What Happens During an Anxiety Attack?

During an anxiety attack, people may experience overwhelming panic, fear, loss of control, chest pain, trouble breathing and other signs of worry.

Anxiety can occur during everyday life, it could be fleeting or it could persist and build. But if you have an anxiety disorder, you may feel your anxiety or panic overwhelm you with intense anxiety and fear. 

The terms "anxiety attack" and "panic attack" may be used interchangeably but they are different. A panic attack is a short burst of fear that seems to happen suddenly and could happen one time or many times in a row. 

Anxiety attacks may have similar characteristics to a panic attack, but they often build up over time from underlying anxiety symptoms, instead of popping up out of nowhere. Anxiety attacks are most often connected to an anxiety disorder.

Recognizing the signs and symptoms of an anxiety attack is important for knowing how to care for yourself and when you should seek help.

Anxiety attacks can happen out of nowhere or gradually build into an overwhelming sense of fear and panic. They often get confused with panic attacks, and some symptoms do overlap. But anxiety attacks are different and have different indicators. It's important to distinguish common anxiety symptoms and signs of an anxiety attack. 

Common anxiety symptoms include: 

• Feeling nervous or restless
• Having a sense of impending danger
• Trouble concentrating or thinking about anything other than present worry
• Gastrointestinal (GI) problems
• Difficulty controlling worry
• Having the urge to avoid things that trigger anxiety

Anxiety attacks are a build-up of common anxiety symptoms and are intensified episodes of panic or fear. They usually peak within 10 minutes and should not last more than 30 minutes. The symptoms of an anxiety attack are:

Surge of overwhelming panic

You may feel like you are in danger or something bad is going to happen. This will occur out of nowhere, which may increase your feeling of panic or impending doom. 

Feeling of losing control 

Adding to the feeling of panic, you may feel like you are losing control of yourself or your surroundings. 

Chest pain or heart palpitations

Anxiety attacks have physical symptoms like an increased heart rate, which can make you think you're having a heart attack. The increased heart rate should last no more than 30 minutes, usually subsiding in 10 minutes. 

Trouble breathing

The feeling of panic and increased heart rate may make you feel like you can't breathe or are choking. You may also start to hyperventilate if you are gasping for breath. 

Hot flashes or chills

Another physical symptom of anxiety attacks is hot flashes or chills. Your body believes it's under attack, and this is a part of your fight or flight response.  

Nausea 

You may feel nauseous or have intense stomach cramps when you have an anxiety attack. 

A detached feeling from reality

You may feel a sense of detachment or feel like your situation is unreal during an anxiety attack. 

If you are experiencing these symptoms and feel like they are increasing in frequency and getting out of your control, you should seek support from a trusted individual or doctor. 

Anxiety attacks can stem from an anxiety disorder. There are several types of anxiety disorders. Below are three common anxiety disorders that lead to anxiety attacks:   

Generalized anxiety disorder (GAD)

This anxiety disorder is diagnosed in people that experience excessive anxiety or worry for more than 6 months. You may have many worries, like health, finances, relationships, or work.

Agoraphobia

This type of anxiety disorder is when you fear places or situations that may cause you panic. You will find yourself avoiding these situations that make you feel trapped, helpless or embarrassed. 

Panic disorder

A panic disorder is diagnosed in people who have recurrent unexpected panic attacks. You may be in constant worry about when or how your next panic attack will occur. 

There are several causes of anxiety. Common ones are:

• Work stressors
• Financial pressure
• Family or relationship problems
• Coping problems
• Reduced mobility or physical function
• Loss of mental function

When these stressors become overwhelming, you may experience an anxiety attack. Anxiety attacks will occur randomly, but they can be triggered by:

Underlying Medical Conditions

Anxiety can be a symptom of certain medical problems. Some of these medical problems may be: 

• Diabetes
• Asthma
• Hypertension

Environmental factors

Many types of stress or traumatic events can cause anxiety. Stress can build up, and small matters can become overwhelming and trigger an anxiety attack. People who have experienced traumatic events as a child or adult are more likely to develop an anxiety disorder. 

Genetics

Anxiety disorders can be genetic. It's a good idea to talk with your family openly about their experience with anxiety. 

Drug or alcohol use

Drug or alcohol use, misuse, or withdrawals can trigger anxiety attacks or worsen anxiety. 

Anxiety may come and go throughout your life. It is common for people to experience worry in their lives. If your anxiety and worries persist and result in multiple anxiety attacks, you’ll want to schedule a visit with your doctor. 

It’s important to see your doctor if: 

• You’re worrying too much and it’s interfering with your normal daily activities
• Your fear, anxiety, or worry is too difficult to control
• You feel depressed or have other mental health concerns along with anxiety
• You have suicidal thoughts or behaviors — if you feel this way, you should contact the National Suicide Prevention Lifeline

Once you have sought out medical help, your doctor will give you a physical and psychological evaluation. They will try to see if your anxiety symptoms come from underlying medical conditions. They will run blood tests to determine that you do not have an illness. Once they've determined your anxiety is not linked to drug use or a physical medical condition, they'll refer you to a mental health professional. 

Once you've been referred, your mental health provider will give you a psychological evaluation. They will have a discussion with you to talk about your thoughts, feelings, and behaviors to determine where your anxiety attacks could be coming from. They will compare your symptoms to the DSM-5 to diagnose an anxiety disorder. 

When anxiety attacks take control of your life and you have a diagnosed anxiety disorder, your doctor may suggest two forms of treatment: 

Psychotherapy

Talk therapy is the first approach to treating anxiety attacks. You and your therapist will discuss what might be the root cause of your anxiety disorder. Psychotherapy helps give you the skills to healthily cope with the symptoms of anxiety. The common types of therapy are cognitive-behavior therapy and exposure therapy.

Medication

There are several types of medication that help relieve anxiety attack symptoms. The type of medicine will depend on the anxiety disorder or other mental health issues you may be facing. Certain antidepressants can treat anxiety. Your doctor may prescribe an anti-anxiety medicine, like buspirone. 

Along with these two types of treatment, there are things you can try at home to help you cope when symptoms start to begin: 

• Getting enough sleep
• Meditation
• Exercising regularly
• Getting social support from trusted loved ones or friends