If you believe you are suffering from Generalized Anxiety Disorder, your doctor will perform a variety of physical exams as well as mental health checks. You might first go to your doctor complaining of constant headaches and trouble sleeping. After he or she rules out any underlying medical conditions that are causing your physical symptoms, s/he may refer you to a mental health specialist for further diagnosis. Your mental health specialist will ask you a series of psychological questions to get a better understanding of your condition. To be clinically diagnosed with Generalized Anxiety Disorder, your doctor and/or mental health provider will assess the length of time you have been suffering from excessive worry and anxiety, your difficulty in controlling your anxiety, how your anxiety interferes with your daily life, and if you are experiencing fatigue, restlessness, irritability, muscle tension, sleep problems, and difficulty concentrating.
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).
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.
Because involuntary panic attacks can be caused by other medical conditions, such as mitral valve prolapse, thyroid problems, hyperglycemia, side effects from certain types of medications, recreational drug use (such as marijuana), stimulants, etc., it’s best to discuss your panic attacks and symptoms with your doctor to rule out any medical cause.

There remains a chance of panic symptoms becoming triggered or being made worse due to increased respiration rate that occurs during aerobic exercise. This increased respiration rate can lead to hyperventilation and hyperventilation syndrome, which mimics symptoms of a heart attack, thus inducing a panic attack.[42] Benefits of incorporating an exercise regimen have shown best results when paced accordingly.[43]
Because there are many medical conditions that can cause anxiety attack signs and symptoms, such as the strong sensations and feelings associated with anxiety attacks, it’s wise to discuss them with your doctor. If your doctor has attributed your anxiety attacks to stress and anxiety, you can feel confident that your doctor’s diagnosis is correct. Anxiety attacks and their signs and symptoms are relatively easy to diagnose and aren’t easily confused with other medical conditions.
Although individual participants may benefit from being part of a clinical trial, participants should be aware that the primary purpose of a clinical trial is to gain new scientific knowledge so that others may be better helped in the future. Decisions about whether to apply for a clinical trial and which ones are best suited for a given individual are best made in collaboration with a licensed health professional.

Another important prevention strategy for anxiety is to incorporate exercise into your daily activities. Exercise has been shown to decrease stress hormones that influence anxiety and also improve overall mood. Exercise can also help you disengage from worry and stress and focus on the current task of exercising. Exercises such as light jogging or brisk walking that can be incorporated into your daily activities can help reduce the impact of anxiety when it occurs.
Your brain focuses on some alleged thread, for instance, a very scary thought that was floating somewhere at your subconscious.  Your thalamus – the part of the brain responsible for regulating consciousness, sleep and alertness – transfers that information to your amygdala – the part of the brain responsible for emotional reactions, decision-making and memory – which marks it as “danger” and sends a signal to your sympathetic nervous system, activating the fight-or-flight response.
Yes, anxiety attacks and their signs and symptoms can feel awful, intense, and threatening. But they aren’t harmful. They pass when the anxiety attack subsides. Getting the right information, help, and support is the best way to treat anxiety attacks and their signs and symptoms. We provide more detailed information in the Recovery Support area of our website.
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.
It is 3:00 in the morning. I wake up from a dead sleep, sit straight up, and immediately know something is wrong. I am sweating, nauseous, and feel as if someone has dumped a bucket of ice water onto my chest. I feel it spill down my abdomen and through my arms and legs. My chest feels as though a giant’s hand is squeezing it with the intention of taking my life.
Guided imagery is another relaxation strategy that can help reduce or prevent overwhelming anxiety. Guided imagery involves directed mental visualization to evoke relaxation. This could involve imagining your favorite beach or a peaceful garden that can distract you from your anxious state and allow your mind and body to focus on the positive thoughts and sensations of the imagery exercise.
Poverty and low education level tend to be associated with anxiety, but it is unclear if those factors cause or are caused by anxiety. While some statistics suggest that disadvantaged ethnic minorities tend to suffer from internalizing disorders like panic disorder less often than the majority population in the United States, other research shows that may be the result of differences in how ethnic groups interpret and discuss signs and symptoms of intense fright, like panic attacks. Also, panic and other anxiety disorders are thought to persist more for some ethnic minorities in the United States. Difficulties the examiner may have in appropriately recognizing and understanding ethnic differences in symptom expression is also thought to play a role in ethnic differences in the reported frequency of panic and other internalizing disorders.
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.

Once the panic attack is over and the person has returned to a calm state, encourage them to seek help from a mental health professional at their earliest convenience, if they haven’t already. You can help them further by assisting with the search for a licensed professional, researching coping techniques online, and looking for self-help books that might be useful.


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).


For example, once you notice you are scaring yourself with anxious thinking, you can change your thinking to calming thoughts, which will stop stress responses and their physiological, psychological, and emotional effects. As you calm yourself down, your body will follow by stopping the flow of stress hormones. As stress hormones are used up or expelled, the sensations, symptoms, and feelings of panic will subside…in time.

