Panic attack symptoms and anxiety symptoms

Panic Attack Symptoms and
Anxiety Symptoms: How to
deal with anxiety and how
to relieve stress.
2016
Our FB Page : fb.com/ PanicAwayProgram

For more infos visit : http://bit.ly/28ZB3lc FB Page : fb.com/ PanicAwayProgram
2
TABLE OF CONTENT
I. PANIC ATTACK SYMPTOMS AND STRESS SYMPTOMS.......................................................................... 3
A Stress Definition............................................................................................................................... 4
Good vs. Bad Stress ............................................................................................................................. 4
An Anxiety Definition .......................................................................................................................... 5
Normal vs. Abnormal Anxiety.............................................................................................................. 5
Signs of Anxiety and Signs of Stress .................................................................................................... 6
Symptoms of Stress and Anxiety......................................................................................................... 7
What Is Stress? Its Impact on Health .................................................................................................. 7
II. ANXIETY DEFINITION, CONTINUED…................................................................................................... 8
Generalized Anxiety Disorder (GAD)................................................................................................... 8
Separation Anxiety .............................................................................................................................. 9
Phobias.............................................................................................................................................. 10
Panic Disorder ................................................................................................................................... 12
Agoraphobia...................................................................................................................................... 13
Social Anxiety Disorder (SAD) or Social Phobia................................................................................. 13
Obsessive Compulsive Disorder (OCD).............................................................................................. 14
Post-Traumatic Stress Disorder (PTSD) ............................................................................................. 15
Anxiety Associated with Medical Conditions .................................................................................... 15
Anxiety Associated with Substance Abuse........................................................................................ 16
III. DIAGNOSING STRESS AND ANXIETY ................................................................................................. 17
Talking to Your Doctor....................................................................................................................... 18
Diagnostic Questionnaires................................................................................................................. 18
Anxiety Tests and Diagnostic Tests ................................................................................................... 19
IV. MANAGING STRESS AND ANXIETY................................................................................................... 20
Making Changes ................................................................................................................................ 20
V. SEEKING PROFESSIONAL HELP .......................................................................................................... 24
Choosing a Therapist......................................................................................................................... 25
Anti-Anxiety Medication ................................................................................................................... 27
Natural Remedies.............................................................................................................................. 28
VI. HOW TO DEAL WITH ANXIETY AND STRESS..................................................................................... 29

3
I. PANIC ATTACK SYMPTOMS AND STRESS
SYMPTOMS
These days, words like stress and anxiety contain a host of negative
associations. They make us think of exams and injections and failing to achieve that
seemingly impossible goal of work-life balance. But both stress and anxiety are normal,
healthy, even necessary bodily functions? It’s true.
Stress and anxiety help keep us alive. They are the reason we go to work or
school in the morning as well as the reason we don’t all just wander off into traffic. The key
is balance. While a certain amount of stress and anxiety keep us moving forward in our lives,
too much can make us unhappy, unable to function, and seriously ill.
A panic attack may come on suddenly, giving you feelings of being overwhelmed.
Let’s take a moment to learn a little bit more about what stress and anxiety
really are and why having some, but not too much, of both is crucial to good health.

4
A Stress Definition
Simply put, stress is your body’s response to potential danger, such as a
speeding bus bearing down on you, or a demand, such as the need to do well on an exam.
Basically, it’s your body’s way of telling you something has to change in order for you to stay
safe or achieve your goals.
Good vs. Bad Stress
Stress is good when it motivates you to meet life’s challenges and keeps you
safe. The stress that induces you to step out of the way of that speeding bus or study for that
crucial exam is good stress. When you are so worried about doing well on the exam that you
can’t concentrate enough to study, or freeze when it’s time to start writing it, that’s bad
stress. An anxiety attack could be described as bad stress.
The thought of taking an exam can produce both “good stress” (studying for it) and “bad
stress” (a severe case of nerves during the test).
In general, stress is useful in short bursts, such as the amount of time it takes
you to show your boss that you deserve that promotion or avoid that mean-looking dog.
Stress that hangs around for much longer periods of time, such as stress associated with
years of worry that you might lose your job, is called chronic stress. Chronic stress causes
significant wear-and-tear on your body and, left unchecked, can result in illness and
disability.

