Anxiety and Panic

Medically Reviewed by Jabeen Begum, MD on May 24, 2024
Written by Stephanie Langmaid
6 min read

You're so worried about an upcoming event that you can't relax. You're exhausted and can't concentrate. Those are some of the symptoms you may feel when you're going through a bout of extreme anxiety.

You might describe that as an anxiety attack. While that really isn't a term that's used in the medical field, periods of excessive worry and dread that make it hard to function are very real for many people.

People who have an anxiety disorder experience more than just the typical amount of anxiety that most people feel from time to time. It's rooted in concern about real events -- such as worrying about a difficult exam or facing a round of layoffs at work -- but your worry or fear is out of proportion.

There may be times when those feelings spike. Maybe you have multiple stressful events happening at once. You might have trouble sleeping and focusing, and just generally feel on edge, which may go on for days or weeks.

A panic attack, on the other hand, is a period of intense fear or feelings of doom that come on quickly and resolve within minutes or hours. It has a clinical definition that's used by doctors to make a diagnosis. To have a panic attack, you must experience at least four of the following:

  • Rapid heartbeat
  • Sweating
  • Trembling
  • Shortness of breath
  • Sense of choking
  • Chest pain
  • Nausea
  • Dizziness
  • Numbness or tingling
  • Chills or hot flushes
  • Fear of losing control
  • Fear of dying
  • A feeling of being detached from reality or like you're having an out-of-body experience

Panic attacks and panic disorder are not the same thing. Panic disorder is one type of anxiety disorder. It involves:

  • Repeated panic attacks
  • Constant fear about having another attack or what may happen if you do
  • Avoiding situations that may trigger attacks

Having panic attacks doesn't automatically mean you have panic disorder, as other things can cause them.

It's possible for a medical condition to cause anxiety attack symptoms. Things that might trigger episodes include:

Panic attacks can also be triggered by psychiatric conditions beyond panic disorder. These include other kinds of anxiety disorders, depression, obsessive-compulsive disorder, and posttraumatic stress disorder (PTSD).

Generalized anxiety disorder

This is excessive and unrealistic worry over a period of at least 6 months. It's associated with at least three of the following symptoms:

  • Restlessness
  • Fatigue
  • Difficulty concentrating
  • Irritability or anger
  • Muscle tension, aches, or soreness
  • Sleep disturbances

Phobic disorders

These are intense, persistent, and recurrent fears of certain objects (such as snakes, spiders, or blood) or situations (such as heights, speaking in front of a group, or public places). Exposure to these may trigger a panic attack. Social phobia and agoraphobia are examples of phobic disorders.

Posttraumatic stress disorder (PTSD)

PTSD describes a range of emotional reactions caused by exposure to either death or near-death circumstances or events that threaten one's own or another person's physical well-being. This includes fires, floods, earthquakes, shootings, assaults, automobile accidents, and war. The traumatic event is re-experienced in thoughts or dreams along with feelings of fear, helplessness, and horror.

Common signs include the following:

  • Avoiding activities, places, or people associated with the event
  • Nightmares or flashbacks
  • Trouble concentrating or sleeping
  • Being hypervigilant (you closely watch your surroundings) or easily startled
  • Irritability or aggression
  • Risky behavior
  • Negative thoughts and feelings about yourself, the future, and the world in general

While symptoms such as chest pain, shortness of breath, rapid heartbeat, dizziness, fainting, and weakness can be caused by anxiety, they can also mean a serious health problem. Get checked by a doctor if you have them.

When you have an anxiety disorder, therapy can help reduce the number and severity of panic and anxiety attacks you have. When one does happen, try these tips to help you or someone you care about restore calm.

Breathe. You can lessen the physical symptoms of a panic attack by breathing deeply or practicing rhythmic breathing techniques. If you're with someone who's panicking, do this along with them.

Relax your muscles. Releasing the tension you're holding in your body can help calm you.

Acknowledge what's happening. Learn to recognize the symptoms so you're aware that you're having an anxiety attack, rather than a medical emergency, and reassure yourself that you're safe and it will pass. You can do the same for a loved one who suffers from anxiety. But don't tell them to stop worrying -- that's likely to just make things worse.

Change your focus. Try to concentrate on something other than your worry, like a relaxing activity. It can help engage your senses, for example, by listening to music or petting the dog. You can help a friend by distracting them until the episode is over.

If you have anxiety or were recently diagnosed with an anxiety disorder, consider asking your doctor these questions at your next visit.

  • How did I get anxiety? Is there a chance I passed this on to my kids?
  • Are there any underlying medical problems that could be causing my anxiety symptoms?
  • What are my treatment options for anxiety? Will I need to take an anxiety drug? Will I take it every day or as needed? How long will I need to take it?
  • What side effects can I expect from medications? Is there a way to minimize or prevent side effects?
  • What should I do if I miss a dose of medication?
  • Should I begin therapy sessions? Which type and for how long?
  • How long before I can expect to feel better?
  • Once treated, how likely is it that my anxiety symptoms will return?
  • What lifestyle changes can I make to help me feel better?
  • How will alcohol or other drugs interact with my medication or affect my anxiety?

These organizations offer information about and resources for anxiety disorders:

Anxiety Disorders Association of America. This nonprofit organization is dedicated to advocacy and education about anxiety disorders. This link will take you to its website: Anxiety and Depression Association of America.

American Psychological Association. This can offer you information on anxiety and help finding a psychologist. You can access its website by clicking on this link: American Psychological Association.

American Psychiatric Association. Learn more about children’s anxiety disorders and other mental health problems. Get help with finding a psychiatrist. This link will take you to the website: American Psychiatric Association.

National Alliance on Mental Illness. Learn more about panic disorder, phobias, and treatments that help. This link will take you to the website: National Alliance on Mental Illness.

A panic or anxiety attack can cause physical symptoms such as a rapid heartbeat, sweating, shaking, dizziness, and trouble breathing. If you have them often, talk to your doctor about whether therapy or medication could help you. You can also learn to calm yourself with breathing and relaxation techniques.

What is the 333 rule for anxiety?

The 333 rule uses your senses to pull you out of an anxiety attack. You make yourself aware of three things you can see, three things you can hear, and three things you can touch. Focusing on your physical environment disrupts the thought patterns causing your anxiety.

What are the symptoms of a silent panic attack?

A silent panic attack is when you have anxiety symptoms that can't be seen by someone else. You seem fine from the outside, but you're frantic on the inside. You may experience intense fear or dread, or feel physical symptoms that can't be seen, such as lightheadedness, nausea, or a fast heartbeat.