Everyone here has issues, but what happens when you’re blue as hell and CANNOT figure out the source of the problem? There is no quote, no book, no video, no saying or phrase, no motto, which is helping me right now. I feel like absolute total HELL. And I damned well know it’s not going to last, and that it’s probably a result of thinking too hard, too long, too deeply. Anyway, thank you all for sharing your pain with strangers. It shows that you’re way stronger than you think.
Antidepressants are widely used to treat anxiety disorders, such as generalized anxiety disorder, panic disorder, agoraphobia and social anxiety disorder. The most commonly prescribed medications are from the selective serotonin reuptake inhibitor (SSRI) class. They are generally effective and have few side-effects, although they do not provide immediate relief. More

Once the diagnosis of panic attack is made, however, the person may be surprised that no medicines are prescribed. Before medications are started, the person requires further evaluation by a mental-health professional to check for the presence of other mental-health disorders. These may include anxiety disorders, depression, or panic disorder (a different diagnosis than panic attack).


Prolonged exposure therapy is a specific type of CBT used to treat PTSD and phobias. The goal of this therapy is to help patients overcome the overwhelming disstress they experience when reminded of past traumas or in confronting their fears. With the guidance of a licensed therapist, the patient is carefully reintroduced to the trauma memories or reminders. During the exposure, the therapist guides the patient to use coping techniques such as mindfulness or relaxation therapy/imagery. The goal of this therapy is to help patients realize that trauma-related memories (or phobias) are no longer dangerous and do not need to be avoided. This type of treatment usually lasts 8-16 weekly sessions.
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.

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.


ACT is a type of CBT that encourages patients to again in positive behaviors even in the presence of negative thoughts and behaviors. The goal is to improve daily functioning despire having the disorder. It is particularly useful for treatment-resistant Generalized Anxiety Disorder and Depression. The length of treatment varies depending on the severity of symptoms.


Foster the development of a strong peer network. It's probably no surprise to hear that peer relationships become a major source of support during adolescence. Encourage your child to engage in interests (like arts, music, and sports) that will help them develop and maintain friendships. If your child already has a very busy and structured schedule, try to carve out some time for more relaxed socializing. However, note that sometimes peers can be the source of anxiety, whether through peer pressure or bullying. Check in with your child about the nature of their relationships with others in their social circle (school or class).
Anxiety cannot increase forever and you cannot experience peak levels of anxiety forever. Physiologically there is a point at which our anxiety cannot become any higher and our bodies will not maintain that peak level of anxiety indefinitely. At that point, there is nowhere for anxiety to go but down. It is uncomfortable to reach that peak but it is important to remember this anxiety will even out and then go down with time.

Obsessive-compulsive disorder (OCD) is characterized by unwanted thoughts or behaviors that seem impossible to stop or control. If you have OCD, you may be troubled by obsessions, such as a recurring worry that you forgot to turn off the oven or that you might hurt someone. You may also suffer from uncontrollable compulsions, such as washing your hands over and over.
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.
Often, a combination of psychotherapy and medications produces good results in the treatment of panic disorder. Improvement is usually noticed in about two to three months. Thus, appropriate treatment for panic disorder can prevent panic attacks or at least substantially reduce their severity and frequency, bringing significant relief to 70%-90% of people with the illness. More than 18% of people who are assessed but not treated for this condition tend to relapse in less than two years. As these statistics indicate, access to appropriate mental health care is key to a positive prognosis for people who suffer from panic attacks. Therefore, it is imperative to alleviate the well documented economic and racial disparities that exist in having and using access to care. Combating other social disparities, like educational, employment, housing, and criminal justice, is also seen as being important to improving the prognosis for recovering from panic attacks and other health problems.

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.
Many people use the terms anxiety attack and panic attack interchangeable, but in reality, they represent two different experiences. The DSM-5 uses the term panic attack to describe the hallmark features of panic disorder or panic attacks that occur as a result of another mental disorder. To be considered a panic attack, four or more of the symptoms outlined in the DSM-5 must be present.
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Shortness of breath is a common symptom of panic attacks that can make you feel frantic and out of control. Acknowledge that your shortness of breath is a symptom of a panic attack and that this is only temporary. Then begin by taking a deep breath in for a total of four seconds, hold for a second, and release it for a total of four seconds. Keep repeating this pattern until your breathing becomes controlled and steady. Focusing on the count of four not only will prevent you from hyperventilating, but it can also help to stop other symptoms in their tracks.
The cause of anxiety disorders is a combination of genetic and environmental factors.[47] Anxiety can stem itself from certain factors: genetics, medicinal side-effects, shortness of oxygen.[48] Risk factors include a history of child abuse, family history of mental disorders, and poverty. Anxiety disorders often occur with other mental disorders, particularly major depressive disorder, personality disorder, and substance use disorder.[49] To be diagnosed symptoms typically need to be present at least six months, be more than would be expected for the situation, and decrease functioning.[10][49] Other problems that may result in similar symptoms including hyperthyroidism, heart disease, caffeine, alcohol, or cannabis use, and withdrawal from certain drugs, among others.[49][7]

