Secondly, the psychobiological conceptualization of panic disorder emphasizes the influence of psychological factors (Meuret, White, Ritz, Roth, Hofmann, & Brown, 2006). This psychological factor refers to a fear of bodily sensations, or a certain set of beliefs that lead individuals to be especially afraid of physical symptoms, such as believing that a racing heart could mean heart disease. Sometimes this is discussed as anxiety sensitivity or a belief that anxiety is harmful. Again, having the belief that physical symptoms are harmful may increase the likelihood of experiencing a panic attack, but it does not make having a panic attack inevitable. Instead, panic attacks can seem abnormal if they occur at the wrong time, when there is no real reason to be afraid. It is important to consider, however, that anxiety can also be adaptive or helpful in contexts where there is true threat.
Once someone has had a panic attack, he or she may develop irrational fears, called phobias, about the situations they are in during the attacks and begin to avoid them. That, in turn, may reach the point where the mere idea of doing things that preceded the first panic attack triggers terror or dread of future panic attacks, resulting in the individual with panic disorder being unable to drive or even step out of the house. If this occurs, the person is considered to have panic disorder with agoraphobia.
[2]DISCLAIMER: Because each body is somewhat chemically unique, and because each person will have a unique mix of symptoms and underlying factors, recovery results may vary. Variances can occur for many reasons, including due to the severity of the condition, the ability of the person to apply the recovery concepts, and the commitment to making behavioral change.
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.

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.
Panic disorder is characterized by unexpected and repeated episodes of intense fear accompanied by physical symptoms that may include chest pain, heart palpitations, shortness of breath, dizziness, or abdominal distress. These sensations often mimic symptoms of a heart attack or other life-threatening medical conditions. As a result, the diagnosis of panic disorder is frequently not made until extensive and costly medical procedures fail to provide a correct diagnosis or relief.

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]
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]
About 2-3% of Americans experience panic disorder in a given year and it is twice as common in women than in men. Panic disorder can interfere a lot with daily life, causing people to miss work, go to many doctor visits, and avoid situations where they fear they might experience a panic attack. The interference is greatest when people also have agoraphobia, as well as panic disorder.
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.
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.[1]
Anyone can learn how to stop and prevent anxiety attacks. It’s a matter of learning more about them and knowing how to control and prevent them. Most people struggle with problematic anxiety attacks because they don’t understand them, and therefore, fear them…which is a common catalyst into Panic Attack Disorder. The more you know, the better off you’ll be.

Agoraphobia is often comorbid with panic disorder — meaning people often suffer from both conditions at the same time. It's an intense fear of not being able to escape whatever place you're in, and can often lead to an avoidance of leaving the house. People with agoraphobia can fear situations where this anxiety might flare up, and typically don't feel comfortable or safe in public, crowded places. 
I think I also be having anxiety attacks! I’m 20yrs old and just lost my baby boy while pregnant at 8months! It’s very sad and depressing to think about it! I went to the doctor and was prescribed xanx! They work but sometimes it takes a while for the anxiety to go away/slow down! Hot/cold feeling! Fast heart beat! The feeling of going in and out! Can hardly breathe! I’m just trying to cope with it, being that I am so young!
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This may sound counter-intuitive but trying to accept one's emotional experience can be very helpful during panic attacks. Remind yourself that anxiety is like a wave, what goes up must come down. Fighting against the experience engages the "fear of fear" cycle that can make you feel even worse. If you notice panic symptoms creeping up, label your experience and you remind yourself, "I will be okay. This will pass in time." Accepting your experience, rather than fighting against it, will likely help your panic symptoms reduce more quickly and will feel easier along the way.

Anxiety disorders respond very well to therapy—and often in a relatively short amount of time. The specific treatment approach depends on the type of anxiety disorder and its severity. But in general, most anxiety disorders are treated with therapy, medication, or some combination of the two. Cognitive-behavioral therapy and exposure therapy are types of behavioral therapy, meaning they focus on behavior rather than on underlying psychological conflicts or issues from the past. They can help with issues such as panic attacks, generalized anxiety, and phobias.
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.
Family Therapy is a type of group therapy that includes the patient's family to help them improve communication and develop better skills for solving conflicts. This therapy is useful if the family is contributing to the patient's anxiety. During this short-term therapy, the patient's family learns how not to make the anxiety symptoms worse and to better understand the patient. The length of treatment varies depending on the severity of symptoms.
A panic attack is a response of the sympathetic nervous system (SNS). The most common symptoms include trembling, dyspnea (shortness of breath), heart palpitations, chest pain (or chest tightness), hot flashes, cold flashes, burning sensations (particularly in the facial or neck area), sweating, nausea, dizziness (or slight vertigo), light-headedness, hyperventilation, paresthesias (tingling sensations), sensations of choking or smothering, difficulty moving, and derealization. These physical symptoms are interpreted with alarm in people prone to panic attacks. This results in increased anxiety and forms a positive feedback loop.[10]
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.
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.
Generalized anxiety disorder involves persistent and excessive worry that interferes with daily activities. This ongoing worry and tension may be accompanied by physical symptoms, such as restlessness, feeling on edge or easily fatigued, difficulty concentrating, muscle tension or problems sleeping. Often the worries focus on everyday things such as job responsibilities, family health or minor matters such as chores, car repairs, or appointments.

