While conducting research for this article, we encountered more than a dozen mental health professionals who mistakenly believed the terms “anxiety attack” and “panic attack” were synonymous. They were licensed professionals, but none of them had a specialty in anxiety. Because “anxiety attack” is not a clinical term, they assumed it was a synonym for “panic attack.” This caused them to use the terms interchangeably.


Many studies in the past used a candidate gene approach to test whether single genes were associated with anxiety. These investigations were based on hypotheses about how certain known genes influence neurotransmitters (such as serotonin and norepinephrine) and hormones (such as cortisol) that are implicated in anxiety. None of these findings are well replicated.[59][60][61], with the possible exception of TMEM132D, COMT and MAO-A.[63] The epigenetic signature of BDNF, a gene that codes for a protein called brain derived neurotrophic factor that is found in the brain, has also been associated with anxiety and specific patterns of neural activity.[62] and a receptor gene for BDNF called NTRK2 was associated with anxiety in a large genome-wide investigation.[64] The reason that most candidate gene findings have not replicated is that anxiety is a complex trait that is influenced by many genomic variants, each of which has a small effect on its own. Increasingly, studies of anxiety are using a hypothesis-free approach to look for parts of the genome that are implicated in anxiety using big enough samples to find associations with variants that have small effects. The largest explorations of the common genetic architecture of anxiety have been facilitated by the UK Biobank, the ANGST consortium and the CRC Fear, Anxiety and Anxiety Disorders.[64][65][66]
Exposure therapy for panic disorder with agoraphobia includes exposure to the situations you fear and avoid is also included in treatment. As in exposure therapy for specific phobias, you face the feared situation until the panic begins to go away. Through this experience, you learn that the situation isn’t harmful and that you have control over your emotions.

Cognitive-behavioral therapy, or CBT, teaches patients to see the links between the their thoughts, beliefs, and actions. By changing distorted thought patterns that maintain the anxiety and by exposing the person to anxiety-provoking symptoms or situations in a gradual manner, CBT can help create mastery over the anxiety and panic symptoms. Therapy may help those with panic disorder to
Anxiety is a normal reaction to danger, the body’s automatic fight-or-flight response that is triggered when you feel threatened, under pressure, or are facing a stressful situation. In moderation, anxiety isn’t necessarily a bad thing. It can help you to stay alert and focused, spur you to action, and motivate you to solve problems. But when anxiety is constant or overwhelming—when it interferes with your relationships and daily activities—you’ve likely crossed the line from normal anxiety into the territory of an anxiety disorder.
Cognitive distortions such as overgeneralizing, catastrophizing, mind reading, emotional reasoning, binocular trick, and mental filter can result in anxiety. For example, an overgeneralized belief that something bad "always" happens may lead someone to have excessive fears of even minimally risky situations and to avoid benign social situations due to anticipatory anxiety of embarrassment. In addition, those who have high anxiety can also create future stressful life events.[90] Together, these findings suggest that anxious thoughts can lead to anticipatory anxiety as well stressful events, which in turn cause more anxiety. Such unhealthy thoughts can be targets for successful treatment with cognitive therapy.
But some think that nature isn’t as much of an influence as nurture. People theorize that women tend to be socialized in a way that gives them permission to openly discuss emotion. So women may feel more comfortable admitting to feelings than men, who tend to be socialized to keep their feelings to themselves and are less likely to confess to emotional problems. Women may therefore get diagnosed with anxiety disorders more often than men. (9)
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. 

^ Nivard, M. G.; Dolan, C. V.; Kendler, K. S.; Kan, K.-J.; Willemsen, G.; van Beijsterveldt, C. E. M.; Lindauer, R. J. L.; van Beek, J. H. D. A.; Geels, L. M. (2014-09-04). "Stability in symptoms of anxiety and depression as a function of genotype and environment: a longitudinal twin study from ages 3 to 63 years". Psychological Medicine. 45 (05): 1039–1049. doi:10.1017/s003329171400213x. ISSN 0033-2917.
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.

