Anxiety and panic attacks
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 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.
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’re feeling anxious or experiencing a panic attack right now, see below for information on panic attacks.
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:
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.
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:
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 below on self-care and treatment for anxiety offer suggestions for help and support.
Watch Lewis, Polly, Faisal, Shelley and Brian talk about what living with anxiety problems feels like for them, and what helps them cope (thanks to Mind for allowing us to share this video).
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:
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 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’.
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:
These can include:
Watch Alex talk about the physical impact anxiety has on his body in this video (our thanks to Mind for allowing us to share this video).
These can include:
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.
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:
In some cases anxiety can have a serious impact on your ability to work. See Mind’s pages on how to be mentally healthy at work for information on how to cope. Mind’s 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 Mind’s legal pages on fitness to drive.
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:
During a panic attack, physical symptoms can build up very quickly. These can include:
During a panic attack you might feel very afraid that you’re:
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.
Panic attacks
Watch Lewis, Polly, Faisal, Shelley and Brian share how panic attacks feel for them, and talk about what helps (our thanks to Mind for allowing us to share this video).
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.
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:
After a panic attack:
See below about self-care for anxiety and treatments for anxiety for more information on what could help.
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.
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.
Everyone’s experience of anxiety is different, so it’s hard to know exactly what causes anxiety problems. There are probably lots of factors involved.
This page covers some things which make anxiety problems more likely to happen:
Research shows that having a close relative with anxiety problems might increase your chances of experiencing anxiety problems yourself. This is sometimes called ‘anxiety sensitivity’.
At the moment there is not enough evidence to show whether this is because we share some genes that make us more vulnerable to developing anxiety, or because we learn particular ways of thinking and behaving from our parents and other family members as we grow up.
Difficult experiences in childhood, adolescence or adulthood are a common trigger for anxiety problems. Going through stress and trauma when you’re very young is likely to have a particularly big impact. Experiences which can trigger anxiety problems include things like:
Having parents who don’t treat you warmly or are overprotective can also be a factor.
Current problems in your life can also trigger anxiety. For example:
Big changes to your day-to-day life can be a particular trigger for anxiety, so you may find that you’ve experienced anxiety problems during the coronavirus pandemic. For information on how coronavirus may have affected your mental health and what could help see Mind’s coronavirus and mental health pages.
Other health problems can sometimes cause anxiety, or might make it worse. For example:
Anxiety can sometimes be a side effect of taking:
To report medication side effects see the government’s Yellow Card website.
Some types of food or drink can trigger symptoms of anxiety or panic, or make them worse. These include sugar and caffeine. See Mind’s pages on food and mood for more information about the relationship between what you eat and how you feel.
Living with anxiety can be very difficult, but there are steps you can take that might help. This page has some suggestions for you to consider.
For tips on coping with panic attacks, see above section on panic attacks.
Talking to someone you trust about what’s making you anxious could be a relief. It may be that just having someone listen to you and show they care can help in itself. If you aren’t able to open up to someone close to you, you could call the Samaritans.
Anxiety can make it really hard to stop worrying. You might have worries you can’t control. Or you might feel like you need to keep worrying because it feels useful – or that bad things might happen if you stop.
It can be helpful to try different ways of addressing these worries. For example, you could:
Try to get enough sleep. Sleep can give you the energy to cope with difficult feelings and experiences. See our page on coping with sleep problems for more information.
Breathing exercises can help you cope and feel more in control. You can find some suggestions on Mind’s page on relaxation. The NHS also has some tips on breathing exercises for stress.
Mindfulness is a way of giving your full attention to the present moment. Some people find mindfulness helpful for coping with certain anxiety disorders, but other people say it makes them feel worse.
One of the reasons for this is that some people find noticing their negative thoughts too intense, and it can make them feel worse. If you try mindfulness and still feel unwell, ask your GP or therapist about other things you could try.
The National Institute for Health and Care Excellence (NICE) – the organisation that produces guidelines on best-practice in healthcare – says that mindfulness is not recommended for social anxiety. Read more about social anxiety (sometimes called social phobia) in our page on types of phobia.
See Mind’s pages on mindfulness for more information.
It might help to make a note of what happens when you get anxious or have a panic attack. This could help you spot patterns in what triggers these experiences for you, or notice early signs that they are beginning to happen.
