Contextual factors that are thought to contribute to anxiety include gender socialization and learning experiences. In particular, learning mastery (the degree to which people perceive their lives to be under their own control) and instrumentality, which includes such traits as self-confidence, independence, and competitiveness fully mediate the relation between gender and anxiety. That is, though gender differences in anxiety exist, with higher levels of anxiety in women compared to men, gender socialization and learning mastery explain these gender differences.[95][medical citation needed] Research has demonstrated the ways in which facial prominence in photographic images differs between men and women. More specifically, in official online photographs of politicians around the world, women's faces are less prominent than men's. The difference in these images actually tended to be greater in cultures with greater institutional gender equality.[96]
Panic attacks are common among all anxiety disorders but what sets panic disorder apart is that panic attacks are unexpected and occur "out of the blue" without an obvious trigger (American Psychiatric Association, 2013; Craske & Barlow, 2007). These unexpected panic attacks must be associated with a significant change in behavior or be followed by at least one month of persistent worry about having another attack or about what will happen if you have another panic attack.
Although your gut response might be to leave the stressful situation immediately, don’t. “Let your anxiety level come down,” advises Carmin. Then you can decide if you want to leave or if there's a way to get back to whatever you were doing when the anxiety attack started. Staying in the moment will help you overcome anxiety, but it’s hard to do this at first.
Everyone has probably experienced panic, or something like it, at least once in their lifetime: on a disturbingly turbulent plane, or before giving an important presentation, or after realizing you hit reply all when you really, really should not have. We all know the paralyzed feeling and the heightened physical sensations. But panic attacks and panic disorder take a different shape. Panic attacks have many physical symptoms and tend to peak around 10 minutes, and may last for 30. Panic disorder is diagnosed by the frequency of these attacks, and the presence of a fear of having them. 
Expected panic attacks are those which occur when you are exposed to one of your triggers. For example, if you have a fear of flying you may have a panic attack when you board a plane. Expected panic attacks are again broken down into two categories: situationally bound (cued) in which a person is anticipating exposure to a particular trigger (as with our flying example), or situationally predisposed, in which a panic attack does not always occur when exposed to the feared situation.

So I can tell you that panic attacks aren't dangerous, but I recognize that this is "easy for me to say". If you're having anxiety attacks, especially if they're a relatively new occurrence for you, you might not be able to believe this right now. That's entirely understandable when you feel that your life is threatened! You don't need to take anything here on faith. Instead, check it all out. Test everything I say against your own experience, as you work your way through this site.

Panic disorder can be effectively treated with a variety of interventions, including psychological therapies and medication[9] with the strongest and most consistent evidence indicating that cognitive behavioral therapy has the most complete and longest duration of effect, followed by specific selective serotonin reuptake inhibitors.[37] Subsequent research by Barbara Milrod and her colleagues[38] suggests that psychoanalytic psychotherapy might be effective in relieving panic attacks, however, those results alone should be addressed with care. While the results obtained in joint treatments that include cognitive behavioral therapy and selective serotonin reuptake inhibitors are corroborated by many studies and meta-analysis, those obtained by Barbara Milrod are not. Scientific reliability of psychoanalytic psychotherapy for treating panic disorder has not yet been addressed. Specifically, the mechanisms by which psychoanalysis reduces panic are not understood; whereas cognitive-behavioral therapy has a clear conceptual basis that can be applied to panic. The term anxiolytic has become nearly synonymous with the benzodiazepines because these compounds have been, for almost 40 years, the drugs of choice for stress-related anxiety.
Sometimes panic can occur “out of the blue”, when you’re not in any danger. These panic episodes are called panic attacks. Because you’re not in any danger, these panic attacks aren’t useful; and in fact, they can cause significant problems. If someone experiences many panic attacks, he or she often begins to worry about having another panic attack and the anticipation causes him or her to feel even more anxiety. Sometimes this worry becomes so strong that he or she will avoid going to places where a panic attack might happen. For some people, this may severely limit where they feel comfortable going (such as: school, the mall, driving on the highway, etc.), resulting in another mental disorder called Agoraphobia.
To activate your parasympathetic nervous system, use this simple meditation technique: focus your gaze on an imaginary point in front of you; relax your focus and use your peripheral vision, as if you are trying to take in everything around you with soft focus. It signals to your brain to relax. The more you practice this technique – the faster it will help you to relax in any situation.

