significant anxiety experience multiple different types of anxiety. Given this co-morbidity, it is not surprising that many risk factors are shared across anxiety disorders, or have the same underlying causes. There is a lot of research identifying risk factors for anxiety disorders, and this research suggests that both nature and nurture are very relevant. It is important to note that no single risk factor is definitive - many people may have a risk factor for a disorder, and not ever develop that disorder. However, it is helpful for research to identify risk factors and for people to be aware of them, as being aware of who might be at risk can potentially help people get support or assistance in order to prevent the development of a disorder.
I just had my first big anxiety attack yesterday. It happened probably because of some friend drama and school responsibilities and how the world is completely crumbling down and I can’t do anything about it. I started sobbing uncontrollably, I was hyperventilating so oxygen couldn’t get to my hands so they started going numb I was alone for about 30 minutes until I had the strength to call my mom. I think what triggered it most was the drama which sounds kinda selfish. My friend always talks about herself and this guy she likes, I also messed up on this project and she told me off and looked disappointed, like I was stupid or something. We are best friends i know it’s just a phase but it’s hurting me.

For people who may be wondering how to avoid panic attacks using treatment without prescribed medication, natural remedies may be an option. While herbal supplements that contain kava have been found to be helpful for some people with mild to moderate panic disorder, the research data is still considered to be too limited for many physicians to recommend treatment with other natural remedies like valerian or passionflower. Also, care should be taken when taking any dietary supplements, since supplements are not regulated in terms of quality, content, or effectiveness.
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.
“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.
If you think a friend or colleague at work is experiencing an anxiety disorder or other mental health difficulty, you should carefully consider how you react. Your actions in the workplace can have work-related and legal consequences. However, intervening early before an emergency situation arises can help prevent greater consequences for your colleague's career, health, and safety.
Have you ever experienced an intense feeling of terror, fear or apprehension, for no apparent reason? If you have, you may have experienced a panic attack. If you experience recurrent panic attacks, you may have a condition called panic disorder. Panic attacks can also be the sign of other underlying medical or mental health conditions, including sleep disorders, post-traumatic stress disorder (PTSD), or depression.

In order to manage threatening situations, humans have evolved to experience a "fight or flight" response. As part of this response, when humans are confronted with a dangerous situation, their body mobilizes by sending blood away from their extremities (e.g. hands and feet) and into the major muscles, producing adrenaline, and increasing heart rate so that we are better equipped to fight off danger.
Cushing's syndrome, sometimes referred to as hypercortisolism, is a hormonal disorder caused by prolonged exposure to high levels of the hormone cortisol. Symptoms may include obesity, thinning arms and legs, a rounded face, and increased fat around the neck. Some causes of Cushing's syndrome is from taking glucocorticoid hormones such as prednisone for inflammatory diseases. Treatment for Cushing's syndrome depends on the cause.
Psychodynamic theory posits that anxiety is often the result of opposing unconscious wishes or fears that manifest via maladaptive defense mechanisms (such as suppression, repression, anticipation, regression, somatization, passive aggression, dissociation) that develop to adapt to problems with early objects (e.g., caregivers) and empathic failures in childhood. For example, persistent parental discouragement of anger may result in repression/suppression of angry feelings which manifests as gastrointestinal distress (somatization) when provoked by another while the anger remains unconscious and outside the individual's awareness. Such conflicts can be targets for successful treatment with psychodynamic therapy. While psychodynamic therapy tends to explore the underlying roots of anxiety, cognitive behavioral therapy has also been shown to be a successful treatment for anxiety by altering irrational thoughts and unwanted behaviors.
In people with anxiety disorders, the brain circuitry that controls the threat response goes awry. At the heart of the circuit is the amygdala, a structure that flags incoming signals as worrisome and communicates with other parts of the brain to put the body on alert for danger. Early life events, especially traumatic ones, can program the circuitry so that it is oversensitive and sends out alarms too frequently and with only minor provocations. Survival mandates a system for perceiving threats and taking quick, automatic action, but those with anxiety see threats where there are none, perhaps because emotional memories color their perceptions.
Butterflies in your stomach before an important event? Worried about how you will meet a deadline? Nervous about a medical or dental procedure? If so, you are like most people, for whom some worry about major events (like having a child, taking an exam, or buying a house), and/or practical issues (like money or health conditions), is a normal part of life. Similarly, it is not uncommon to have fears about certain things (like spiders, injections, or heights) that cause you to feel some fear, worry, and/or apprehension. For example, many people get startled and feel nervous when they see a snake or a large insect. People can differ in what causes them to feel anxious, but almost everyone experiences some anxiety in the course of their life.

Social Anxiety Disorder;Fear of social situations in which the person is exposed to unfamiliar people or to possible scrutiny by others. The individual fears that he or she will act in a way (or show anxiety symptoms) that will be embarrassing and humiliating, often times leading to avoidance of social situations and severe distress when participation in social situations can't be avoided. [2]
If you have anxiety that’s severe enough to interfere with your ability to function, medication may help relieve some anxiety symptoms. However, anxiety medications can be habit forming and cause unwanted or even dangerous side effects, so be sure to research your options carefully. Many people use anti-anxiety medication when therapy, exercise, or self-help strategies would work just as well or better—minus the side effects and safety concerns. It’s important to weigh the benefits and risks of anxiety medication so you can make an informed decision.
Everyone here has issues, but what happens when you’re blue as hell and CANNOT figure out the source of the problem? There is no quote, no book, no video, no saying or phrase, no motto, which is helping me right now. I feel like absolute total HELL. And I damned well know it’s not going to last, and that it’s probably a result of thinking too hard, too long, too deeply. Anyway, thank you all for sharing your pain with strangers. It shows that you’re way stronger than you think.