You could also make a note of what’s going well. Living with anxiety can mean you think a lot about things that worry you or are hard to do. It’s important to be kind to yourself and notice the good things too.
Peer support brings together people who’ve had similar experiences to support each other. Many people find it helps them to share ideas about how to stay well, connect with others and feel less alone. You could:
See Mind’s pages on peer support for more information about what it involves and how to find a peer support group to suit you.
If you’re new to online peer support you might also find it helpful to read information on how to stay safe online.
You may find that complementary and alternative therapies help you to manage your anxiety. There are many types that you can try, to see what works for you. These include:
Some people find that one or more of these methods can help them to relax or sleep better.
Many chemists and health shops stock different remedies and should be able to offer advice.
There are various evidence-based treatments that have been found to help with anxiety and panic disorder. This page covers:
A self-help resource might be the first treatment option your GP offers you. This is because it’s available quite quickly, and there’s a chance it could help you to feel better without needing to try other options.
Self-help could be delivered through:
If self-help resources aren’t likely to help with the anxiety problems you’re experiencing, or you’ve already tried them and they haven’t helped, your doctor should offer you a talking treatment.
There are two types of talking treatment recommended for anxiety and panic:
See Mind’s pages on talking therapies and CBT for more information on these and other kinds of therapy.
Your doctor might offer to prescribe you medication to help manage your symptoms. Some people find it helpful to try talking therapies and medication at the same time, but medication shouldn’t be the only thing you’re offered.
Here are some medications you might be offered:
Usually this will be a type called a selective serotonin reuptake inhibitor (SSRI). For some people SSRIs can cause side effects, such as sleep problems or feeling more anxious than you did before. If they don’t work, or aren’t right for you, you may be offered a different kind.
See Mind’s pages on antidepressants for more information.
In some cases, such as if you have a diagnosis of generalised anxiety disorder (GAD), your doctor may decide to prescribe you a drug called pregabalin. This is an antiseizure drug which is normally used to treat epilepsy, a neurological disorder that can cause seizures, but is also licensed to treat anxiety.
See Mind’s pages on anti-anxiety medication and pregabalin for more information.
Beta-blockers are sometimes used to treat the physical symptoms of anxiety, such as a rapid heartbeat, palpitations and tremors (shaking). But they are not psychiatric drugs so they don’t reduce any of the psychological symptoms. They may be helpful in certain situations that trigger your phobia.
See our page on treatment for phobias for more information.
If you experience very severe anxiety that is having a significant impact on your day-to-day life, you may be offered a benzodiazepine tranquilliser. But these drugs can cause unpleasant side effects and can become addictive, so your doctor should only prescribe them at a low dose for a short time, to help you through a crisis period.
See Mind’s page on benzodiazepines for more information.
Before deciding to take any drug, it’s important to make sure you have all the facts you need to make an informed choice.
See Mind’s pages on things to consider before taking medication and your right to refuse medication for more information.
Mind’s pages on coming off medication give guidance on how to come off medication safely.
To get treatment on the NHS, the first step is normally to visit your GP. They will do an assessment, which might include asking you to fill in a questionnaire about how often you feel worried, anxious and nervous.
They should then explain your treatment options to you, and you can decide together what might suit you best.
See Mind’s pages on seeking help for a mental health problem for more information on how to prepare for an appointment and have your say in treatment.
Unfortunately NHS waiting lists for talking treatments can be very long. If you’re finding it hard to access talking therapies you could consider:
It can be especially hard to get treatment if making or attending an appointment with your doctor involves doing something that causes lots of anxiety for you. For example, you might not feel able to talk on the phone or leave the house.
Here are some things you could try:
See the National Institute for Health and Care Excellence (NICE)’s guidelines for treating anxiety disorders for more detailed information.
Your doctor should offer you regular appointments to check how you’re doing, and see how well any treatment is working for you.
Different things work for different people, so if a particular medication, type of talking therapy or particular therapist doesn’t work for you, your doctor should offer an alternative.
If you’ve tried a range of treatments and none of them have helped, your doctor might refer you to a community mental health team (CMHT). This is made up of a number of different healthcare professionals, such as psychiatrists and clinical psychologists. Your CMHT can assess you separately and offer you a personalised treatment plan.
