Suddenly something feels very wrong. You feel like you might be losing control. You feel physical symptoms that mimic serious health problems and in some cases you feel as if death or doom is eminent.
The feeling builds up over time. It starts to get overwhelming. You feel one immense moment of pure fear as if this is your last moment on earth and then suddenly - out of nowhere - it fades away.
What you suffered from may feel as severe as a heart attack. But more likely what you suffered from is an anxiety attack. Anxiety attacks are intense moments of pure anxiety that cause real physical symptoms that create intense and devastating anxiety.
Did You Have An Anxiety Attack?
Our free 7 minute anxiety test can score your anxiety severity, see if it’s likely you had an anxiety/panic attack, and give you recommendations for how to control it.
Introduction to Anxiety Attacks/Panic Attacks
Anxiety attacks are not a psychological term, so their definition can vary a bit depending on the speaker. But anxiety attacks are often used either synonymously with the term "panic attacks" (or as a way of referring to lighter versions of panic attacks that are a bit less debilitating but still very troublesome). To get a better idea of what type of anxiety you may have, take our free 7 minute anxiety test.
Panic attacks are short term (usually about 10 minutes) moments of anxiety so severe, it can feel like you are about to die. During an anxiety attack, you'll often experience a host of physical and mental symptoms that can leave you severely frightened and incredibly drained once they pass. These include:
- Rapid and pounding heartbeat.
- Heart pressure.
- Chest pains.
- Sweating or hot/cold sensations.
- Shortness of breath.
- Muscle weakness or tingling.
- Feelings of losing control.
- Intense feeling of doom.
- Depersonalization or feelings of going crazy.
- Nausea or stomach discomfort.
- Need to urinate or defecate.
- Head pressure or headache.
It's not uncommon to experience other unusual symptoms during an anxiety attack that all contribute to further fear. Anxiety attacks tend to peak around 10 minutes in and then slowly fade over the course of a few hours, often leaving the individual drained and anxious, and in some cases wondering what went wrong.
These panic attacks are rarely just feelings of nervousness or worry. They are very physical and mental events. Those that have never had a panic attack before don’t always realize that they had an anxiety attack. Some people have first-time anxiety attacks so severe that they call the hospital because they think something is going horribly wrong.
What Triggers an Anxiety Attack?
Anxiety attacks are unusual, in that they can be triggered under moments of heavy stress or fear, or they can be triggered by nothing at all. Often the first anxiety attack comes at a moment in a person's life when they're experiencing a lot of stress (although not always). But future panic attacks can be caused by almost anything:
- Worry that they’ll have another panic attack.
- Paying too much attention to how the body feels.
- Absolutely nothing.
Once again, it is because anxiety attacks can seem and feel so random that not everyone that has them even knows or believes that they’re having an anxiety attack. Those that have panic attacks too often may even start to develop other anxiety conditions, such as health anxiety, because of how difficult it is to feel like their anxiety attacks are real.
Not everyone that has an anxiety attack once will have it again, however. Some people only experience an anxiety attack because they are under profound stress and exhaustion, or they’re faced with a dangerous situation. For example, if you almost got into a car accident you may experience a panic attack, but only because your anxiety in that situation was so strong that it was uncontrollable.
But many that have panic attacks will have them again. It depends on the individual.
What Anxiety Attacks Feel Like
Because of the very physical nature of anxiety attacks, they often are mistaken for some type of serious illness, and in some cases they may create a feeling of health anxiety. For many, the experience of an anxiety attack resembles that of more serious diseases, such as:
- Heart Attacks.
- Multiple Sclerosis
- Lyme Disease
- Brain Tumors
- Heart Failure
Those that only experience an anxiety attack once may overcome it and their fears of a health problem may dissipate. For others, the experience of an anxiety attack may be so pronounced that it creates serious health fears that lead to hospitalization or several visits to the doctor.
It should be noted that only a doctor can rule out more serious conditions, so there is no harm in seeing the doctor for both a medical opinion of the causes of your experiences, and to ease your mind. But note that when you suffer from anxiety attacks it can be very difficult for a doctor to convince you that you that you are healthy. Treating anxiety attacks is often the only way to find relief.
