Panic disorder is a separate but related diagnosis to panic attacks. People experiencing repeated panic attacks and who meet other diagnostic criteria may be diagnosed with this illness. Panic disorder is thought to have more of an inherited component than panic attacks that are not a part of panic disorder. Certain medical conditions, like asthma and heart disease, as well as certain medications, like steroids and some asthma medications, can cause anxiety attacks as a symptom or side effect. As individuals with panic disorder are at higher risk of having a heart-valve abnormality called mitral valve prolapse (MVP), that should be evaluated by a doctor since MVP may indicate that specific precautions be taken when the person is treated for a dental problem.

Anxiety attacks usually peak within 10 minutes, and they rarely last more than 30 minutes. But during that short time, the terror can be so severe that you feel as if you’re about to die or totally lose control. The physical symptoms of anxiety attacks are themselves so frightening that many people believe they’re having a heart attack. After an anxiety attack is over, you may be worried about having another one, particularly in a public place where help isn’t available or you can’t easily escape.
Most people experience feelings of anxiety before an important event such as a big exam, business presentation or first date. Anxiety disorders, however, are illnesses that cause people to feel frightened, distressed and uneasy for no apparent reason. Left untreated, these disorders can dramatically reduce productivity and significantly diminish an individual's quality of life.
Psychodynamic theory posits that anxiety is often the result of opposing unconscious wishes or fears that manifest via maladaptive defense mechanisms (such as suppression, repression, anticipation, regression, somatization, passive aggression, dissociation) that develop to adapt to problems with early objects (e.g., caregivers) and empathic failures in childhood. For example, persistent parental discouragement of anger may result in repression/suppression of angry feelings which manifests as gastrointestinal distress (somatization) when provoked by another while the anger remains unconscious and outside the individual's awareness. Such conflicts can be targets for successful treatment with psychodynamic therapy. While psychodynamic therapy tends to explore the underlying roots of anxiety, cognitive behavioral therapy has also been shown to be a successful treatment for anxiety by altering irrational thoughts and unwanted behaviors.
Panic attacks cause a variety of distressing symptoms that can be terrifying for the individual experiencing the attack. Some people mistake panic attacks for heart attacks and many believe that they are dying. Others feel a mixture of self-doubt or impending doom. Some can also find the episodes extremely embarrassing and refrain from telling their friends, family, or a mental health professional.

Antidepressants can take time to work, so it’s important to give the medication a chance before reaching a conclusion about its effectiveness. If you begin taking antidepressants, do not stop taking them without the help of a doctor. When you and your doctor have decided it is time to stop the medication, the doctor will help you slowly and safely decrease your dose. Stopping them abruptly can cause withdrawal symptoms.


People facing anxiety may withdraw from situations which have provoked anxiety in the past.[5] There are various types of anxiety. Existential anxiety can occur when a person faces angst, an existential crisis, or nihilistic feelings. People can also face mathematical anxiety, somatic anxiety, stage fright, or test anxiety. Social anxiety and stranger anxiety are caused when people are apprehensive around strangers or other people in general. Stress hormones released in an anxious state have an impact on bowel function and can manifest physical symptoms that may contribute to or exacerbate IBS. Anxiety is often experienced by those who have an OCD and is an acute presence in panic disorder. The first step in the management of a person with anxiety symptoms involves evaluating the possible presence of an underlying medical cause, whose recognition is essential in order to decide the correct treatment.[6][7] Anxiety symptoms may mask an organic disease, or appear associated with or as a result of a medical disorder.[6][7][8][9]

Seeing a friend or loved one suffering a panic attack can be frightening. Their breathing may become abnormally fast and shallow, they could become dizzy or light-headed, tremble, sweat, feel nauseous, or think they’re having a heart attack. No matter how irrational you think their panicked response to a situation is, it’s important to remember that the danger seems very real to your loved one. Simply telling them to calm down or minimizing their fear won’t help. But by helping your loved one ride out a panic attack, you can help them feel less fearful of any future attacks.


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]
Situationally predisposed panic attacks don’t always occur immediately upon exposure to a feared situation or cue, but the individual is more likely to experience an attack in such situations. For example, a person who has a fear of social situations but who does not experience a panic episode in every social situation, or who experiences a delayed attack after being in a social environment for an extended period of time.
Generalized anxiety disorder is a condition in which your worries overwhelm you to the point where your daily routine seems difficult to carry out, and you have been worrying this way for at least six months. You may feel on edge and have difficulty focusing on tasks. There may be a tendency to fear and expect the worst; some call this catastrophic thinking. You even may know that your worries are perhaps irrational, but you still go on feeling them. 
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.
Some people have only one or two attacks and are never bothered again. Panic attacks can occur with other psychiatric disorders. In panic disorders, however, the panic attacks return repeatedly and the person develops an intense fear of having another attack. Without help, this "fear of fear" can make people avoid certain situations and can interfere with their lives even when they are not having a panic attack. Therefore, it is very important to recognize the problem and get help.