This is particularly recommended if:
It’s important to remember that recovery is a journey, and it won’t always be straightforward. For example, you might find it more helpful to focus on learning more about yourself and developing ways to cope, rather than trying to get rid of all your symptoms.
See Mind’s pages on recovery and facing and overcoming barriers for more information.
It can be really difficult when someone you care about is experiencing anxiety or panic attacks, but there are things you can do to help. Here are some tips.
Try not to put pressure on your friend or family member to do more than they feel comfortable with. It’s really important to be patient, listen to their wishes and take things at a pace that feels okay for them.
It’s understandable to want to help them face their fears or find practical solutions, but it can be very distressing for someone to feel they’re being forced into situations before they feel ready. This could even make their anxiety worse.
Try to remember that being unable to control their worries is part of having anxiety, and they aren’t choosing how they feel.
It’s understandable to feel frightened if someone you care about experiences a panic attack – especially if it seems to happen without warning. But it can help if you:
You should never encourage someone to breathe into a paper bag during a panic attack. This isn’t recommended and it might not be safe.
See above for more information on panic attacks and tips on how to cope.
Find out as much as you can about anxiety. This will help you understand what they are going through. Reading personal stories of anxiety can help too.
Ask about their experience. You could ask them how anxiety affects their day-to-day life, and what makes it better or worse. Listening to how they experience things could help you to empathise with how they feel.
Your friend or family member may already know how you can support them – for example, helping them with difficult situations, talking to them calmly or doing breathing exercises with them.
By asking them what they need or how you can help, you can support them to feel more in control themselves.
Knowing that there is someone around who knows what to do if they start to feel frightened or panicked could help them feel safer and calmer.
If you think your friend or family member’s anxiety is becoming a problem for them, you could encourage them to seek treatment by talking to a GP or therapist. You could:
See Mind’s page on helping someone else seek help for more information.
It can sometimes be really challenging to support someone with a mental health problem – you are not alone if you feel overwhelmed at times. It is important to remember to look after your own mental health too, so you have the energy, time and space you need to be able to help.
For example:
Anxiety Care UK
anxietycare.org.uk
Helps people with anxiety disorders.
Anxiety UK
03444 775 774 (helpline)
07537 416 905 (text)
anxietyuk.org.uk
Advice and support for people living with anxiety.
British Association for Counselling and Psychotherapy (BACP)
bacp.co.uk
Professional body for talking therapy and counselling. Provides information and a list of accredited therapists.
Hub of Hope
hubofhope.co.uk
UK-wide mental health service database. Lets you search for local, national, peer, community, charity, private and NHS mental health support. You can filter results to find specific kinds of support.
Mind
Mind’s helplines provide information and support by phone and email.
Local Minds offer face-to-face services across England and Wales. These services include talking therapies, peer support and advocacy.
Side by Side is Mind’s supportive online community for anyone experiencing a mental health problem.
NHS Services Finder
nhs.uk/service-search (England)
Searchable database of NHS services.
NHS talking therapies self-referral
nhs.uk/service-search/mental-health/find-an-nhs-talking-therapies-service
Information about local NHS therapy services for certain mental health problems. You can self-refer (England only) but you must be registered with a GP.
No More Panic
nomorepanic.co.uk
Provides information, support and advice for those with panic disorder, anxiety, phobias or OCD, including a forum and chat room.
No Panic
0300 7729844
nopanic.org.uk
Provides a helpline, step-by-step programmes, and support for people with anxiety disorders.
Samaritans
116 123 (freephone)
jo@samaritans.org
Freepost SAMARITANS LETTERS
samaritans.org
Samaritans are open 24/7 for anyone who needs to talk. You can visit some Samaritans branches in person
Triumph Over Phobia (TOP UK)
topuk.org
Self-help therapy groups and support for those with OCD, phobias and related anxiety disorders.
Our friendly team at the Portsmouth Mental Health Hub are here to help.
Enter your details and someone will call you back between 8am and 6pm, Monday to Friday.
If you or someone you know needs urgent mental health help, please call 111 – the NHS non-emergency number. It’s available 24 hours a day, 7 days a week and is free from any phone. They have specialist mental health nurses who can support adults and young people.
In a life-threatening emergency, always call 999.