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.
Medications — most often antidepressants and anti-anxiety drugs — can also be used to help treat panic disorder. Your doctor may initially prescribe you an anti-anxiety drug, such as Xanax (alprazolam), and then add an antidepressant, such as Effexor XR (venlafaxine). After a month or sooner, your doctor may stop the Xanax and have you remain on the antidepressant.
If you’ve ever had a panic attack, you’ll know it can be both a terrifying experience and exhausting experience. Panic disorder is a diagnosis given to people who experience recurrent unexpected panic attacks—that is, the attack appears to occur from out of the blue. Panic attack symptoms include sweating, shaking, shortness of breath, feelings of choking, chest pain, and a fear of dying.
Great questions. Unfortunately, there is usually no clear cut answer – and like many mental health disorders – it is likely caused by a combination of genetic, behavioral, and developmental factors. Anatomically speaking, Generalized Anxiety Disorder is most closely related to a disruption in the functional connectivity of the amygdala – the “emotional control center” of the brain – and how it processes feelings of fear and anxiety. Genetics also play a role in Generalized Anxiety Disorder. If you have a family member that also suffers from this disorder, your chances of suffering from it are increased, especially in the presence of a life stressor. Interestingly, long-term substance abuse also increases your chances of Generalized Anxiety Disorder, as the use of benzodiazepines can worsen your anxiety levels, as can excessive alcohol use. Tobacco use and caffeine are also both associated with increased levels of anxiety.
More medications are available than ever before to effectively treat anxiety disorders. These include antidepressants (SSRIs, SNRIs, Tricyclic Antidepressants, MAOIs), tranquilizers (benzodiazepines, etc.) and in some cases, anticonvulsants. A person may have to try more than one medication before finding a drug or combination of drugs that works for them. Learn more about medications.
Post-Traumatic Stress Disorder affects people after terrifying events such as physical or sexual abuse, car accidents, war or natural disasters. Individuals with PTSD may experience depression, flashbacks, nightmares, sleep difficulties, irritability, aggression, violence, and a feeling of detachment or numbness. Symptoms can be triggered by anything that reminds the individual of their trauma.
Heredity, other biological factors, stressful life events, and thinking in a way that exaggerates relatively normal bodily reactions are all believed to play a role in the onset of panic disorder. Some research suggests panic attacks occur when a “suffocation alarm mechanism” in the brain is activated, falsely reporting that death is imminent. The exact cause or causes of panic disorder are unknown and are the subject of intense scientific investigation.
The psychotherapy component of treatment for panic disorder is at least as important as medication. In fact, research shows that psychotherapy alone or the combination of medication and psychotherapy treatment are more effective than medication alone in the long-term management of panic attacks. In overcoming anxiety, cognitive behavioral therapy is widely accepted as an effective form of psychotherapy treatment, for both adults and children. This form of psychotherapy seeks to help those with panic disorder identify and decrease the irrational thoughts and behaviors that reinforce panic symptoms and can be done either individually, in group therapy, in partner-assisted therapy, and even over the Internet. Behavioral techniques that are often used to decrease anxiety include relaxation techniques (like breathing techniques or guided imagery) and gradually increasing exposure to situations that may have previously triggered anxiety in the panic disorder sufferer. Helping the person with anxiety understand how to handle the emotional forces that may have contributed to developing symptoms (panic-focused psychodynamic psychotherapy) has also been found to be effective in teaching an individual with panic disorder how to prevent an anxiety attack or how to calm down in order to decrease or stop a panic attack once it starts.
Our experience has shown that the most effective treatment for anxiety attacks is the combination of good self-help information and Personal Coaching/Counseling/Therapy. Since the underlying factors that cause issues with anxiety are learned, generally a professional therapist is required to help uncover, identify, and successfully address them. Working with a professional therapist ensures that these underlying factors are effectively treated.
For more information, please visit Mental Health Medications Health Topic webpage. Please note that any information on this website regarding medications is provided for educational purposes only and may be outdated. Diagnosis and treatment decisions should be made in consultation with your doctor. Information about medications changes frequently. Please visit the U.S. Food and Drug Administration website for the latest information on warnings, patient medication guides, or newly approved medications.
While the use of drugs in treating panic attacks can be very successful, it is generally recommended that people also be in some form of therapy, such as cognitive behavioral therapy. Drug treatments are usually used throughout the duration of panic attack symptoms, and discontinued after the patient has been free of symptoms for at least six months. It is usually safest to withdraw from these drugs gradually while undergoing therapy. While drug treatment seems promising for children and adolescents, they are at an increased risk of suicide while taking these medications and their well-being should be monitored closely.
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).
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.
Not everyone who worries a lot has an anxiety disorder. You may be anxious because of an overly demanding schedule, lack of exercise or sleep, pressure at home or work, or even from too much caffeine. The bottom line is that if your lifestyle is unhealthy and stressful, you’re more likely to feel anxious—whether or not you actually have an anxiety disorder. These tips can help to lower anxiety and manage symptoms of an anxiety disorder:
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.
Not everyone understands is that someone with an anxiety disorder cannot "just let things go". This makes the struggle with an anxiety disorder even harder, and may prevent one from looking for help. However, it is very important to talk about these anxieties with someone and preferably find a health care professional as soon as you experience these symptoms. Anxiety should be considered as severe as a physical disease; however, most people in society do not appreciate the severity of this disorder. Some people may consider anxiety a fault or a weakness; however, it may help if people realize that many research studies have demonstrated biological explanations for (some of) the symptoms observed in anxiety disorders. Brain scans have demonstrated brain abnormalities in certain anxiety disorders, and also altered brain functioning has been demonstrated for individuals with anxiety disorders. Furthermore, there is some evidence that anxiety disorders might be linked to chemical imbalances in the brain.
These episodes are a serious health problem in the U.S. At least 20% of adult Americans, or about 60 million people, will suffer from panic at some point in their lives. About 1.7% of adult Americans, or about 3 million people, will have full-blown panic disorder at some time in their lives, women twice as often as men. The most common age at which people have their first panic attack (onset) is between 15 and 19 years of age. Panic attacks are significantly different from other types of anxiety, in that panic attacks are very sudden and often unexpected, appear to be unprovoked, and are often disabling.
Panic disorder sometimes runs in families, but no one knows for sure why some family members have it while others don’t. Researchers have found that several parts of the brain, as well as biological processes, play a key role in fear and anxiety. Some researchers think that people with panic disorder misinterpret harmless bodily sensations as threats. By learning more about how the brain and body functions in people with panic disorder, scientists may be able to create better treatments. Researchers are also looking for ways in which stress and environmental factors may play a role.
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.
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.
People with panic disorder often worry about when the next attack will happen and actively try to prevent future attacks by avoiding places, situations, or behaviors they associate with panic attacks. Worry about panic attacks, and the effort spent trying to avoid attacks, cause significant problems in various areas of the person’s life, including the development of agoraphobia (see below).