Anxiety attacks usually peak within 10 minutes, and they rarely last more than 30 minutes. But during that short time, the terror can be so severe that you feel as if you’re about to die or totally lose control. The physical symptoms of anxiety attacks are themselves so frightening that many people believe they’re having a heart attack. After an anxiety attack is over, you may be worried about having another one, particularly in a public place where help isn’t available or you can’t easily escape.

i am disabled my husband is with me 24/7 so for the first time i had a attack this morning went to local jobcentre and normally we get seen on lower ground but for some reason it was changed to upstairs resulting in no wheelchair access so husband left me in waitingroom while he had his appointment….omg it started with sweaty hands then tingling my heartbeat was in my ears then came the fear and restlessness my head was swimming the sounds of everything was as if my head was under water and peoples faces were so close although not near me mouth kept watering.. the security man came to me asked if i was ok but i couldnt speak i was shaking and felt sick then came the most embarrising part my bladder released(i wear incontience pants thank god but small amount was leaked onto pants and wheelchair seat ) the security got my husband and we left to come home but omg i thought i was dying i havent had anything like that just normally its nervousness and dry mouth
Phobic avoidance – You begin to avoid certain situations or environments. This avoidance may be based on the belief that the situation you’re avoiding caused a previous panic attack. Or you may avoid places where escape would be difficult or help would be unavailable if you had a panic attack. Taken to its extreme, phobic avoidance becomes agoraphobia.
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.

It is not unusual to experience only one or two symptoms at a time, such as vibrations in their legs, shortness of breath, or an intense wave of heat traveling up their bodies, which is not similar to hot flashes due to estrogen shortage. Some symptoms, such as vibrations in the legs, are sufficiently different from any normal sensation that they clearly indicate panic disorder. Other symptoms on the list can occur in people who may or may not have panic disorder. Panic disorder does not require four or more symptoms to all be present at the same time. Causeless panic and racing heartbeat are sufficient to indicate a panic attack.[9]


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.
^ Leicht, Gregor; Mulert, Christoph; Eser, Daniela; Sämann, Philipp G.; Ertl, Matthias; Laenger, Anna; Karch, Susanne; Pogarell, Oliver; Meindl, Thomas; Czisch, Michael; Rupprecht, Rainer (2013). "Benzodiazepines Counteract Rostral Anterior Cingulate Cortex Activation Induced by Cholecystokinin-Tetrapeptide in Humans". Biological Psychiatry. 73 (4): 337–44. doi:10.1016/j.biopsych.2012.09.004. PMID 23059050.
A panic attack is an abrupt surge of intense fear or discomfort that reaches a peak within minutes, and during which time a variety of psychological and physical symptoms occur. These symptoms include rapid heart rate, sweating, shaking, shortness of breath, hot flashes, and lightheadedness—as well as a sense of impending doom, chills, nausea, abdominal pain, chest pain, headache, and numbness or tingling.
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.

One of the scariest early experiences in panic disorder is having a panic attack and not knowing what is happening to your body. By learning more about panic attacks and panic disorder, you can start to label and identify the experience that you are having. Although the experience of panic attacks is very distressing, having a panic attack will not cause you to die or to completely lose control and they do not mean that you are going crazy. Sometimes, just knowing what is going on can help people to feel better. For example, the next time you have a panic attack, you can tell yourself "this is anxiety. I have felt this before and I was okay."
Panic attacks and panic disorder are treatable once the underlying cause of is identified. “Usually medical conditions and other factors (substance use or withdrawal from substances) are ruled out before making the diagnosis,” says Flo Leighton, psychiatric nurse practitioner, and therapist with Union Square Practice in Manhattan. Getting to the root cause typically takes a couple of sessions, says Leighton. Here are some options that may be recommended to you :
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).
Anxiety disorders are characterized by a general feature of excessive fear (i.e. emotional response to perceived or real threat) and/or anxiety (i.e. worrying about a future threat) and can have negative behavioral and emotional consequences. 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. Trauma- and stressor- related anxiety disorders are related to the experience of a trauma (e.g., unexpected death of a loved one, a car accident, or a violent incident) or stressor (e.g., divorce, beginning college, moving).
Research is inconsistent as to whether nutritional deficiencies (for example, zinc or magnesium deficiency) may be risk factors for panic disorder. While food additives like aspartame, alone or in combination with food dyes, are suspected to play a role in the development of panic attacks in some people, it has not been confirmed by research so far.
The signs and symptoms of a panic attack develop abruptly and usually reach their peak within 10 minutes. They rarely last more than an hour, with most ending within 20 to 30 minutes. Panic attacks can happen anywhere and at any time. You may have one while you’re in a store shopping, walking down the street, driving in your car, or even sitting on the couch at home.
The cause of panic attacks is unknown but there are several theories, including a chemical imbalance in the brain or a genetic predisposition. They can be triggered by a variety of conditions and situations, including the presence of a mood disorder, such as anxiety or depression; extreme stress over a long period of time; a physical health problem such as a heart, respiratory, or thyroid condition; overuse of alcohol, nicotine, or caffeine; and the side effects of some medical and recreational drugs. Frequent panic attacks generally indicate a panic disorder. Panic attacks can also occur while an individual is sleeping, causing them to wake up suddenly with feelings of fear and dread. Adolescents and young adults who have panic attacks often have other mental health issues or are at significant risk of developing other issues, such as obsessive-compulsive disorder, anxiety, or other mood disorders, eating disorders, and problems with substance abuse.
Biological causes may include obsessive compulsive disorder, Postural Orthostatic Tachycardia Syndrome, post traumatic stress disorder, hypoglycemia, hyperthyroidism, Wilson's disease, mitral valve prolapse, pheochromocytoma, and inner ear disturbances (labyrinthitis). Dysregulation of the norepinephrine system in the locus ceruleus, an area of the brain stem, has been linked to panic attacks.[13]
Panic attacks involve sudden feelings of terror that strike without warning. These episodes can occur at any time, even during sleep. People experiencing a panic attack may believe they are having a heart attack or they are dying or going crazy. The fear and terror that a person experiences during a panic attack are not in proportion to the true situation and may be unrelated to what is happening around them. Most people with panic attacks experience several of the following symptoms:
If you can identify that after a long day of parenting you often feel exhausted and overcome with anxiety by all of the things you need to do, you can work to schedule in "me time" where you can make sure that you have time to relax, exercise or engage in an enjoyable activity that you know helps to reduce your anxiety. Taking care of yourself is important to be able to take care of others.
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.