Alternative Anxiety Attack Definition
Earlier we mentioned that "anxiety attack" is not a medical term, but rather a descriptive term for intense moments of anxiety. Most people, including some medical professionals, refer to panic attacks as “anxiety attacks” simply because it is easier for people to understand. When you say “panic,” people tend to think of someone running away from Godzilla. When you term them “anxiety attacks,” people tend to understand it better.
But because anxiety attack is not a medical term, not everyone uses it the same way. Some people use anxiety attack as a way of describing severe symptoms of other anxiety disorders. For example, those with obsessive compulsive disorder may have an "anxiety attack" when they encounter a trigger of extreme anxiety that forces them deep into their compulsions. Those with an upcoming test in school may call their significant worry about the test an “anxiety attack” even though they’re really just talking about being very nervous.
Keep this in mind when people describe anxiety attack, as the term may lead to a bit of miscommunication. For the purposes of this article, however, we’re talking about panic attacks, because panic attacks are a very real, very common anxiety problem that most people are referring to when they say they have these attacks.
How Severe is Your Anxiety?
My 7 minute anxiety test was specifically developed to give you an idea of how severe your anxiety is, compare it to others, and give you tools to control it.
Why Do Anxiety Attacks Cause These Physical Symptoms?
One of the most common reasons that anxiety attacks are such a frightening experience is because they cause physical symptoms that mimic more serious diseases. This causes many people to become incredibly fearful for their health, believing that there is no way something like anxiety can lead to such a physical response.
But anxiety causes a host of different physical reactions that can explain most of the anxiety symptoms, and the most common cause is hyperventilation.
What is Hyperventilation?
Even though your body needs oxygen to survive, and turns that oxygen into carbon dioxide when it's been used up within the blood stream, your body also expects a healthy amount of carbon dioxide in your circulatory system as well. Hyperventilation is the act of breathing either too quickly or incorrectly in such a way that you're taking in too much oxygen while breathing out too much carbon dioxide.
Interestingly, during this time it may feel as though you're not getting enough air, and your instinct may be to take deeper breaths. But by responding to that sensation by trying to take in more air, you're actually making your hyperventilation worse, which is why those that try to get deeper breaths often feel their symptoms getting worse, causing further panic.
When there isn't enough carbon dioxide in your blood, you experience the symptoms of an anxiety attack, including:
- Chest pains
- Rapid heartbeat
- Slurred speech
- Numbness/tingling in the extremities
- Shortness of breath
- Dizziness and more
Notice how each of these symptoms are the same as when you're suffering from severe anxiety, which is why it often feels like an "attack" and why the symptoms feel so physical. They build on each other to create an experience that feels like something is terribly wrong.
The most likely cause of hyperventilation is breathing too quickly, which is a common response to anxiety. But it's not the only cause either. You may also hyperventilate because:
- You Breathe Poorly in General Those with anxiety often have alterations in their breathing that cause them to breathe in a way that is less than ideal for their body, either by taking in too much air or by breathing in an inefficient way. Anxiety attacks can also create poor breathing habits. This may be one of the reasons that people experience an anxiety attack seemingly out of nowhere, because they may be hyperventilating even when no anxiety is present.
- You Think About Your Breathing Another common cause of hyperventilation occurs when you think too often about your breathing. Your body generally takes in as much air as it needs, often with very shallow breaths because your body only needs a very small amount of oxygen. Those that think about their breathing cause their breathing to be under their own control, and many people will then try to take in deeper breaths than their body needs.
So while breathing quickly during stress and anxiety is the most common reason that people hyperventilate, it is not the only cause.
Hyperventilation from anxiety is not dangerous. All your body needs to do is regain its balance, which it will do once your anxiety attack starts to fade. But the symptoms of anxiety certainly feel dangerous at the time, which explains why so many people experience a rush of anxiety and panic.
Other Causes of Anxiety Attack Symptoms
Hyperventilation is not the only cause of anxiety attack symptoms either. Anxiety and stress have a tendency to cause your body to experience very strange sensations - often sensations that differ from person to person. Some people may feel like they can't lift their head, or that something is wrong with their brain - these are all issues that may be caused by anxiety stress.
In addition, anxiety has a tendency to cause the brain to focus on sensations that would otherwise be normal. This is the result of over-sensitization - your mind is so tuned in to your body that it notices very small sensations that someone without anxiety would otherwise ignore.
Finally, the fear of getting anxiety attack symptoms can also trigger the symptoms. It's unclear why this occurs, but most likely it is psychosomatic in some way (caused by your mind).