5
Stopping a Panic Attack
While panic attacks are a truly horrible experience, the good news is that there are techniques that can
stop them in their tracks. One of the most effective is deep breathing. Panic attacks are often driven by
hyperventilation—or breathing too quickly. Learning to slow down your breathing and to take deep,
slow breaths actually tells your brain to silence those alarm bells. Whether you’re in the midst of a
panic attack or just having an anxious day, deep breathing should help you feel better within a few
minutes.
Try the 4-7-8 deep breathing technique:
1. Inhale slowly through your nose to the count of 4. Be sure to fill your lungs and feel your belly
expand.
2. Hold your breath while you count slowly to 7.
3. Slowly breathe out through your mouth to a slow count of 8, making a whooshing sound.
4. Without pausing, start breathing in again through your nose to the count of 4.
5. Repeat several times until you feel better. Don’t stop if you don’t feel better immediately, as it can
take few minutes before you feel the effects.
An Anxiety Definition
Anxiety is an emotional response characterized by feelings of tension and
worry often combined with physical changes, like an increase in blood pressure. It is
perfectly normal to experience anxiety in response to stressful circumstances. For instance,
it’s pretty normal, even healthy, to feel anxious when you hear someone break into your
house. Many people will also feel anxious about challenges such as making important
presentations at work or learning to skydive for the first time.
Normal vs. Abnormal Anxiety
As with stress, good or bad anxiety is really a matter of degrees. Everyone feels
anxiety, and it’s pretty easy to manage when it pops up only when we are facing real
dangers or challenges, never becomes overwhelming, and then drifts away once we have
overcome what we need to. Anxiety is abnormal and problematic when it seems to have no
real cause, when worry seems to take over your life, when you can’t help but worry about
very minor things (did that stranger give me a funny look?) or that something pretty unlikely
is going to happen to you (will I be the victim of a terrorist attack?). Anxiety is also a problem

6
when it’s overwhelming. The most extreme form of anxiety is called panic. Panic attack
symptoms can prevent you from functioning at all.
Let’s look a little bit at how stress and anxiety affect the body.
Signs of Anxiety and Signs of Stress
Stress is often described in the context of the body’s fight or flight response.
That is, in the presence of a danger, your body prepares to face the danger (fight) or run
away to a safe place (flight).
Fight or flight: the way your body reacts when facing danger.
In order to prepare you for action, your body has to make some quick changes.
This starts with an increased production of the stress-related chemicals cortisol, adrenaline
and noradrenaline. These speed up your breathing and heart rate, providing much-needed
oxygen to the brain and muscles to prepare them for action. Your overall body metabolism
speeds up. Non-essential bodily activity, such as digestion and immune function, are
temporarily suppressed so that body can focus all its energies on dealing with the task at
hand.

7
Symptoms of Stress and Anxiety
The changes in your body that occur as the result of the presence of a stressor
(that is, something that produces stress) produce all the symptoms that we associate with
being stressed or anxious. These include:
 Fast heart rate or palpitations
 Dizziness
 Nausea or butterflies in the stomach
 Sweating
 Trembling
 Numbness or tingling
 Chest pain
 Pulsing in the ears
 Burning skin
 Shortness of breath
 Weakness or wobbliness in the legs
What Is Stress? Its Impact on Health
Our bodies are designed to take the “hit” of short-term stress and anxiety. We
adapted for an environment where we might have to run from a hungry animal or work hard
to obtain food to feed ourselves and our families. What our bodies are less able to handle is
long-term stress and anxiety, the kind of stress that eats away at you over months and years.
This is the kind of stress that, if you don’t learn to manage it, can promote poor health.
Stress pushes the cardiovascular system to work harder, getting oxygen-rich
blood to the brain and muscles in times of need. When this stress response is continuous or
when it keeps being triggered over and over every day, it can cause excessive wear and tear
on your heart and blood vessels. Long-term ongoing stress can increase the risk of high
blood pressure, heart attack, and stroke.
Stress causes the muscles to tense up, making them ready for action. But
chronically tense muscles can lead to tension or migraine headaches. It can also lead to pain
in your neck, shoulders, back, or wherever you happen to store your tension.
Your hormonal or endocrine system is also vulnerable to chronic stress or
anxiety. Constant release of stress hormones triggers your liver to release sugar into the