Funnily enough that was my first reaction to calm myself down. I was in my room when it happened, and when I was in control enough I crouched down and just stared at a part of my carpet. I wasn’t paying attention to anything in particular, I was just “seeing”. And you just let the image of what you’re looking at fill your mind, just observe the shapes, colors, you look around that image without moving your eyes. It rly worked for me. But I’m still not sure if what I had was a panic attack, bc I’ve never had one before. I didn’t have too much fear because I knew what started the emotions and that I wasn’t in danger, they were just extremely exaggerated and sudden. I mostly had a rapid heart beat, shortness of breath, feeling a loss of coutrol and need to cry/shout, but no shaking,dizziness or chest pain. Also it just lasted 4-5 mins so I don’t know?


The avoidance, anticipation of, or distress of the phobic object/situation must cause significant distress or interferes with the individual's daily life, occupational, academic, or social functioning to meet diagnosis. The symptoms cannot be better accounted for by another mental disorder or be caused by substances, medications, or medical illness.
I’m not sure if this counts as a panic attack, but lately I’ve experienced instances where my head feels like it’s being squeezed, I feel really dizzy, and I get an intense fear of becoming schizophrenic because In that moment it feels like I’m going crazy. It’s happening right now and I’m kind of freaking out because the feeling won’t stop. I’m worried that it’ll never go away and I’ll be like this forever. Hopefully this is just a panic attack?
The buildup phase of a panic attack is the most important phase, because it is when you can prevent it. If you are under chronic stress, you become worn down and have no reserve left. Anything can push you over the edge. But if you regularly reduce your stress through a combination of cognitive behavioral therapy and mind-body relaxation, you will have enough reserve left to handle life’s surprises.
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.
Those who experience anxiety attack disorder are not alone. It’s estimated that 19 percent of the North American adult population (ages 18 to 54) experiences an anxiety disorder, and 3 percent of the North American adult population experiences anxiety attack disorder. We believe that number is much higher, since many conditions go undiagnosed and unreported.
How do you know if you're having a panic or anxiety attack? Panic attacks and anxiety attacks share some symptoms, but they differ in intensity, duration, and whether or not there is a trigger. Some treatments are similar and include therapy, stress management, and breathing exercises. Learn more about the differences between a panic attack and an anxiety attack here. Read now
Characterized by a suite of symptoms that persist for at least three days and up to one month after a traumatic experience (same diagnostic criteria for "trauma" as listed above). The specific symptoms of the disorder vary across individuals, but a common feature is intense anxiety in response to re-experiencing symptoms (e.g., recurrent intrusive recollections of traumatic event) of the trauma.
Over time, many who suffer panic attacks develop an on-going fear of having another attack. This fear can severely hamper daily activities and overall quality of life. Some people refuse to leave their houses or to put themselves in situations that remind them of their previous attacks. Agoraphobia (a fear of being outside of known and safe surroundings) or other mental problems may follow.

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.

Panic attacks are sudden periods of intense fear that may include palpitations, sweating, shaking, shortness of breath, numbness, or a feeling that something bad is going to happen.[1][2] The maximum degree of symptoms occurs within minutes.[2] Typically they last for about 30 minutes but the duration can vary from seconds to hours.[3] There may be a fear of losing control or chest pain.[2] Panic attacks themselves are not typically dangerous physically.[6][7]
To the extent that a person is fearful of social encounters with unfamiliar others, some people may experience anxiety particularly during interactions with outgroup members, or people who share different group memberships (i.e., by race, ethnicity, class, gender, etc.). Depending on the nature of the antecedent relations, cognitions, and situational factors, intergroup contact may be stressful and lead to feelings of anxiety. This apprehension or fear of contact with outgroup members is often called interracial or intergroup anxiety.[34]