Panic disorder can be effectively treated with a variety of interventions, including psychological therapies and medication[9] with the strongest and most consistent evidence indicating that cognitive behavioral therapy has the most complete and longest duration of effect, followed by specific selective serotonin reuptake inhibitors.[37] Subsequent research by Barbara Milrod and her colleagues[38] suggests that psychoanalytic psychotherapy might be effective in relieving panic attacks, however, those results alone should be addressed with care. While the results obtained in joint treatments that include cognitive behavioral therapy and selective serotonin reuptake inhibitors are corroborated by many studies and meta-analysis, those obtained by Barbara Milrod are not. Scientific reliability of psychoanalytic psychotherapy for treating panic disorder has not yet been addressed. Specifically, the mechanisms by which psychoanalysis reduces panic are not understood; whereas cognitive-behavioral therapy has a clear conceptual basis that can be applied to panic. The term anxiolytic has become nearly synonymous with the benzodiazepines because these compounds have been, for almost 40 years, the drugs of choice for stress-related anxiety.
"This tends to make the individual vulnerable to developing an anxiety disorder, rather than cause them to directly inherit one," she says. Environmental factors, she adds, interact with genetic predispositions to trigger the onset of anxiety disorders. A study published in August 2017 in the journal Emotion may offer clues as to how both genes and environment combine to make anxiety take root. (4)
At some point in our lives, most of us will experience a panic attack in response to an actual danger or acute stress. But when panic attacks occur or recur for no reason and in the absence of danger or extreme stress, or when the fear of experiencing another attack is so strong that you change your behavior by avoiding certain places or people, you may have panic disorder.
Kirstie Craine Ruiz, 46, has lived with anxiety, panic attacks, and panic disorder for about ten years. For a long time, she had full-blown attacks 2-3 nights a week. “I would usually awake to a racing heart or the feeling of my heart expanding in my chest…like it might explode… From there, I would begin to panic and my heart would go even faster….and my body would shake so hard that it felt like I was having a convulsion.  I could barely breathe and was usually pretty sure I was having a heart attack and that I was going to die. Sometimes I’d go the ER and they’d hold me overnight because my heart would be going so fast and they couldn’t get it to go down.”

Cognitive behavioral therapy (CBT), is based on the idea that our thoughts cause our feelings and behaviors, not external things, like people, situations, and events. According to the National Association of Cognitive Behavioral Therapists the benefit of this therapy is that we can change the way we think to feel and act better even if the situation does not change. CBT focuses on determining the thought and behavior patterns responsible for sustaining or causing the panic attacks. CBT is a time-limited process (treatment goals—and the number of sessions expected to achieve them—are established at the start) that employs a variety of cognitive and behavioral techniques to affect change.
So I can tell you that panic attacks aren't dangerous, but I recognize that this is "easy for me to say". If you're having anxiety attacks, especially if they're a relatively new occurrence for you, you might not be able to believe this right now. That's entirely understandable when you feel that your life is threatened! You don't need to take anything here on faith. Instead, check it all out. Test everything I say against your own experience, as you work your way through this site.
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. 

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]
An evolutionary psychology explanation is that increased anxiety serves the purpose of increased vigilance regarding potential threats in the environment as well as increased tendency to take proactive actions regarding such possible threats. This may cause false positive reactions but an individual suffering from anxiety may also avoid real threats. This may explain why anxious people are less likely to die due to accidents.[91]
Anxiety disorders often first appear in childhood. This is a very good time to intervene or seek treatment, because children's brains are still developing, and can more easily adapt to new "modes" of thinking, relative to adult brains. Helping your child cope with an anxiety disorder can be a complex task, potentially involving family members, friends, teachers and counselors, and mental health professionals. These five basic tips may also help:

People with generalized anxiety disorder (GAD) display excessive anxiety or worry, most days for at least 6 months, about a number of things such as personal health, work, social interactions, and everyday routine life circumstances. The fear and anxiety can cause significant problems in areas of their life, such as social interactions, school, and work.
As is true for other mood and anxiety disorders, the use of Selective Serotonin Reuptake Inhibitors (SSRI's; e.g.., Paxil, Prozac, Zoloft), Benzodiazepines (e.g., Xanax, Lorazepam), and Selective Norepinephrine Reuptake Inhibitors (SNRI's; e.g., Cymbalta, Effexor, Pristiq) are common medical treatments for panic disorder. Additionally, D-cycloserine is a medication that is now being explored as a way to enhance effects of CBT (e.g., Hofmann et al., 2013). These medications may have side effects and taking them can lead to tolerance, withdrawal symptoms, and dependence, so it is important that you consult with a physician before starting or stopping these medications. There is evidence that taking one of these medications in addition to receiving behavioral therapy (e.g., CBT) can significantly benefit patients with panic disorder, although seeking psychotherapy in itself is largely effective (Arch et al., 2017).
Be smart about caffeine, alcohol, and nicotine. If you struggle with anxiety, you may want to consider reducing your caffeine intake, or cutting it out completely. Similarly alcohol can also make anxiety worse. And while it may seem like cigarettes are calming, nicotine is actually a powerful stimulant that leads to higher, not lower, levels of anxiety. For help kicking the habit, see How to Quit Smoking.
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.
Panic disorder sometimes runs in families, but no one knows for sure why some family members have it while others don’t. Researchers have found that several parts of the brain, as well as biological processes, play a key role in fear and anxiety. Some researchers think that people with panic disorder misinterpret harmless bodily sensations as threats. By learning more about how the brain and body functions in people with panic disorder, scientists may be able to create better treatments. Researchers are also looking for ways in which stress and environmental factors may play a role.