Panic attacks are often confusing for the sufferer. They are usually sudden and are accompanied by extremely intense physical sensations, leaving one to believe they may have a serious medical condition. Because the physical symptoms associated with a panic attack are similar to certain serious medical conditions, it is important to rule out any medical causes.
Since panic attacks are caused by overly apprehensive behavior or chronic stress, addressing our overly apprehensive behavior and stress can stop and prevent panic attacks, and eventually, panic disorder. The combination of good self-help information and therapy is the most effective way of addressing overly apprehensive behavior.[2] Accessing good self-help information and applying it is a good way to reduce stress.
Although how long a panic attack lasts can vary greatly, its duration is typically more than 10 minutes. A panic is one of the most distressing conditions that a person can endure, and its symptoms can closely mimic those of a heart attack. Typically, most people who have one panic attack will have others, and when someone has repeated attacks with no other apparent physical or emotional cause and it negatively changes their behavior due to the attacks or feels severe anxiety about having another attack, he or she is said to have panic disorder. A number of other emotional problems can have panic attacks as a symptom. Some of these illnesses include posttraumatic stress disorder (PTSD), obsessive-compulsive disorder, schizophrenia, and intoxication or withdrawal from alcohol and certain other drugs of abuse.

Although breathing into a paper bag was a common recommendation for short-term treatment of symptoms of an acute panic attack,[45] it has been criticized as inferior to measured breathing, potentially worsening the panic attack and possibly reducing needed blood oxygen.[46][47] While the paper bag technique increases needed carbon dioxide and so reduces symptoms, it may excessively lower oxygen levels in the blood stream.


As the result of years of research, there are a variety of treatments available to help people who suffer from panic attacks learn how to control the symptoms. This includes several effective medical treatments, and specific forms of psychotherapy. In terms of medications, specific members of the selective serotonin reuptake inhibitor (SSRI), the selective serotonin and norepinephrine reuptake inhibitors (SSNRI), and the benzodiazepine families of medications are approved by the U.S. Food and Drug Administration (FDA) for effective treatment of panic disorder. Examples of anti-anxiety medications include fluoxetine (Prozac), sertraline (Zoloft), paroxetine (Paxil), escitalopram (Lexapro), citalopram (Celexa), vortioxetine (Brintellix), and vilazodone (Viibryd) from the SSRI group, duloxetine (Cymbalta), venlafaxine (Effexor), desvenlafaxine (Pristiq), and levomilnacipran (Fetzima) from the SSNRI group, and clonazepam (Klonopin) and lorazepam (Ativan) from the benzodiazepine group. Although alprazolam (Xanax) is often used to treat panic attacks, its short duration of action can sometimes result in having to take it several times per day. Medications from the beta-blocker family (for example, propranolol [Inderal]) are sometimes used to treat the physical symptoms, like racing heart rate associated with a panic attack. Some individuals who suffer from severe panic attacks may benefit from treatment with gabapentin (Neurontin), which was initially found to treat seizures, or benefit from a neuroleptic medication like risperidone (Risperdal), olanzapine (Zyprexa), quetiapine (Seroquel), aripiprazole (Abilify), paliperidone (Invega), asenapine (Saphris), iloperidone (Fanapt), or lurasidone (Latuda).


Obsessive-compulsive and related disorders are characterized by obsessive, intrusive thoughts (e.g. constantly worrying about staying clean, or about one's body size) that trigger related, compulsive behaviors (e.g. repeated hand-washing, or excessive exercise). These behaviors are performed to alleviate the anxiety associated with the obsessive thoughts. These types of disorders can restrict participation in everyday life and/or generate significant distress, for instance, by making it difficult to leave the house without many repetitions of a compulsive behavior (e.g. checking that the doors are locked). Periodically experiencing worry or having a few "idiosyncratic" habits does not constitute an obsessive-compulsive or related disorder. Instead, these disorders are characterized by unusually high levels of worry and related compulsive behaviors, in comparison with a typical range of individuals.
If you have Panic Disorder, the chances are very high that you have altered your life in some significant way in an effort to prevent or avoid additional panic attacks. It is common, for instance, for people to limit their travel; to restrict their driving (maybe staying within a certain radius from home, or avoiding highways); to avoid large, crowded shopping malls; and in general, to attempt to avoid any activity from which "escape" may be difficult.
Anxiety disorders are associated with chronic life stress. Unpredictable, unrelenting, unresolvable stressors chronically stimulate the stress hormone system and cardiovascular system, and lead to states of constant increased activity. Biologically, the body has evolved to deal with imminent and concrete danger in the environment, rather than continuous stressors. Under normal conditions where chronic stress is low, exposure to a sudden threat activates the autonomic nervous system, i.e. increased levels of adrenaline and faster breathing, and racing heart rate. These reactions in turn trigger activation of stress hormones, such as cortisol. One of the effects of these stress hormones is to increase glucose levels in the bloodstream in order to respond to the imminent threat, so that muscles can be activated for the flight or fight response. Another effect of stress hormones is to supress the immune system, since processes such as healing and repair can wait until after the threat subsides. However, in someone with an anxiety disorder, where there is constant activation of these responses to everyday stressors, the stress hormone system loses its ability to control immune function, thus contributing to heightened systemic inflammation that increases risk for cardiovascular and even autoimmune disorders. Neuroscience and clinical research continues to investigate how anxiety disorders increase individual risk for developing physical health co-morbidities in hopes of identifying new treatments that may alleviate suffering from and prevent the development of these whole-body disorders.

