In contrast, the term anxiety attack is not a specifier outlined in the DSM-5. Rather, anxiety is used to describe a core feature of multiple different anxiety disorders. The culmination of symptoms that result from being in a state of anxiety—such as restlessness, shortness of breath, increased heart rate, and difficulty concentrating—may feel like an “attack,” but are generally less intense than those experienced at the height of a panic attack.
One of the scariest early experiences in panic disorder is having a panic attack and not knowing what is happening to your body. By learning more about panic attacks and panic disorder, you can start to label and identify the experience that you are having. Although the experience of panic attacks is very distressing, having a panic attack will not cause you to die or to completely lose control and they do not mean that you are going crazy. Sometimes, just knowing what is going on can help people to feel better. For example, the next time you have a panic attack, you can tell yourself "this is anxiety. I have felt this before and I was okay."
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.
Researchers have conducted both animal and human studies to pinpoint the particular parts of the brain that are involved in anxiety and fear. Because fear evolved to deal with danger, it sets off an immediate protective response without conscious thought. This fear response is believed to be coordinated by the amygdala, a structure deep inside the brain. Although relatively small, the amygdala is quite complex, and recent studies suggest that anxiety disorders may be associated with abnormal activity within it.
People with panic disorder have sudden and repeated attacks of fear that last for several minutes or longer. These are called panic attacks. Panic attacks are characterized by a fear of disaster or of losing control even when there is no real danger. A person may also have a strong physical reaction during a panic attack. It may feel like having a heart attack. Panic attacks can occur at any time, and many people with panic disorder worry about and dread the possibility of having another attack.
Everyone has probably experienced panic, or something like it, at least once in their lifetime: on a disturbingly turbulent plane, or before giving an important presentation, or after realizing you hit reply all when you really, really should not have. We all know the paralyzed feeling and the heightened physical sensations. But panic attacks and panic disorder take a different shape. Panic attacks have many physical symptoms and tend to peak around 10 minutes, and may last for 30. Panic disorder is diagnosed by the frequency of these attacks, and the presence of a fear of having them.
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.
Selective serotonin reuptake inhibitors, or SSRIs, work in the brain via a chemical messenger called serotonin. SSRIs commonly prescribed for panic disorder include Fluoxetine (Prozac), sertraline (Zoloft), escitalopram (Lexapro), paroxetine (Paxil), and citalopram (Celexa). SSRIs are also used to treat panic disorder when it occurs in combination with obsessive-compulsive disorder, social phobia, or depression. SSRI's tend to have fewer side effects than other antidepressants. Patients may initially experience nausea, drowsiness, diarrhea, or sexual side effects when they first take SSRIs, but over time, symptoms subside. An adjustment in dosage or a switch to another SSRI may also correct the problem. Clients should discuss all side effects or concerns with their doctor so that any needed changes in medication can be made.
Anxiety disorders differ from normal feelings of nervousness or anxiousness and involve excessive fear or anxiety. Anxiety disorders are the most common of mental disorders and affect more than 25 million Americans. But anxiety disorders are treatable and a number of effective treatments are available. Treatment helps most people lead normal productive lives.
It is not clear what causes panic disorder. In many people who have the biological vulnerability to panic attacks, they may develop in association with major life changes (such as getting married, having a child, starting a first job, etc.) and major lifestyle stressors. There is also some evidence that suggests that the tendency to develop panic disorder may run in families. People who suffer from panic disorder are also more likely than others to suffer from depression, attempt suicide, or to abuse alcohol or drugs.
It should be noted that finding the right strategy that works for you to control your anxiety is important. Maybe you feel that you do not have the time to schedule "me time" with your busy schedule or kids, and you need to find another way to reduce your anxiety. A friend or therapist could be a great resource to turn to if you believe you need help with finding the right strategies to reduce your anxiety.
Although your gut response might be to leave the stressful situation immediately, don’t. “Let your anxiety level come down,” advises Carmin. Then you can decide if you want to leave or if there's a way to get back to whatever you were doing when the anxiety attack started. Staying in the moment will help you overcome anxiety, but it’s hard to do this at first.
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.