Your health care provider can determine if your panic disorder is caused by an underlying medical condition, such as heart disease or thyroid problems. This may require blood tests and an electrocardiogram (ECG). A complete assessment should also include questions about your caffeine and alcohol consumption, and any substance use, which can contribute to an anxiety disorder.

Anxiety is a normal reaction to stress and can be beneficial in some situations. It can alert us to dangers and help us prepare and pay attention. 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 nearly 30 percent of adults at some point in their lives. . But anxiety disorders are treatable and a number of effective treatments are available. Treatment helps most people lead normal productive lives.
A person with separation anxiety disorder is excessively fearful or anxious about separation from those with whom he or she is attached. The feeling is beyond what is appropriate for the person’s age, persists (at least four weeks in children and six months in adults) and causes problems functioning. A person with separation anxiety disorder may be persistently worried about losing the person closest to him or her, may be reluctant or refuse to go out or sleep away from home or without that person, or may experience nightmares about separation. Physical symptoms of distress often develop in childhood, but symptoms can carry though adulthood.
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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).
Although each anxiety disorder has unique characteristics, most respond well to two types of treatment: psychotherapy, or “talk therapy,” and medications. These treatments can be given alone or in combination. Cognitive behavior therapy (CBT), a type of talk therapy, can help a person learn a different way of thinking, reacting and behaving to help feel less anxious. Medications will not cure anxiety disorders, but can give significant relief from symptoms. The most commonly used medications are anti-anxiety medications (generally prescribed only for a short period of time) and antidepressants. Beta-blockers, used for heart conditions, are sometimes used to control physical symptoms of anxiety.
A variety of medical and mental health professionals are qualified to assess and treat panic disorders. From purely medical professionals like primary care doctors, emergency room physicians to practitioners with mental health training like psychiatrists, psychologists, and social workers, a variety of health care providers may be involved in the care of panic disorder sufferers. Some practitioners will administer a self-test of screening questions to people whom they suspect may be suffering from panic disorder. In addition to looking for symptoms of repeated panic attacks using what is described in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), asking detailed questions about the sufferer's history and conducting a mental-status examination, mental health professionals will explore the possibility that the individual's symptoms are caused by another emotional illness instead of or in addition to the diagnosis of panic disorder. For example, people with an addiction often experience panic attacks, but those symptom characteristics generally only occur when the person is either intoxicated or withdrawing from the substance. Someone who has post-traumatic stress disorder (PTSD) may have panic attacks when reminded of trauma they experienced and in a person with obsessive-compulsive disorder, panic attacks may be triggered by their being unable to perform a compulsive behavior. The practitioner will also likely ensure that a physical examination and any other appropriate medical tests have been done recently to explore whether there is any medical problem that could be contributing to the occurrence of panic attacks. That is particularly important since many medical conditions may have panic attacks as a symptom and therefore require that the underlying medical condition be treated in order to alleviate the associated anxiety. Examples of that include the need for treatment with antibiotics for infections like Lyme disease or vitamin supplements to address certain forms of anemia.
What is depression and what can I do about it? Depression is a mood disorder characterized by low mood, a feeling of sadness, and a general loss of interest in things. Depression is not a short-term problem and can last for months. There are many types of depression, and it is essential to see a doctor or mental health therapist for correct diagnosis and treatment. Read now
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]
People with panic disorder may also experience comorbid bipolar disorder, alcohol or substance use disorder, or medical problems that accompany their panic. It is common for individuals with panic disorder to have thyroid problems, respiratory issues, heart problems, or feelings of dizziness (APA, 2013). In general, it has been reported that 93.7% of people with panic disorder meet criteria for at least one other medical or mental disorder (Arch, Kirk, & Craske, 2017). That being said, comorbidity is not inevitable with panic disorder and it is important to discuss your symptoms thoroughly with a medical professional. Additionally, the causality of the link between panic disorders and medical problems remains unclear.

Moreover, this hypocapnia and release of adrenaline during a panic attack cause vasoconstriction resulting in slightly less blood flow to the head which causes dizziness and lightheadedness.[28][29] A panic attack can cause blood sugar to be drawn away from the brain and toward the major muscles. Neuroimaging suggests heightened activity in the amygdala, thalamus, hypothalamus, and brainstem regions including the periaqueductal gray, parabrachial nucleus, and Locus coeruleus.[30] In particular, the amygdala has been suggested to have a critical role.[31] The combination of high arousal in the amygdala and brainstem along with decreased blood flow and blood sugar in the brain can lead to dramatically decreased activity in the prefrontal cortex region of the brain.[32] There is evidence that having an anxiety disorder increases the risk of cardiovascular disease (CVD).[33] Those affected also have a reduction in heart rate variability.[33]
“I thought I would be smart, take care of myself, and not go out as much,” Sideman says. He managed to find ways to build his business without leaving his home office. After he had a panic attack on a freeway, he decided to avoid driving on the freeway — a tough stand to take in Los Angeles. He kept withdrawing from activities to try to avoid panic attacks, but that never solved the problem, he says, and after two and a half years, he realized the attacks were getting worse.
The emotional effects of anxiety may include "feelings of apprehension or dread, trouble concentrating, feeling tense or jumpy, anticipating the worst, irritability, restlessness, watching (and waiting) for signs (and occurrences) of danger, and, feeling like your mind's gone blank"[20] as well as "nightmares/bad dreams, obsessions about sensations, déjà vu, a trapped-in-your-mind feeling, and feeling like everything is scary."[21]
Antidepressants called selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs) are commonly used as first-line treatments for anxiety. Less-commonly used — but effective — treatments for anxiety disorders are older classes of antidepressants, such as tricyclic antidepressants and monoamine oxidase inhibitors (MAOIs).
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