Many patients first report symptoms to their primary care physician. Primary care physicians (PCPs) will administer a thorough physical exam to rule out hormonal imbalances, side effects of medications, and certain illnesses. If the symptoms are not due to other conditions, the physician may diagnose the patient with anxiety and therefore refer the patient to a psychologist or psychiatrist. Physicians practice in hospitals, clinics and private practices.
Without treatment, panic attacks tend to occur repeatedly for months or years. While they typically begin in young adulthood, the symptoms may arise earlier or later in life in some people. Complications, which are symptoms that can develop as a result of continued panic attacks and develop into other mental illnesses, may include specific irrational fears (phobias), especially of leaving home (agoraphobia) and avoidance of social situations. Other possible complications can include depression, work or school problems, suicidal thoughts or actions, financial problems, and alcohol or other substance abuse. For children and adolescents, panic disorder can even interfere with normal development. Panic disorder and other anxiety disorders also predispose sufferers to developing heart or gastrointestinal diseases, high blood pressure or diabetes, having more severe symptoms if they have a respiratory disease, and of dying prematurely.
People generally can overcome panic attacks faster if they seek help after the first one or two, says psychologist Cheryl Carmin, PhD, director of clinical psychology training at the Wexner Medical Center and a professor at Ohio State University in Columbus. When you do seek help, your doctor or therapist will ask about your symptoms and the situations in which they arise, and might also recommend additional medical testing to rule out other health concerns.
Prevention is more effective than treatment for panic attacks. Prevention involves stress management methods such as meditation and mindfulness to reduce your stress so that it doesn’t accumulate and eventually erupt into a panic attack. Prevention is not about stopping a panic attack just before it happens. The best you can do just before a panic attack is manage it.

Often, a combination of psychotherapy and medications produces good results in the treatment of panic disorder. Improvement is usually noticed in about two to three months. Thus, appropriate treatment for panic disorder can prevent panic attacks or at least substantially reduce their severity and frequency, bringing significant relief to 70%-90% of people with the illness. More than 18% of people who are assessed but not treated for this condition tend to relapse in less than two years. As these statistics indicate, access to appropriate mental health care is key to a positive prognosis for people who suffer from panic attacks. Therefore, it is imperative to alleviate the well documented economic and racial disparities that exist in having and using access to care. Combating other social disparities, like educational, employment, housing, and criminal justice, is also seen as being important to improving the prognosis for recovering from panic attacks and other health problems.
While obsessive-compulsive disorder is not officially classified by the American Psychological Association as an anxiety disorder, it shares many traits with common anxiety disorders, such as generalized anxiety disorder. In both conditions, you may know that your thoughts are irrational, but you feel unable to stop thinking them. Often, but not always, these thoughts may concern cleanliness, sex, or religion.

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.
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.
Simply put - agoraphobia means that you avoid a lot of ordinary activities and situations for fear of having panic attacks. To most people who get this diagnosis, the term sounds pretty scary, but that's all it means. It does not mean you are or will become house bound. That can happen to people, and is an extremely severe case of agoraphobia, but the great majority of people with agoraphobia do not experience it to that extent.
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.

So, if anxiety has so many negative effects, why is it relatively common? Many scientists who study anxiety disorders believe that many of the symptoms of anxiety (e.g., being easily startled, worrying about having enough resources) helped humans survive under harsh and dangerous conditions. For instance, being afraid of a snake and having a "fight or flight" response is most likely a good idea! It can keep you from being injured or even killed. When humans lived in hunter-gatherer societies and couldn't pick up their next meal at a grocery store or drive-through, it was useful to worry about where the next meal, or food for the winter, would come from. Similarly avoiding an area because you know there might be a bear would keep you alive —worry can serve to motivate behaviors that help you survive. But in modern society, these anxiety-related responses often occur in response to events or concerns that are not linked to survival. For example, seeing a bear in the zoo does not put you at any physical risk, and how well-liked you are at work does not impact your health or safety. In short, most experts believe that anxiety works by taking responses that are appropriate when there are real risks to your physical wellbeing (e.g., a predator or a gun), and then activating those responses when there is no imminent physical risk (e.g., when you are safe at home or work).
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