At some point in our lives, most of us will experience a panic attack in response to an actual danger or acute stress. But when panic attacks occur or recur for no reason and in the absence of danger or extreme stress, or when the fear of experiencing another attack is so strong that you change your behavior by avoiding certain places or people, you may have panic disorder.

My grandparents, who I lived with my entire life, just passed away. One in june and the other in september. My girlfriend wants to spend the night with her sister and the thought of it scares me. I fear that I am pushing her away, thus for sending me into a state of anger at myself followed by a heavy cold sadness, panic and fear. Then I start to get a small headache, clammy feeling overcomea my body, I start feeling naucious and then the next thing I know, my girlfriend is waking me up trying to pick me up off the floor. Is this a simple anxiety attack that will go away?
People with generalized anxiety disorder (GAD) display excessive anxiety or worry, most days for at least 6 months, about a number of things such as personal health, work, social interactions, and everyday routine life circumstances. The fear and anxiety can cause significant problems in areas of their life, such as social interactions, school, and work.

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.


People with panic attacks often report a fear of dying or heart attack, flashing vision, faintness or nausea, numbness throughout the body, heavy breathing and hyperventilation, or loss of body control. Some people also suffer from tunnel vision, mostly due to blood flow leaving the head to more critical parts of the body in defense. These feelings may provoke a strong urge to escape or flee the place where the attack began (a consequence of the "fight-or-flight response", in which the hormone causing this response is released in significant amounts). This response floods the body with hormones, particularly epinephrine (adrenaline), which aid it in defending against harm.[9]
For example, a person with obsessive-compulsive disorder may experience a panic attack when their schedule or compulsions are interrupted. Individuals who struggle with specific phobias are also susceptible to panic attacks. A person with an extreme fear of heights (acrophobia) may experience a panic attack in a penthouse apartment. And for someone with generalized anxiety disorder (GAD), a condition characterized by extreme fear or worry, the unending anxiety can escalate to a panic attack. People with post-traumatic stress disorder (PTSD) have a higher incidence of panic disorder than the general population.  Illness or traumatic events increase the chances of panic attacks.
I don’t know what to do any more I’ve had enough I’m suffering from severe anxiety it all started 10 years ago in Spain I was getting ready to go out one evening when I experienced tingling around my eyes thought nothing of it ten minutes later all my muscles contorted I fell in a heap the doctor came and seen me telling me I hyperventilated since then it’s like it’s messed my circuit board up I’ve had to finish work I cry everyday can’t cope with the attacks I’m crying out for help cant seem to get any I’m so depressed help
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.
If you’ve ever experienced a sudden surge of overwhelming anxiety and fear then you’re familiar with the feeling of having a panic attack. Your heart pounds, you can’t breathe, and you may even feel like you’re dying or going crazy. Left untreated, panic attacks can lead to panic disorder and other problems. They may even cause you to withdraw from normal activities. But panic attacks can be cured and the sooner you seek help, the better. With the right treatment and self-help, you can reduce or eliminate the symptoms of panic, regain your confidence, and take back control of your life
^ 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

While a single panic attack may only last a few minutes, the effects of the experience can leave a lasting imprint. If you have panic disorder, the recurrent panic attacks take an emotional toll. The memory of the intense fear and terror that you felt during the attacks can negatively impact your self-confidence and cause serious disruption to your everyday life. Eventually, this leads to the following panic disorder symptoms:

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 attack disorder generally starts with one unexplained attack that can include a number of intense anxiety attack symptoms, which causes the individual to become concerned. As other attacks occur, fear of having anxiety attacks, what they mean, what the associated symptoms mean, and where the attacks and symptoms may lead, increases. This escalation of fear is often the catalyst that brings on the attacks, causing the individual to be seemingly caught in a cycle of fear then panic, then more fear, then more panic, and so on.
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