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.
There has been recent interest in using psychoactive substances in conjunction with psychotherapy; the two that have received increased attention have been cannabis (marijuana) and methylenedioxymethamfetamine (MDMA, known as ecstasy or molly). These drugs are somewhat controversial, given that they also have psychoactive, i.e. "feeling high" effects. However, with increasing legalization of marijuana it is important to address whether these substances could be used to alleviate clinical symptoms of anxiety. While there have been only a few randomized clinical trials for these drugs, certain forms of cannabis have demonstrated positive effects on anxiety. Specifically, cannabidiol, a component of cannabis has been effective for Social Anxiety Disoder, and tetrahydrocannabinol (THC) has helped PTSD patients. However, the plant form of cannabis has not shown great efficacy and has potential to worsen symptoms, so should be used with caution and only under supervision of a provider. MDMA has shown some positive effects for PTSD, but should only be used as an adjunct to psychotherapy, again under clinical care.
The condition of steady, pervasive anxiety is called Generalized Anxiety Disorder. Yet there are numerous anxiety-related disorders. One is panic disorder—severe episodes of anxiety that occur in response to specific triggers. Another is obsessive-compulsive disorder, marked by persistent intrusive thoughts or compulsions to carry out specific behaviors, such as hand-washing. Post-traumatic stress disorder may develop after exposure to a terrifying event in which severe physical harm occurred or was threatened. Anxiety so frequently co-occurs with depression that the two are thought to be twin faces of one disorder. Like depression, anxiety strikes twice as many adult females as males.
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.

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]
How does cognitive behavioral therapy work? Cognitive behavioral therapy (CBT) is a short-term talking therapy where a professional counselor or therapist works with an individual to help them find new ways to approach difficult challenges, including stress, fear, and relationship issues. It is a person-centered and time-limited technique. Read now
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.

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.
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.
Some research suggests that your body's natural fight-or-flight response to danger is involved in panic attacks. For example, if a grizzly bear came after you, your body would react instinctively. Your heart rate and breathing would speed up as your body prepared for a life-threatening situation. Many of the same reactions occur in a panic attack. But it's unknown why a panic attack occurs when there's no obvious danger present.
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]

As is true for other mood and anxiety disorders, the use of Selective Serotonin Reuptake Inhibitors (SSRI's; e.g.., Paxil, Prozac, Zoloft), Benzodiazepines (e.g., Xanax, Lorazepam), and Selective Norepinephrine Reuptake Inhibitors (SNRI's; e.g., Cymbalta, Effexor, Pristiq) are common medical treatments for panic disorder. Additionally, D-cycloserine is a medication that is now being explored as a way to enhance effects of CBT (e.g., Hofmann et al., 2013). These medications may have side effects and taking them can lead to tolerance, withdrawal symptoms, and dependence, so it is important that you consult with a physician before starting or stopping these medications. There is evidence that taking one of these medications in addition to receiving behavioral therapy (e.g., CBT) can significantly benefit patients with panic disorder, although seeking psychotherapy in itself is largely effective (Arch et al., 2017).
Cognitive behavioral therapy has been shown to help with treating panic disorder and agoraphobia. According to a study published in December 2013 in the journal Behaviour Research and Therapy, its effects lasted as long as two years after the initial treatment. And a study published in August 2017 in the Journal of Consulting and Clinical Psychology suggested that it may be superior to traditional psychotherapy in the treatment of this condition.
Acupuncture is a treatment derived from traditional Chinese medicine. It consists of inserting very thin needles into the body in targeted areas. To date there is very little evidence that acupuncture can significantly treat generalized anxiety, although there are currently ongoing research trials for PTSD. One study did find that acupuncture can reduce pre-operative anxiety.
Only 16, Caroline, had her first panic attack a year ago. Her mother was dropping her off at her summer job at a local school when, without warning, a full-blown panic attack engulfed her. “My heart started racing and my body felt so hot. I started to sweat and shake uncontrollably. My vision became distorted and my body felt limp, like a wet noodle,” she says. For 20 minutes, until the panic attacked passed, Caroline refused to get out of the car. Her mother didn’t know what to do.
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.
"The fight-or-flight system is hardwired for us humans to manage dangerous situations, and those of us with anxiety have an activated fight-or-flight response when the trigger is not really dangerous," says Beth Salcedo, MD, the medical director of The Ross Center for Anxiety & Related Disorders and board president of the Anxiety and Depression Association of America.
People with panic attacks often report a fear of dying or heart attack, flashing vision, faintness or nausea, numbness throughout the body, heavy breathing and hyperventilation, or loss of body control. Some people also suffer from tunnel vision, mostly due to blood flow leaving the head to more critical parts of the body in defense. These feelings may provoke a strong urge to escape or flee the place where the attack began (a consequence of the "fight-or-flight response", in which the hormone causing this response is released in significant amounts). This response floods the body with hormones, particularly epinephrine (adrenaline), which aid it in defending against harm.[9]
Yes. My anxiety started really bad in college when I could no longer play football and I lost the love of my life and on top of that I was broke. 2 major things that I loved was taken from me. And they both could have been prevented and when I came home from college I had no job no money little friends extremely little support and I felt like a failure. I had no directions in life. My mother never understood my anxiety so she didn’t help treat it with care . To her it was pretty much get over it. I felt like I was losing touch with reality. To this day I still struggle with it, but therapy and coping techniques keeps me somewhat grounded and leveled.
Many of us may know what it feels like to be nervous before a party, or when meeting new people or making an important phone call. Those with social anxiety disorder have very intense versions of those fears — intense fears of being judged by others that cause them to avoid those kinds of situations. For most people, fears of social situations usually subside once the intimidating event has been faced. But in social anxiety disorder, these feelings are persistent and usually last for at least six months. 
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