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Anxiety and panic attacks
Anxiety and panic attacks
Explains anxiety and panic attacks, including possible causes and how you can access treatment and support. Includes tips for helping yourself, and guidance for friends and family.
What is anxiety?
Anxiety is what we feel when we are worried, tense or afraid – particularly about things that are about to happen, or which we think could happen in the future.
Anxiety is a natural human response when we feel that we are under threat. It can be experienced through our thoughts, feelings and physical sensations.
“For me, anxiety feels as if everyone in the world is waiting for me to trip up, so that they can laugh at me. It makes me feel nervous and unsure whether the next step I take is the best way forward.”
Most people feel anxious at times. It’s particularly common to experience some anxiety while coping with stressful events or changes, especially if they could have a big impact on your life. See our pages on how to manage stress for more information about stress.
If you are feeling anxious or experiencing a panic attack right now, see our page on how to manage panic attacks.
What is the ‘fight, flight or freeze’ response?
Like all animals, human beings have evolved ways to help us protect ourselves from danger. When we feel under threat our bodies react by releasing certain hormones, such as adrenaline and cortisol, which can be helpful. These hormones:
- make us feel more alert, so we can act faster
- make our hearts beat faster, quickly sending blood to where it’s needed most.
After we feel the threat has passed, our bodies release other hormones to help our muscles relax. This can sometimes cause us to shake.
This is commonly called the ‘fight, flight or freeze’ response – it’s something that happens automatically in our bodies, and we have no control over it.
“Going out of the house is a challenge because I have a fear of panicking and feel that I’m being watched or judged. It’s just horrible. I want to get help but I’m afraid of being judged.”
When is anxiety a mental health problem?
Anxiety can become a mental health problem if it impacts your ability to live your life as fully as you want to. For example, it may be a problem if:
- your feelings of anxiety are very strong or last for a long time
- your fears or worries are out of proportion to the situation
- you avoid situations that might cause you to feel anxious
- your worries feel very distressing or are hard to control
- you regularly experience symptoms of anxiety, which could include panic attacks
- you find it hard to go about your everyday life or do things you enjoy.
If your symptoms fit a particular set of medical criteria then you might be diagnosed with a particular anxiety disorder. But it’s also possible to experience problems with anxiety without having a specific diagnosis. Our pages on self-care and treatment for anxiety offer suggestions for help and support.
What do anxiety problems feel like?
Watch Lewis, Polly, Faisal, Shelley and Brian talk about what living with anxiety problems feels like for them, and what helps them cope:
Gus’ story
Heart FM DJ Matt Wilkinson talks to Gus Marshall about his experience of anxiety and panic attacks.
Read the transcript of the podcast here. Find out more about our podcasts or subscribe to our podcast on iTunes or Audioboom.
“You know that feeling when you’re rocking on the back legs of your chair and suddenly for a split second you think you’re about to fall; that feeling in your chest? Imagine that split second feeling being frozen in time and lodged in your chest for hours/days, and imagine with it that sense of dread sticking around too, but sometimes you don’t even know why.”
What are anxiety disorders?
Anxiety can be experienced in lots of different ways. If your experiences meet certain criteria your doctor might diagnose you with a specific anxiety disorder.
Some commonly diagnosed anxiety disorders are:
- Generalised anxiety disorder (GAD) – this means having regular or uncontrollable worries about many different things in your everyday life. Because there are lots of possible symptoms of anxiety this can be quite a broad diagnosis, meaning that the problems you experience with GAD might be quite different from another person’s experiences.
- Social anxiety disorder – this diagnosis means you experience extreme fear or anxiety triggered by social situations (such as parties, workplaces, or everyday situations where you have to talk to another person). It is also known as social phobia. See our page on types of phobia for more information.
- Panic disorder – this means having regular or frequent panic attacks without a clear cause or trigger. Experiencing panic disorder can mean that you feel constantly afraid of having another panic attack, to the point that this fear itself can trigger your panic attacks. See our page on panic attacks for more information.
- Phobias – a phobia is an extreme fear or anxiety triggered by a particular situation (such as going outside) or a particular object (such as spiders). See our pages on phobias for more information.
- Post-traumatic stress disorder (PTSD) – this is a diagnosis you may be given if you develop anxiety problems after going through something you found traumatic. PTSD can involve experiencing flashbacks or nightmares which can feel like you’re re-living all the fear and anxiety you experienced at the time of the traumatic events. See our pages on PTSD and complex PTSD for more information.
