In an anxiety-related disorder, your fear or worry does not go away and can get worse over time. It can influence your life to the extent that it can interfere with daily activities like school, work and/or relationships. Fear, stress, and anxiety are "normal feelings and experiences" but they are completely different than suffering from any of the seven diagnosable disorders plus substance-induced anxiety, obsessive-compulsive disorders, and trauma- or stressor-related disorders.

So how do you know if your anxiety is “normal” or “excessive?” It’s normal to be worried about an upcoming test or wondering how you are going to cope financially when you unexpectedly find out you need major repairs done to your house. If you are suffering from the type of excessive worry that accompanies Generalized Anxiety Disorder, you may see a report on the local news about a new health scare in a different country and stay awake at night worrying about you or your family being affected, even though risks are minimal at best. You will likely spend the next few days and weeks in a constant state of worry about the well-being of your family and experience anxiety that is debilitating, intrusive, excessive, and persistent.
Depression is a condition in which a person feels discouraged, sad, hopeless, unmotivated, or disinterested in life in general for more than two weeks and when the feelings interfere with daily activities. Major depression is a treatable illness that affects the way a person thinks, feels, behaves, and functions. At any point in time, 3 to 5 percent of people suffer from major depression; the lifetime risk is about 17 percent.
The combination of good self-help information and working with an experienced anxiety disorder coach, counselor, or therapist is the most effective way to address anxiety disorder and its many symptoms. Until the core causes of anxiety are addressed - the underlying factors that motivate apprehensive behavior - a struggle with anxiety disorder can return again and again. Identifying and successfully addressing anxiety's underlying factors is the best way to overcome problematic anxiety.
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.
Nevertheless, if you are struggling with symptoms of an anxiety disorder it is not uncommon to feel alone and misunderstood. Because the fear that people with an anxiety disorder have is not experienced by others, they may not understand why, for example, being in a crowd of people, not being able to wash your hands after meeting a new person, or driving through the street where you got in a car accident can be really anxiety-provoking for someone with an anxiety disorder. People may comment that "there is no reason to worry about it" or that you "should just let it go".
The cognitive effects of anxiety may include thoughts about suspected dangers, such as fear of dying. "You may ... fear that the chest pains are a deadly heart attack or that the shooting pains in your head are the result of a tumor or an aneurysm. You feel an intense fear when you think of dying, or you may think of it more often than normal, or can't get it out of your mind."[22]
Carbonell compares the type of breathing you’ll need with the breathing of infants, whose bellies rise and fall with each inhale and exhale. When an anxiety attack starts, exhale deeply, loosen your shoulders, and focus on some longer, deeper inhales and exhales that let your belly rise and fall. Place one hand on your belly if you need to feel this happening.
According to the American Psychological Association, "most specialists agree that a combination of cognitive and behavioral therapies are the best treatment for panic disorder. Medication might also be appropriate in some cases."[50] The first part of therapy is largely informational; many people are greatly helped by simply understanding exactly what panic disorder is and how many others suffer from it. Many people who suffer from panic disorder are worried that their panic attacks mean they are "going crazy" or that the panic might induce a heart attack. Cognitive restructuring helps people replace those thoughts with more realistic, positive ways of viewing the attacks.[51] Avoidance behavior is one of the key aspects that prevent people with frequent panic attacks from functioning healthily.[14] Exposure therapy,[52] which includes repeated and prolonged confrontation with feared situations and body sensations, helps weaken anxiety responses to these external and internal stimuli and reinforce realistic ways of viewing panic symptoms.
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Panic disorder affects 2-3% of people every year in the United States and Europe, with varying rates depending on race and ethnicity. On average, Native American Indian populations experience panic disorder at higher rates than non-Latino white Americans. In contrast, African Americans, Latinos, Caribbean Blacks, and Asian Americans all experience the disorder at lower rates than non-Latino white Americans. In addition, it has been well established than females are twice as likely to be diagnosed with panic disorder than males (Asnaani, Gutner, Hinton, & Hofmann, 2009; McLean, Asnaani, Litz, & Hofmann, 2011). A number of factors (e.g., biological influences, temperament, exposure to stressors and trauma, cognitive factors, and environmental factors) have been identified as possibly influencing sex differences in rates of panic disorder (McLean & Anderson, 2009). However, no one theory has been determined so the underlying reason for sex differences in rates of panic disorder remains unknown.

The prognosis for people who suffer a panic attack is overall, good. Some people have a single attack and are never bothered again. Yet, two-thirds of people experiencing a panic attack go on to be diagnosed with panic disorder. Also, half of those who go through a panic attack might develop clinical depression within the following year, if not treated promptly. Occasionally, a person will, after a long evaluation, be diagnosed with a medical condition that causes panic symptoms.
Panic disorder is characterized by repeated, unexpected panic attacks, as well as fear of experiencing another episode. A panic disorder may also be accompanied by agoraphobia, which is the fear of being in places where escape or help would be difficult in the event of a panic attack. If you have agoraphobia, you are likely to avoid public places such as shopping malls, or confined spaces such as an airplane.

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).
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.
2.This exposure happened either by directly experiencing the event(s), witnessing the event(s) in person, learning that the event(s) happened to a close friend or loved one (note: for cases of death or near death, it must have been violent or accidental), or being repeatedly exposed to the aversive details from traumatic events (e.g., as an emergency room doctor or nurse who frequently sees dead and mutilated bodies).
Yes, panic attacks can feel awful, intense, and threatening. But they aren’t harmful and generally pass when the body calms down. And yes, they can range in number, intensity, and frequency with each person experiencing a unique set of panic attack symptoms. But panic attacks and their symptoms can be overcome for good by getting the right information, help, and support. We provide more detailed information in the Recovery Support area of our website.