Your brain focuses on some alleged thread, for instance, a very scary thought that was floating somewhere at your subconscious.  Your thalamus – the part of the brain responsible for regulating consciousness, sleep and alertness – transfers that information to your amygdala – the part of the brain responsible for emotional reactions, decision-making and memory – which marks it as “danger” and sends a signal to your sympathetic nervous system, activating the fight-or-flight response.
Benzodiazepines are sedatives indicated for anxiety, epilepsy, alcohol withdrawal and muscle spasms. Benzodiazepines demonstrate short-term effectiveness in the treatment of Generalized Anxiety Disorder and can help with sleep disturbances. A doctor may prescribe these drugs for a limited period of time to relieve acute symptoms of anxiety. However, long-term use of these medications is discouraged because they have a strong sedative effect and can be habit forming. In addition, taking benzodiazepines while also engaging in psychotherapy such as PE can reduce the effectiveness of the exposuere therapy,. Some well-known brand names are Librium, Xanax, Valium, and Ativan.
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.
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.
During the day if she was out, the attack felt “like my head suddenly weighed a thousand pounds and my chest would get really heavy. It literally felt like something was pulling me down. I would usually have to head home immediately.  I would then experience foggy vision where it …actually looked like there was fog in the air. I also experienced double vision and parts of my body—like my neck or one arm or one entire side of my face– would go totally numb.”
Women are more than two times as likely as men to be diagnosed with an anxiety disorder. (6) It’s not clear why this is the case, but researchers have theorized that it may be due to a combination of social and biological factors. Scientists are still investigating the complex role that sex plays in brain chemistry, but some research suggests that in women, the amygdala, which is the part of the brain responsible for processing potential threats, may be more sensitive to negative stimuli and may hold on to the memory of it longer. (7) 

The symptoms of a panic attack may cause the person to feel that their body is failing. The symptoms can be understood as follows. First, there is frequently the sudden onset of fear with little provoking stimulus. This leads to a release of adrenaline (epinephrine) which brings about the fight-or-flight response when the body prepares for strenuous physical activity. This leads to an increased heart rate (tachycardia), rapid breathing (hyperventilation) which may be perceived as shortness of breath (dyspnea), and sweating. Because strenuous activity rarely ensues, the hyperventilation leads to a drop in carbon dioxide levels in the lungs and then in the blood. This leads to shifts in blood pH (respiratory alkalosis or hypocapnia), causing compensatory metabolic acidosis activating chemosensing mechanisms which translate this pH shift into autonomic and respiratory responses.[25][26] The person him/herself may overlook the hyperventilation, having become preoccupied with the associated somatic symptoms.[27]
These attacks are a symptom of panic disorder, a type of anxiety disorder that affects some 2.4 million U.S. adults. The disorder most often begins during the late teens and early adulthood and strikes twice as many American women as men. No one knows what causes panic disorder, though researchers suspect a combination of biological and environmental factors, including family history (panic disorder seems to run in families), stressful life events, drug and alcohol abuse, and thinking patterns that exaggerate normal physical reactions.

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]
I don’t know what to do any more I’ve had enough I’m suffering from severe anxiety it all started 10 years ago in Spain I was getting ready to go out one evening when I experienced tingling around my eyes thought nothing of it ten minutes later all my muscles contorted I fell in a heap the doctor came and seen me telling me I hyperventilated since then it’s like it’s messed my circuit board up I’ve had to finish work I cry everyday can’t cope with the attacks I’m crying out for help cant seem to get any I’m so depressed help
i am disabled my husband is with me 24/7 so for the first time i had a attack this morning went to local jobcentre and normally we get seen on lower ground but for some reason it was changed to upstairs resulting in no wheelchair access so husband left me in waitingroom while he had his appointment….omg it started with sweaty hands then tingling my heartbeat was in my ears then came the fear and restlessness my head was swimming the sounds of everything was as if my head was under water and peoples faces were so close although not near me mouth kept watering.. the security man came to me asked if i was ok but i couldnt speak i was shaking and felt sick then came the most embarrising part my bladder released(i wear incontience pants thank god but small amount was leaked onto pants and wheelchair seat ) the security got my husband and we left to come home but omg i thought i was dying i havent had anything like that just normally its nervousness and dry mouth
Benzodiazepines are often used to provide short-term relief of panic symptoms. Clonazepam (Klonopin) and lorazepam (Ativan) are examples of this group of medications. Although another benzodiazepine, alprazolam (Xanax), is often used to treat panic attacks, the short period of time that it works can cause the panic sufferer to have to take it multiple times each day. Benzodiazepines tend to be effective in decreasing panic attacks by up to 70%-75% almost immediately; however, this class of medications has a strong addiction potential and should be used with caution. Additional drawbacks include sedation, memory loss, and after several weeks, tolerance to their effects and withdrawal symptoms may occur.
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.
One of the most important things you can do is to listen to your family member or friend talk about the things in his/her life that are sources of stress. A first instinct might be to offer advice or ideas for a "quick fix". However, simply accepting your friend's stress levels can help them deal with their anxiety, knowing that they can rely on you as a source of support even when their symptoms might be tough to watch. Studies show that social support from family and friends can be one of the strongest protective factors against debilitating levels of anxiety.
Most people have experienced fleeting symptoms associated with anxiety disorders at some point in their life. Such feelings — such as having a shortness of breath, feeling your heart pounding for no apparent reason, experiencing dizziness or tunnel vision — usually pass as quickly as they come and don’t readily return. But when they do return time and time again, that can be a sign that the fleeting feelings of anxiety have turned into an anxiety disorder.
Anxiety is typified by exaggerated worries and expectations of negative outcomes in unknown situations, and such concerns are often accompanied by physical symptoms. These include muscle tension, headaches, stomach cramps, and frequent urination. Behavioral therapies, with or without medication to control symptoms, have proved highly effective against anxiety, especially in children.