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.
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.
Anxiety attacks symptoms and heart attack symptoms can seem similar because their signs and symptoms can be similar. But most medical professionals can quickly tell the difference as heart attacks have distinct symptoms that aren’t anxiety-like. If you are unsure of which is an anxiety attack symptom and which is a heart attack symptom, seek immediate medical advice. If the doctor diagnoses your symptoms as anxiety attack symptoms, you can feel confident the doctor’s diagnosis is correct. Therefore, there is no need to worry about a heart attack.
When people are confronted with unpleasant and potentially harmful stimuli such as foul odors or tastes, PET-scans show increased bloodflow in the amygdala.[87][88] In these studies, the participants also reported moderate anxiety. This might indicate that anxiety is a protective mechanism designed to prevent the organism from engaging in potentially harmful behaviors.
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.
Mindfulness involves spending time focusing on the present moment and using a nonjudgmental stance (things are not good or bad, they just are). This may sound straightforward but it can be tricky as our mind often wanders. Try to spend some time each day focusing on a single activity for 10 minutes. For example, focus on the experience of breathing: noticing the physical sensations that you have, the sound of your breath, the feeling of your chest rising and falling as you breathe, the feeling of air entering and leaving your lungs, etc. Try your best to keep your mind focused on these sensations. If you notice your mind wandering, gently redirect it back to the exercise. Engaging in these exercises on a regular basis can help you to feel emotionally centered. Check out websites, apps, and books for more information on mindfulness and guided mindfulness exercises.
^ Anxiety: management of anxiety (panic disorder, with or without agoraphobia, and generalised anxiety disorder) in adults in primary, secondary and community care. National Institute for Health and Clinical Excellence. Clinical Guideline 22. Issue date: April 2007 "Archived copy" (PDF). Archived from the original (PDF) on 24 August 2009. Retrieved 2009-07-21. ISBN 1-84629-400-2
A phobia is an unrealistic or exaggerated fear of a specific object, activity, or situation that in reality presents little to no danger. Common phobias include fear of animals (such as snakes and spiders), fear of flying, and fear of heights. In the case of a severe phobia, you might go to extreme lengths to avoid the thing you fear. Unfortunately, avoidance only strengthens the phobia.
[3]DISCLAIMER: Because each body is somewhat chemically unique, and because each person will have a unique mix of symptoms and underlying factors, recovery results may vary. Variances can occur for many reasons, including due to the severity of the condition, the ability of the person to apply the recovery concepts, and the commitment to making behavioral change.
Some medical conditions, like thyroid abnormalities and anemia, as well as certain medications, can produce severe anxiety. Examples of such medications include stimulants like methylphenidate (Ritalin) or amphetamine salts (Adderall), diabetes medications like metformin (Glucophage) and insulin, antimalarial medications like quinine, as well as corticosteroid withdrawal, such as withdrawal from dexamethasone (Decadron). As individuals with panic disorder seem to be at higher risk of having a heart valve abnormality called mitral valve prolapse (MVP), this possibility should be investigated by a doctor since MVP may dictate the need for special precautions when the individual is being treated for any dental problem. While the development of panic attacks has been attributed to the use of food additives like aspartame, alone or in combination with food dyes, more research is needed to better understand the role such substances may have on this disorder.
Anxiety disorders respond very well to therapy—and often in a relatively short amount of time. The specific treatment approach depends on the type of anxiety disorder and its severity. But in general, most anxiety disorders are treated with therapy, medication, or some combination of the two. Cognitive-behavioral therapy and exposure therapy are types of behavioral therapy, meaning they focus on behavior rather than on underlying psychological conflicts or issues from the past. They can help with issues such as panic attacks, generalized anxiety, and phobias.
Generalized Anxiety Disorder is one of the most common anxiety disorders and affects approximately 3.1% of the American adult population. With 6.8 million reported cases among American adults aged 18 and older, the average age of onset is 31 years old. While it can occur at any point of life, the most common points of onset occur between childhood and middle age. If you are a woman, you are twice as likely to suffer from Generalized Anxiety Disorder than men.
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.
“Panic disorder is diagnosed if the individual has recurrent panic attacks (minimum four in a four-week period), and at least one of the attacks is accompanied by one or more physical symptoms, including persistent concern about having another attack, worry about the implication or consequences of the attack (i.e., having a heart attack), and/or a significant change in behaviour due to the attacks, such as quitting a job.7 In addition, the panic attacks cannot be due to the physiological effects of a substance or another general medical condition.”[1]
It is important to note that genetic factors can also bestow resilience to anxiety disorders, and the field continues to pursue large-scale genomics studies to identify novel genetic factors that are associated with anxiety disorders in hopes of better understanding biological pathways that: 1) contribute to the development and maintenance of anxiety; and 2) may lead to better treatment for these disorders. Most people are not aware of what specific genetic markers they may have that confer risk for anxiety disorders, so a straightforward way to approximate genetic risk is if an individual has a history of anxiety disorders in their family. While both nature and nurture can be at play with family history, if several people have anxiety disorders it is likely that a genetic vulnerability to anxiety exists in that family.
Although the exact causes of panic attacks and panic disorder are unclear, the tendency to have panic attacks runs in families. There also appears to be a connection with major life transitions such as graduating from college and entering the workplace, getting married, or having a baby. Severe stress, such as the death of a loved one, divorce, or job loss can also trigger panic attacks.
Although beta-blockers are most often used to treat high blood pressure, they can also be used to help relieve the physical symptoms of anxiety, such as rapid heartbeat, shaking, trembling, and blushing. These medications, when taken for a short period of time, can help people keep physical symptoms under control. They can also be used “as needed” to reduce acute anxiety, including as a preventive intervention for some predictable forms of performance anxieties.
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