Anxiety and Panic

Medically Reviewed by Dr. K on 12 April 2021

Panic attacks are brief periods of extreme fear or doom that last up to ten minutes and are associated with at least four of the following symptoms. Including :

  • Sudden overwhelming fear
  • Palpitations
  • Sweating
  • Trembling
  • Shortness of breath
  • Sense of choking
  • Chest pain
  • Nausea
  • Dizziness
  • A feeling of being detached from the world (derealization)
  • Fear of dying
  • Numbness or tingling in the limbs or entire body
  • Chills or hot flushes

Panic attacks are not the same as panic disorder. Recurrent panic attacks are associated with recurring fears of potential attacks and, in many cases, avoiding circumstances that could cause or remind someone of previous attacks. Panic disorder is not the only cause of panic attacks; other causes can also set off a panic attack. They may include the following :

  • Mitral valve prolapse
  • Hypoglycemia
  • Hyperthyroidism
  • Heart attacks
  • Social phobia
  • Agoraphobia (fear of not being able to escape, such as flying in an airplane or being in crowds)
  • Post-traumatic stress disorder (PTSD)
Generalized anxiety disorder

Excessive and unrealistic worry for at least six months is a symptom of generalized anxiety disorder. It’s linked to at least three of the following signs and symptoms :

  • Restlessness
  • Fatigue
  • Difficulty concentrating
  • Irritability or explosive anger
  • Muscle tension
  • Sleep disturbances
  • Personality changes, such as becoming less social
Phobic disorders

Phobias are serious, recurring, and repeated fears of specific objects or circumstances (such as snakes, spiders, or blood) (such as heights, speaking in front of a group, public places). These exposures have the potential to trigger a panic attack. Phobia disorders include social phobia and agoraphobia.

Post-traumatic stress disorder

In earlier versions of the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders, post-traumatic stress disorder (PTSD) was classified as an anxiety disorder. However, in 2013, PTSD was reclassified as a separate disorder. It refers to a wide variety of emotional responses triggered by death or near-death situations (such as fires, floods, earthquakes, shootings, assault, car accidents, or wars) or incidents that put one’s or another’s physical well-being in jeopardy. The traumatic incident is relieved with terror, helplessness, or horror, and it can manifest itself in thoughts and dreams. The following are examples of common behaviors:

  • Avoiding the events, locations, or people who were involved in the triggering cause.
  • Difficulty in concentrating
  • Sleeping problems
  • Being too vigilant (you closely watch your surroundings)
  • Having a general sense of doom and gloom, as well as a lack of emotion (such as loving feelings or aspirations for the future)

Symptoms like chest pain, shortness of breath, palpitations, dizziness, fainting, and fatigue should not be mistaken for anxiety and should be evaluated by a doctor.

Panic Attack Symptoms

Panic attacks are feelings of fear that occur suddenly and without warning. These episodes can happen at any time, even when you’re sleeping. People who are having a panic attack may think they are having a heart attack, dying, or going insane. During a panic attack, a person’s anxiety and terror are out of proportion to the true situation and may be irrelevant to what is going on around them. Several of the following symptoms are common to panic attack sufferers :

  • “Racing" heart
  • Feeling weak, faint, or dizzy
  • Tingling or numbness in the hands and fingers
  • Sense of terror, or impending doom or death
  • Feeling sweaty or having chills
  • Chest pains
  • Breathing difficulties
  • Feeling a loss of control

Panic attacks are usually short, lasting less than ten minutes, but certain symptoms may last for longer. People who have had one panic attack are more likely to have more panic attacks in the future than people who have never had one. When attacks occur regularly and there is fear of getting more, an individual is diagnosed with panic disorder.

Individuals suffering from panic disorder can experience intense anxiety and fear, as they are unable to predict when the next episode will occur. Panic disorder is a moderately common condition that affects about 6 million people in the United States. The condition affects twice as many women as it does men, and symptoms typically appear in early adulthood.

The cause of the panic disorder remains unknown. Many people who are biologically predisposed to panic attacks experience them in response to significant life changes (such as marriage, raising a child, beginning a first career, etc.) and significant lifestyle stressors. Additionally, there is some evidence that the predisposition to develop panic disorder may run in families. Panic disorder sufferers are much more likely than the general population to suffer from depression, attempt suicide, or consume alcohol or drugs.

Panic disorder, fortunately, is a treatable illness. Psychotherapy and medicine have also been used successfully to treat panic disorder, either alone or in combination. If treatment is required, your doctor can prescribe anti-anxiety medicines, certain antidepressants, or sometimes anticonvulsant medications with anti-anxiety properties, or a class of heart medications called beta-blockers to help avoid or stabilize panic disorder episodes.


Referenced on 2.3.2021

  2. National Institute of Mental Health.
  3. MedicineNet: Panic Attack Symptoms.
  4. National Institute of Mental Health: “What is Panic Disorder?"

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