Medication can be used to temporarily control or reduce some of the symptoms of panic disorder. However, it doesn’t treat or resolve the problem. Medication can be useful in severe cases, but it should not be the only treatment pursued. Medication is most effective when combined with other treatments, such as therapy and lifestyle changes, that address the underlying causes of panic disorder.
Be smart about caffeine, alcohol, and nicotine. If you struggle with anxiety, you may want to consider reducing your caffeine intake, or cutting it out completely. Similarly alcohol can also make anxiety worse. And while it may seem like cigarettes are calming, nicotine is actually a powerful stimulant that leads to higher, not lower, levels of anxiety. For help kicking the habit, see How to Quit Smoking.
Although many people breathe into a paper bag in an attempt to alleviate the hyperventilation that can be associated with panic, the benefit received may be the result of the individual thinking it will help (a placebo effect). Unfortunately, breathing into a paper bag while having trouble breathing can worsen symptoms when the hyperventilation is caused by a condition associated with oxygen deprivation, like an asthma attack or a heart attack.
Anxiety can be experienced with long, drawn out daily symptoms that reduce quality of life, known as chronic (or generalized) anxiety, or it can be experienced in short spurts with sporadic, stressful panic attacks, known as acute anxiety.[18] Symptoms of anxiety can range in number, intensity, and frequency, depending on the person. While almost everyone has experienced anxiety at some point in their lives, most do not develop long-term problems with anxiety.
There are also things that people with panic disorder can do to learn how to handle it and to make treatment more effective. Since substances like drinking alcohol or caffeinated beverages, or using illicit drugs can worsen panic attacks, those things should be avoided. Other tips to prevent or manage panic attacks include engaging in aerobic exercise and stress-management techniques like deep breathing, massage therapy, and yoga, since these self-help activities have also been found to help decrease the frequency and severity of panic attacks. Although many people use home remedies like breathing into a paper bag when afflicted by the hyperventilation that can be associated with panic, the benefit received may be the result of the individual believing it will remedy the symptoms (placebo effect). Also, breathing into a paper bag when one is already having trouble breathing can make matters worse when the hyperventilation is the result of conditions of oxygen deprivation, like an asthma attack or a heart attack.
Paula had her first panic attack six months ago. She was in her office preparing for an important work presentation when, suddenly, she felt an intense wave of fear. Then the room started spinning and she felt like she was going to throw up. Her whole body was shaking, she couldn’t catch her breath, and her heart was pounding out of her chest. She gripped her desk until the episode passed, but it left her deeply shaken.
A first panic attack is usually unexpected, and comes "out of the blue." It may scare you so much that you start taking steps to protect yourself from future attacks. Maybe you start avoiding places that remind you of your first attack. Maybe you only go out after making sure you have your cell phone, a bottle of water, and other objects you hope will keep you safe. Maybe you try hard to "stop thinking about it." You work hard to keep the panic at bay.

The mutism must also include impairment in social, academic, or occupational achievement or functioning to qualify as a diagnosis. Selective mutism is not present if it is related to lack of knowledge or comfort with the spoken language required of the situation or is due to embarrassment from a communication or developmental disorder. The symptoms cannot be better accounted for by another mental disorder or be caused by substances, medications, or medical illness.
For me it’s knowing or believing I don’t have enough time to finish an assignment, and then I feel like a failure. Right now, I’m doing the most difficult assignment of my life, and if I don’t finish it on time, my graduation will be delayed. This is on top of all my other responsibilities. And to think that I’m supposed to have an accommodation for extra time. Ha! The university and the state don’t care. They just want me to fail so I have to dish out more money to line the pockets of the corporation that assigned this required project.

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.
In addition to the emotional turmoil and the physical manifestations that Caroline and Kirstie describe panic attacks can cause palpitations, pounding heart or accelerated heart rate; sweating; trembling or shaking; sensations of shortness of breath or smothering; feelings of choking; chest pain or discomfort; nausea or abdominal distress; feeling dizzy, unsteady, light-headed or faint; chills or overheating; numbness or tingling; feelings of unreality (derealization) or being detached from oneself (depersonalization); fear of losing control or “going crazy”; and fear of dying.
The electrocardiograph in a person with panic attacks often shows tachycardia, but does not usually show any of the changes typically seen in people with heart attacks or angina. However, if significant risk factors for cardiovascular disease are present, a noninvasive evaluation to rule out coronary artery disease (CAD) may sometimes be a good idea.
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.
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