How to Control an Anxiety Attack
Anxiety attacks can be difficult to stop after they've started, but there are techniques that can help reduce their severity. If you believe you're having or about to have an anxiety attack, try the following:
- Remind Yourself it's Anxiety It's not going to stop an anxiety attack, but remind yourself that you're having one. The symptoms you're experiencing are very real and very stressful. In some cases they may even be painful. But they'll go away when the attack is over. The more you worry that something is wrong with your health, the more likely the attack will be worse.
- Controlled Breathing Remember that hyperventilation is the most common cause of anxiety attack symptoms. If you can stop hyperventilating, the symptoms will decrease. Take slower breaths and don't worry about trying to expand your chest. Breathe in through your stomach and breathe out very slowly. It can take a while to reduce the sensation that you need to get a deep breath, but it should stop the symptoms from getting worse.
- Hold Your Breath at Peak For 2 or three seconds at the peak of each breath, hold your breath before breathing out. Remember, you want to give your body back a healthy balance of carbon dioxide, so holding your breath for a short time (not too long, but a couple of seconds) can increase CO2 in your body.
- Tell People If you're out with others, don't be shy about your anxiety attack. Holding it in causes you to think about it too much, and that can increase your anxiety and feelings of doom. It may be a bit embarrassing to tell people that you're suffering from a panic attack, but not telling people will not make the anxiety attack any better, and talking about it to others can reduce its severity.
- Call Someone If you're alone, calling someone on the phone and just talking to them can be a tremendous help. That's because calling someone acts as a distraction. Remember, anxiety attacks are still caused by your mind and thoughts. When you're on the phone talking with someone, you're taken out of your own thoughts and engaging in conversation. This can have a powerful effect on the severity of your attack.
- Other Distractions The more you're taken "out of your own head," the less severe your anxiety attacks will be. Try other things like going for a speed walk (if your legs are feeling strong enough), drinking water, turning on the TV, and anything else that keeps you from focusing too much on the symptoms.
Anxiety attacks are very difficult to stop once they've started, but by using the above tips you can reduce the severity. The less severe your panic attacks, the less you'll fear them, and the easier they'll be to control.
Anxiety Attack Prevention
Once your anxiety attacks are under more control, you'll need to take steps to prevent them. Anxiety attacks can be one time things, but they're still indicative of a larger anxiety problem and many people find that their anxiety attacks become recurring.
Prevention is about three things:
- Controlling your overall anxiety and stress.
- Controlling the way you react to severe stress.
- Controlling the way you respond to anxiety attack symptoms.
Going to the doctor is always a good place to start. Make sure that you've had a full physical so that you will have greater peace of mind about your health. Try to stay away from panic attack medications, however - most cause severe fatigue and other symptoms that make them less than ideal for daily use.
Start exercising as well. Exercise is a known stress cure - one of the most effective ways to relieve your daily anxiety. It's also a healthy way to retrain your breathing. When you run, your body breathes as efficiently as possible, and this can help your body re-learn to breathe correctly.
Also, take my 7 minute anxiety test I developed it to give you a better understanding of your anxiety, and from there you'll be able to get accurate treatment options based on the way you respond to the anxiety questionnaire.
So take the test now to get started.
Heistad DD, Wheeler RC, Mark AL, et al. Effects of adrenergic stimulation on ventilation in man. J Clin Invest 1972; 51:1469-1475.
Lary D, Goldschlager N. Electrocardiographic changes during hyperventilation resembling myocardial ischemia in patients with normal coronary arteriograms. Am Heart J 1974; 87:383-390.
Magarian, GREGORY J., D. A. Middaugh, and D. H. Linz. Hyperventilation syndrome: a diagnosis begging for recognition. Western Journal of Medicine 138.5 (1983): 733.
Panic Disorder. CTSA: Symptoms. University of Pennsylvania, n.d. Web. 08 Dec. 2012.
Nelson, William A., and George A. Clum. Assessment of panic frequency: Reliability and validity of a time-line follow-back method. Journal of Psychopathology and Behavioral Assessment 24.1 (2002): 47-54.
Mendel, Julius G.; Klein, Donald F. Anxiety attacks with subsequent agoraphobia. Comprehensive Psychiatry, Vol 10(3), 1969, 190-195.