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.
Social anxiety varies in degree and severity. For some people, it is characterized by experiencing discomfort or awkwardness during physical social contact (e.g. embracing, shaking hands, etc.), while in other cases it can lead to a fear of interacting with unfamiliar people altogether. Those suffering from this condition may restrict their lifestyles to accommodate the anxiety, minimizing social interaction whenever possible. Social anxiety also forms a core aspect of certain personality disorders, including avoidant personality disorder.[33]
Adoration Aesthetic emotions Affection Agitation Agony Amusement Anger Anguish Annoyance Anxiety Apathy Arousal Attraction Awe Boredom Calmness Compassion Contempt Contentment Defeat Depression Desire Disappointment Disgust Ecstasy Embarrassment Vicarious Empathy Enthrallment Enthusiasm Envy Euphoria Excitement Fear Flow (psychology) Frustration Gratitude Grief Guilt Happiness Hatred Hiraeth Homesickness Hope Horror Hostility Humiliation Hygge Hysteria Infatuation Insecurity Insult Interest Irritation Isolation Jealousy Joy Limerence Loneliness Longing Love Lust Melancholy Mono no aware Neglect Nostalgia Panic Passion Pity Pleasure Pride hubris Rage Regret Rejection Remorse Resentment Sadness Saudade Schadenfreude Sehnsucht Sentimentality Shame Shock Shyness Sorrow Spite Stress Suffering Surprise Sympathy Tenseness Wonder Worry
Anxiety can be caused by numerous factors, ranging from external stimuli, emotional abandonment, shame, to experiencing an extreme reaction when first exposed to something potentially anxiety-provoking. Research has not yet explained why some people will experience a panic attack or develop a phobia, while others growing up in the same family and shared experiences do not. It is likely that anxiety disorders, like all mental illness, is caused by a complex combination of factors not yet fully understood. These factors likely include childhood development, genetics, neurobiology, psychological factors, personality development, and social and environmental cues.

Some people have only one or two attacks and are never bothered again. Panic attacks can occur with other psychiatric disorders. In panic disorders, however, the panic attacks return repeatedly and the person develops an intense fear of having another attack. Without help, this "fear of fear" can make people avoid certain situations and can interfere with their lives even when they are not having a panic attack. Therefore, it is very important to recognize the problem and get help.
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In a decision context, unpredictability or uncertainty may trigger emotional responses in anxious individuals that systematically alter decision-making.[46] There are primarily two forms of this anxiety type. The first form refers to a choice in which there are multiple potential outcomes with known or calculable probabilities. The second form refers to the uncertainty and ambiguity related to a decision context in which there are multiple possible outcomes with unknown probabilities.[46]
Some people with anxiety disorders might benefit from joining a self-help or support group and sharing their problems and achievements with others. Internet chat rooms might also be useful, but any advice received over the internet should be used with caution, as Internet acquaintances have usually never seen each other and what has helped one person is not necessarily what is best for another. You should always check with your doctor before following any treatment advice found on the internet. Talking with a trusted friend or member of the clergy can also provide support, but it is not necessarily a sufficient alternative to care from a doctor or other health professional.
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