- Obsessive-compulsive disorder (OCD) – you may be given this diagnosis if your anxiety problems involve having repetitive thoughts, behaviours or urges. See our pages on OCD for more information.
- Health anxiety – this means you experience obsessions and compulsions relating to illness, including researching symptoms or checking to see if you have them. It is related to OCD. You can find out more about health anxiety on the Anxiety UK website.
- Body dysmorphic disorder (BDD) – this means you experience obsessions and compulsions relating to your physical appearance. See our pages on BDD for more information.
- Perinatal anxiety or perinatal OCD – some people develop anxiety problems during pregnancy or in the first year after giving birth. See our pages on perinatal anxiety and perinatal OCD for more information.
You might not have, or want, a diagnosis of a particular anxiety disorder – but it might still be useful to learn more about these different diagnoses to help you think about your own experiences of anxiety, and consider options for support.
“It’s like a swarm of bees just buzzing buzzing buzzing, not stopping, making it impossible to focus and seemingly impossible to slow down and take a breath.”
Anxiety and other mental health problems
It’s very common to experience anxiety alongside other mental health problems, such as depression or suicidal feelings. If you have symptoms of both anxiety and depression but don’t fit one more clearly than the other, you might be given a diagnosis of ‘mixed anxiety and depressive disorder’.
“I have generalised anxiety disorder and depression which seem to come in cycles. It is the unexpected attacks that I find the hardest.”
What are the symptoms of anxiety?
Anxiety feels different for everyone. You might experience some of the physical and mental effects listed on this page, as well as effects in other areas of your life.
You might also have experiences or difficulties with anxiety that aren’t recognised here.
This page covers:
- effects of anxiety on your body
- effects of anxiety on your mind
- other effects of anxiety
Effects of anxiety on your body
These can include:
- a churning feeling in your stomach
- feeling light-headed or dizzy
- pins and needles
- feeling restless or unable to sit still
- headaches, backache or other aches and pains
- faster breathing
- a fast, thumping or irregular heartbeat
- sweating or hot flushes
- sleep problems
- grinding your teeth, especially at night
- nausea (feeling sick)
- needing the toilet more or less often
- changes in your sex drive
- having panic attacks.
The physical effects of anxiety
Watch Alex talk about the physical impact anxiety has on his body in this video:
Effects of anxiety on your mind
These can include:
- feeling tense, nervous or unable to relax
- having a sense of dread, or fearing the worst
- feeling like the world is speeding up or slowing down
- feeling like other people can see you’re anxious and are looking at you
- feeling like you can’t stop worrying, or that bad things will happen if you stop worrying
- worrying about anxiety itself, for example worrying about when panic attacks might happen
- wanting lots of reassurance from other people or worrying that people are angry or upset with you
- worrying that you’re losing touch with reality
- low mood and depression
- rumination – thinking a lot about bad experiences, or thinking over a situation again and again
- depersonalisation – a type of dissociation where you feel disconnected from your mind or body, or like you are a character that you are watching in a film
- derealisation – another type of dissociation where you feel disconnected from the world around you, or like the world isn’t real
- worrying a lot about things that might happen in the future – you can read more about these sorts of worries on the Anxiety UK website.
“I could feel all these physical symptoms building inside me, literally filling every part of my body until I felt completely light-headed and disembodied.”
Anxiety and physical health problems
Some studies suggest that experiencing anxiety could increase the risk of developing certain long-term physical health problems, including diabetes, stomach ulcers and heart problems. But there’s not enough evidence to say for sure exactly what the risks are, or what groups of people are most likely to be affected.
Having a physical illness or disability can also make you feel stressed and anxious, so it might sometimes feel like your anxiety problems and physical health problems are part of a vicious circle.
Sometimes it might be difficult to work out whether your symptoms are totally related to anxiety, or might be related to a different illness. If you’re experiencing any physical symptoms it’s best to talk to your GP, so they can check out what may be causing them.
“I constantly thought I was dying of undiagnosed illnesses, because I was convinced that the physical symptoms were too bad to be ‘just anxiety’.”
Other effects of anxiety
Anxiety symptoms can last for a long time, or come and go. You might find you have difficulty with day-to-day parts of your life, including:
- looking after yourself
- holding down a job
- forming or maintaining relationships
- trying new things
- simply enjoying your leisure time.