Why stress happens and how to manage it Stress is essential for survival; the chemicals it triggers help the body prepare to face danger and cope with difficulty. Long-term stress is linked to various health conditions and can cause physical and psychological symptoms. How is it diagnosed, what types of stress are there, and how is it treated or managed? Read now
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
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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]


When taking medications, it is important for clients to be educated about potential side effects, the rationale for the type of medication prescribed, and other drugs or substances that may counteract or interact with the effects of the medications. Before stopping taking the prescribed drug, or if the medication does not seem to alleviate symptoms, the doctor should be consulted.

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.
Fear and anxiety are part of life. You may feel anxious before you take a test or walk down a dark street. This kind of anxiety is useful - it can make you more alert or careful. It usually ends soon after you are out of the situation that caused it. But for millions of people in the United States, the anxiety does not go away, and gets worse over time. They may have chest pains or nightmares. They may even be afraid to leave home. These people have anxiety disorders. Types include

Research demonstrates that the most effective treatments for anxiety are behavioral. Such treatments often involve gradually exposing sufferers to the situations they fear. Anxiety therapy may also focus on changing distorted thought patterns that underlie the condition. Drugs may help patients control their anxiety, but they are typically effective only during treatment and do not usually cure the condition. Increasingly, researchers are finding that mindfulness meditation can be a successful technique that helps lessen anxiety.


When taking medications, it is important for clients to be educated about potential side effects, the rationale for the type of medication prescribed, and other drugs or substances that may counteract or interact with the effects of the medications. Before stopping taking the prescribed drug, or if the medication does not seem to alleviate symptoms, the doctor should be consulted.
The following are trademarks of NAMI: NAMI, NAMI Basics, NAMI Connection, NAMI Ending the Silence, NAMI FaithNet, NAMI Family & Friends, NAMI Family Support Group, NAMI Family-to-Family, NAMI Grading the States, NAMI Hearts & Minds, NAMI Homefront, NAMI HelpLine, NAMI In Our Own Voice, NAMI On Campus, NAMI Parents & Teachers as Allies, NAMI Peer-to-Peer, NAMI Provider, NAMI Smarts, NAMIWalks and National Alliance on Mental Illness. All other programs and services are trademarks of their respective owners.
Since anxiety disorders are a group of related conditions rather than a single disorder, they can look very different from person to person. One individual may suffer from intense anxiety attacks that strike without warning, while another gets panicky at the thought of mingling at a party. Someone else may struggle with a disabling fear of driving, or uncontrollable, intrusive thoughts. Yet another may live in a constant state of tension, worrying about anything and everything. But despite their different forms, all anxiety disorders illicit an intense fear or anxiety out of proportion to the situation at hand.
Although we don’t yet completely understand what causes Panic Disorder, we do know that genes play a large role because it’s very common for the immediate family members of someone with Panic Disorder to also have Panic Disorder. Research also suggests that experiencing really stressful events (e.g., major loss or abuse) might play a role in the development of Panic Disorder. And in certain people, marijuana appears to trigger the start of Panic Disorder, suggesting that the family members of someone with Panic Disorder or other anxiety disorders should probably stay away from this (and other) drugs.

Cognitive behavioral therapy has been shown to help with treating panic disorder and agoraphobia. According to a study published in December 2013 in the journal Behaviour Research and Therapy, its effects lasted as long as two years after the initial treatment. And a study published in August 2017 in the Journal of Consulting and Clinical Psychology suggested that it may be superior to traditional psychotherapy in the treatment of this condition.
SSRIs and SNRIs are commonly used to treat depression, but they are also helpful for the symptoms of panic disorder. They may take several weeks to start working. These medications may also cause side-effects, such as headaches, nausea, or difficulty sleeping. These side effects are usually not severe for most people, especially if the dose starts off low and is increased slowly over time. Talk to your doctor about any side effects that you have.
^ 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.
Some research suggests that your body's natural fight-or-flight response to danger is involved in panic attacks. For example, if a grizzly bear came after you, your body would react instinctively. Your heart rate and breathing would speed up as your body prepared for a life-threatening situation. Many of the same reactions occur in a panic attack. But it's unknown why a panic attack occurs when there's no obvious danger present.
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