Generalized Anxiety Disorder (GAD) is characterized by chronic and exaggerated worry and tension, much more than the typical anxiety that most people experience in their daily lives. People may have trembling, twitching, muscle tension, nausea, irritability, poor concentration, depression, fatigue, headaches, light-headedness, breathlessness or hot flashes.
Desperate for help, he reached out to the Anxiety and Depression Association of America, which sent him a list of therapists experienced in treating panic attacks and anxiety. “This is how I got better," Sideman says. "I found a therapist who understood what panic disorder was, understood agoraphobia, and knew cognitive behavioral therapy, which I had not known about.” He also started practicing meditation.
Shortness of breath and chest pain are the predominant symptoms. People experiencing a panic attack may incorrectly attribute them to a heart attack and thus seek treatment in an emergency room. Because chest pain and shortness of breath are hallmark symptoms of cardiovascular illnesses, including unstable angina and myocardial infarction (heart attack), a diagnosis of exclusion (ruling out other conditions) must be performed before diagnosing a panic attack. It is especially important to do this for people whose mental health and heart health statuses are unknown. This can be done using an electrocardiogram and mental health assessments.

Had my first panic attack today and wanted to be sure about what I was experiencing. I sat there crying hysterically, hyperventilating, chest shaking, my hands went very numb. Took me about 10 minutes to get sort of calm, sat in the shower for about half an hour afterwards to fully calm myself down. Every time I tried to focus on my breathing and taking longer breaths I would start hyperventilating again. Felt like I was choking, awful awful experience.
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.
Many of us may know what it feels like to be nervous before a party, or when meeting new people or making an important phone call. Those with social anxiety disorder have very intense versions of those fears — intense fears of being judged by others that cause them to avoid those kinds of situations. For most people, fears of social situations usually subside once the intimidating event has been faced. But in social anxiety disorder, these feelings are persistent and usually last for at least six months. 
It's important to note that everyone feels anxiety to some degree regularly throughout their life - fear and anxiety are adaptive and helpful emotions that can function to help us notice danger or threat, keep us safe, and help us adapt to the environment. Anxiety disorders represent states when fear or anxiety becomes severe or extreme, to the extent that it causes an individual significant distress, or impairs their ability to function in important facets of life such as work, school, or relationships. It is also important that risk factors don't at all imply that anxiety is anyone's fault; anxiety disorders are a very common difficulty that people experience. In this section, we will review risk factors for anxiety disorders. There are many potential risk factors for anxiety disorders, and most people likely experience multiple different combinations of risk factors, such as neurobiological factors, genetic markers, environmental factors, and life experiences. However, we do not yet fully understand what causes some people to have anxiety disorders.
Warren: So if you’re walking down a dark alley, you are probably thinking that there could be potential danger; that anxiety of anticipation, the feeling in your stomach, the elevated heart rate. But if you’re walking down that alley and somebody jumps out with a knife, then you’re likely to have a panic attack — an overwhelming urge to escape a situation that is dangerous.
In Europe about 3% of the population has a panic attack in a given year while in the United States they affect about 11%.[2] They are more common in females than males.[2] They often begin during puberty or early adulthood.[2] Children and older people are less commonly affected.[2] A meta-analysis was conducted on data collected about twin studies and family studies on the link between genes and panic disorder. The researchers also examined the possibility of a link to phobias, obsessive-compulsive disorder (OCD), and generalized anxiety disorder. The researchers used a database called MEDLINE to accumulate their data.[61] The results concluded that the aforementioned disorders have a genetic component and are inherited or passed down through genes. For the non-phobias, the likelihood of inheriting is 30%-40% and for the phobias, it was 50%-60%.[61]
“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]
Anxiety can be either a short-term 'state' or a long-term personality "trait". Trait anxiety reflects a stable tendency across the lifespan of responding with acute, state anxiety in the anticipation of threatening situations (whether they are actually deemed threatening or not).[40] A meta-analysis showed that a high level of neuroticism is a risk factor for development of anxiety symptoms and disorders.[41] Such anxiety may be conscious or unconscious.[42]
A key component to the prevention of anxiety is awareness. Learning to recognize your anxious thinking patterns when they arise can help you manage and reduce them quickly. Awareness of anxiety begins with trying to identify the cause and/or trigger of anxiety and gaining an understanding of how it affects your mood and behaviors. Is it that your boss recently gave you negative feedback at work and you are worried each day that you are not doing well enough for their standards? Is it that you waited until the last minute to study for a test and are feeling anxious that you will not perform well? Awareness of the source of your anxiety is the first step to finding out the best way to relieve it.

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]
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.

At least 6 million Americans suffer from panic attacks and panic disorder both conditions classified as anxiety disorders. According to the Anxiety and Depression Association of America (ADAA), about 2-3% of Americans experience panic disorder in a given year and it is twice as common in women as in men. Panic disorder typically affects individuals when they’re in their 20s but is also seen in young children, adolescents, and older adults.


So how do you know if your anxiety is “normal” or “excessive?” It’s normal to be worried about an upcoming test or wondering how you are going to cope financially when you unexpectedly find out you need major repairs done to your house. If you are suffering from the type of excessive worry that accompanies Generalized Anxiety Disorder, you may see a report on the local news about a new health scare in a different country and stay awake at night worrying about you or your family being affected, even though risks are minimal at best. You will likely spend the next few days and weeks in a constant state of worry about the well-being of your family and experience anxiety that is debilitating, intrusive, excessive, and persistent.
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]
Genetics and family history (e.g., parental anxiety) may predispose an individual for an increased risk of an anxiety disorder, but generally external stimuli will trigger its onset or exacerbation.[57] Genetic differences account for about 43% of variance in panic disorder and 28% in generalized anxiety disorder.[58] Although single genes are neither necessary nor sufficient for anxiety by themselves, several gene polymorphisms have been found to correlate with anxiety: PLXNA2, SERT, CRH, COMT and BDNF.[59][60][61] Several of these genes influence neurotransmitters (such as serotonin and norepinephrine) and hormones (such as cortisol) which are implicated in anxiety. The epigenetic signature of at least one of these genes BDNF has also been associated with anxiety and specific patterns of neural activity.[62]
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.
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