In some cases anxiety can have a serious impact on your ability to work. See our pages on how to be mentally healthy at work for information on how to cope. Our legal pages on discrimination at work can provide information about your rights in the workplace.
If you drive you may have to tell the DVLA if you have an anxiety disorder. For information on your right to drive, including when and how to contact the DVLA, see our legal pages on fitness to drive.
What is a panic attack?
Panic attacks are a type of fear response. They’re an exaggeration of your body’s normal response to danger, stress or excitement. This page covers:
- What do panic attacks feel like?
- When might I have panic attacks?
- What helps to manage panic attacks?
- What is panic disorder?
“My teeth would chatter uncontrollably and my whole body would tremble, I’d hyperventilate and cry with panic as the feeling that I was going to fall unconscious was so convincing.”
What do panic attacks feel like?
During a panic attack, physical symptoms can build up very quickly. These can include:
- a pounding or racing heartbeat
- feeling faint, dizzy or light-headed
- feeling very hot or very cold
- sweating, trembling or shaking
- nausea (feeling sick)
- pain in your chest or abdomen
- struggling to breathe or feeling like you’re choking
- feeling like your legs are shaky or are turning to jelly
- feeling disconnected from your mind, body or surroundings, which are types of dissociation.
During a panic attack you might feel very afraid that you’re:
- losing control
- going to faint
- having a heart attack
- going to die.
You might find that you become scared of going out alone or to public places because you’re worried about having another panic attack. If this fear becomes very intense, it may be called agoraphobia. See our pages on types of phobia for more information.
“I felt like I couldn’t breathe, I just wanted to get out, to go somewhere else, but I couldn’t because I was on a train.”
Panic attacks
Watch Lewis, Polly, Faisal, Shelley and Brian share how panic attacks feel for them, and talk about what helps:
When might I have panic attacks?
Panic attacks happen at different times for everyone. Some people have one panic attack then don’t ever experience another, or you might find that you have them regularly, or several in a short space of time. You might notice that particular places, situations or activities seem to trigger panic attacks. For example, they might happen before a stressful appointment.
Most panic attacks last between 5 to 20 minutes. They can come on very quickly. Your symptoms will usually be at their worst within 10 minutes. You might also experience symptoms of a panic attack over a longer period of time. This could be because you’re having a second panic attack, or you’re experiencing other symptoms of anxiety.
“My panic attacks seem to come out of the blue now. But in fact, they seem to be triggered mainly at night when I want to go to sleep but cannot stop my mind racing, experiencing worry and panic about anything that may be on my mind.”
What helps to manage panic attacks?
Panic attacks can be frightening, but there are things you can do to help yourself cope. It could help to print off these tips, or write them down, and keep them somewhere easy to find.
During a panic attack:
- Focus on your breathing. It can help to concentrate on breathing slowly in and out while counting to five.
- Stamp on the spot. Some people find this helps control their breathing.
- Focus on your senses. For example, taste mint-flavoured sweets or gum, or touch or cuddle something soft.
- Try grounding techniques. Grounding techniques can help you feel more in control. They’re especially useful if you experience dissociation during panic attacks. See our page on self-care for dissociation for more information on grounding techniques.
After a panic attack:
- Think about self-care. It’s important to pay attention to what your body needs after you’ve had a panic attack. For example, you might need to rest somewhere quietly, or eat or drink something.
- Tell someone you trust. If you feel able to, it could help to let someone know you’ve had a panic attack. It could be particularly helpful to mention how they might notice if you’re having another one, and how you’d like them to help you.
See our pages on self-care for anxiety and treatments for anxiety for more information on what could help.
What is panic disorder?
If you’re having lots of panic attacks at unpredictable times and there doesn’t seem to be a particular trigger or cause, you might be given a diagnosis of panic disorder. It’s common to experience panic disorder and certain types of phobia together. People who experience panic disorder may have some periods with few or no panic attacks, but have lots at other times.
Panic disorder and high sensitivity
Some research suggests that people who have panic disorder might be very sensitive to sensory experiences (such as sunlight, smells and changes in the weather), but there’s not enough evidence yet to say for sure.
Also it’s not clear whether having a high level of sensitivity to these sorts of things is something that might cause you to develop panic disorder, or whether it may be an effect of having it.