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]
Nevertheless, if you are struggling with symptoms of an anxiety disorder it is not uncommon to feel alone and misunderstood. Because the fear that people with an anxiety disorder have is not experienced by others, they may not understand why, for example, being in a crowd of people, not being able to wash your hands after meeting a new person, or driving through the street where you got in a car accident can be really anxiety-provoking for someone with an anxiety disorder. People may comment that "there is no reason to worry about it" or that you "should just let it go".

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.
People generally can overcome panic attacks faster if they seek help after the first one or two, says psychologist Cheryl Carmin, PhD, director of clinical psychology training at the Wexner Medical Center and a professor at Ohio State University in Columbus. When you do seek help, your doctor or therapist will ask about your symptoms and the situations in which they arise, and might also recommend additional medical testing to rule out other health concerns.
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]
With panic attacks, we might show them a diagram and explain the fight-or-flight response; their mind or body is trying to help them. If you’ve had a panic attack that came out of the blue, you might become afraid of lightheadedness and avoid activities that spur adrenaline. So we might hyperventilate for a minute in a controlled way to get to the point where they’re not afraid of their own bodily sensation. We work on internal avoidance of those cues that become scary, and desensitize them.
Had my first panic attack today and wanted to be sure about what I was experiencing. I sat there crying hysterically, hyperventilating, chest shaking, my hands went very numb. Took me about 10 minutes to get sort of calm, sat in the shower for about half an hour afterwards to fully calm myself down. Every time I tried to focus on my breathing and taking longer breaths I would start hyperventilating again. Felt like I was choking, awful awful experience.

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


Although phobias can be crippling, they're not obvious at all times. In fact, they may not surface until you confront a specific situation and discover you're incapable of overcoming your fear. "A person who's afraid of snakes can go for years without having a problem," Winston says. "But then suddenly their kid wants to go camping, and they realize they need treatment."
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 attacks usually peak within 10 minutes, and they rarely last more than 30 minutes. But during that short time, the terror can be so severe that you feel as if you’re about to die or totally lose control. The physical symptoms of anxiety attacks are themselves so frightening that many people believe they’re having a heart attack. After an anxiety attack is over, you may be worried about having another one, particularly in a public place where help isn’t available or you can’t easily escape.


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.
No matter what your plan is, having one in place is the most important thing. You can think of your plan as your go-to set of instructions for yourself when you feel a panic attack coming on. One plan might be to take yourself out of your current environment, sit down, and call a friend or family member that can help distract you from your symptoms and help you to calm down. Then you can incorporate the following techniques.
The person being treated will be closely monitored for the possibility of side effects that can range from minor to severe and can sometimes even be life-threatening. Because of the possible risks to the fetus of a mother being treated with medications for panic attacks, psychotherapy continues to be the treatment of first choice when treatment of this symptom is given during pregnancy.
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.
Seek medical follow-up. For those who are diagnosed with panic disorder, depression, or another form of anxiety disorder, the news is encouraging when treatment is received. These disorders are usually well controlled with medications. However, many people suffer the effects of these illnesses for years before coming to a doctor for evaluation. These conditions can be extremely disabling, so follow-up after the initial visit to the doctor is crucial so that diagnosis and treatment can continue.

Cognitive Behavioral Therapy (CBT) is considered to be the gold standard of treatment, especially for panic disorder. CBT focuses on educating clients about their disorders, identifying and changing maladaptive thoughts and fears, learning relaxation and other coping strategies, and helping clients face their fears. Research has shown that CBT for panic disorder is also effective when there are other comorbid disorders present as well and that the key component that makes CBT effective is the exposure ("facing your fears") module (Hofmann, 2011).
Anxiety is a normal reaction to danger, the body’s automatic fight-or-flight response that is triggered when you feel threatened, under pressure, or are facing a stressful situation. In moderation, anxiety isn’t necessarily a bad thing. It can help you to stay alert and focused, spur you to action, and motivate you to solve problems. But when anxiety is constant or overwhelming—when it interferes with your relationships and daily activities—you’ve likely crossed the line from normal anxiety into the territory of an anxiety disorder.
You can learn more about this in the Recovery Support area of our website. Our support area contains a wealth of self-help information on how to treat anxiety disorder, including anxiety attacks. Many find it to be their “one stop” destination for anxiety disorder help. You can click here for more information about our Recovery Support area membership options.
Anxiety disorders reflect disorders that share a general feature of excessive fear (i.e. emotional response to perceived or real threat) and/or anxiety (i.e. anticipation of future threat) and demonstrate behavioral and functional disturbances as a result. Panic attacks are a feature that can occur in the context of many anxiety disorders and reflect a type of fear response.
The disorder in younger children is less likely to have the symptoms that involve ways of thinking (cognitive symptoms). For example, panic attacks in children may result in the child's grades declining, decreased school attendance, and avoiding that and other separations from their parents. Both children and teens with panic disorder are further at risk for developing substance abuse and depression as well as suicidal thoughts, plans, and/or actions.
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.[53]
Other research suggests that social structures that contribute to inequality, such as lower wages, may play a part. In a study published in January 2016 in the journal Social Science and Medicine, Columbia epidemiologists reviewed data on wages and mood disorders, and noted that, at least in their data set, when a woman's pay rose higher than a man's, the odds of her having both generalized anxiety disorder and major depression decreased. (10)
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