Anxiety and panic disorder: excessive worry and sudden fear

Anxiety is a normal, useful feeling

Anxiety is a natural emotion that helps us prepare for danger. But if it is far bigger than the actual threat, or lasts long enough to disrupt daily life, it may be an anxiety disorder.

Generalized anxiety disorder

Hard-to-control worry about many different things lasting six months or more. Along with the worry, symptoms such as these appear:

• Restlessness or feeling on edge
• Tiring easily
• Trouble concentrating, or your mind going blank
• Irritability
• Muscle tension, stiff shoulders
• Trouble falling or staying asleep

Panic disorder

A panic attack is a sudden rush of intense fear that usually peaks within minutes. Your heart races, you feel short of breath, your chest tightens, you feel dizzy, and you may feel as though you are about to die.

If panic attacks keep happening and you constantly worry about the next one, or start avoiding places such as the subway or elevators, it may be diagnosed as panic disorder.

If you have these symptoms for the first time, see a doctor first to rule out physical causes such as heart or thyroid problems.

During a panic attack

1. 1Tell yourself: "This is a panic attack. It is uncomfortable but not dangerous, and it will pass."
2. 2Breathe slowly: in for 4 seconds, pause briefly, then out over 6 seconds.
3. 3Ground yourself in the present by naming 5 things you can see and 3 things you can hear.
4. 4If you can, do not rush away — wait for the symptoms to settle. Most ease within 10 to 20 minutes.

Treatment

Anxiety and panic disorders respond well to treatment. Antidepressants (such as SSRIs) are the main medication, and cognitive behavioral therapy helps you work with anxious thoughts and gradually face situations you have been avoiding. Cutting back on caffeine and alcohol also helps.