8
blood. It’s another way your body provides the energy needed to fight off or flee danger. But
for some people, all that extra sugar can increase the risk of developing type 2 diabetes.
Many people feel the effects of stress and anxiety in their stomachs. Anxiety
attack symptoms include stomachaches, diarrhea, heartburn, and a host of other
gastrointestinal (GI) complaints that stem from too much uncontrolled stress or anxiety.
Your immune system also takes a hit from chronic stress and anxiety. Your
body diverts its energy away from the immune system while it prepares to fight or flee the
perceived danger at hand. It’s not unusual to find that you get sick more often or take longer
to get over illnesses when you are stressed or anxious a lot of the time.
Chronic stress appears to contribute to the production of all-over
inflammation in your body. This can trigger or worsen illnesses in which inflammation plays a
key role, including asthma, heart disease, arthritis, depression, and autoimmune conditions
like multiple sclerosis and lupus.
Finally, all that energy spent worrying and unconsciously preparing to fight can
leave you feeling drained. Chronic fatigue is a common effect of being constantly stressed or
anxious.
II. ANXIETY DEFINITION, CONTINUED…
When anxiety goes beyond the normal worries and concerns of everyday life,
when it is intense or frequent enough to cause significant distress and affect your ability to
function and enjoy your life, you may have an anxiety disorder.
Let’s look at the main features of some of the most common anxiety
symptoms.
Generalized Anxiety Disorder (GAD)
Someone with GAD feels excessive anxiety or worry about a wide array of
activities or events (or potential events). The level of anxiety is out of proportion with the

9
actual risk. So, for instance, someone with GAD might be sick with worry about going
canoeing for fear of drowning, even if she is wearing a lifejacket, knows how to swim, and is
accompanied by a lifeguard.
Typically, people suffering from GAD find it difficult to control their worries,
and worrisome thoughts become so intrusive that they find it difficult to get on with the
everyday tasks of life. A mother, for instance, may worry so much about the risk of car
accidents that she finds herself unable to pick her child up from school.
Concerns that are only mild annoyances for some, such as good job
performance, getting chores done, or being late for appointment, can be overwhelming for
someone with GAD. The specific things that a person with GAD may worry about can change
from time to time. What remains constant is the tendency to worry excessively.
According to the 5th edition of the Diagnostic and Statistical Manual of Mental
Disorders (DSM V), the anxiety and worry associated with GAD manifest as three or more of
the following six anxiety symptoms:
 Restlessness or feeling keyed up or on edge
 Being easily fatigued
 Difficulty concentrating or mind going blank
 Irritability
 Muscle tension
 Sleep disturbance
Separation Anxiety
Typically affecting children, separation anxiety occurs when they experience
excessive fear or worry upon leaving home or separating from those they are most attached
to, often their mother or other parent or primary caregiver. Most young children show at
least some hesitation or distress when separating from a parent, and it’s pretty normal for
young children to cry when being dropped off at daycare or preschool. A child with
separation anxiety, on the other hand, will be far more upset than other children their age
when facing the same type and duration of separation.
A child with separation anxiety may cling to his mother even when she is
present and refuse even to be in a different room from her or let her out of his sight.

10
Bedtime can be a particularly difficult time, and the child may refuse to sleep alone or at
least fall asleep while alone. For older children, refusal to go to school or experiencing
significant anxiety while at school due to separation can affect academic performance. While
some children go through phases of being deeply distressed when they separate from their
primary caregiver, a child with separation anxiety will express this distress consistently over
weeks or months.
Other features of separation anxiety listed in the DSM V include:
 Worrying that some type of harm may come to their primary caregiver
 Worrying that something will occur (e.g., kidnapping) that will separate them
from their primary caregiver
 Refusing to go places because of fear of separation
 Refusing to sleep away from home without their primary caregiver
 Recurrent nightmares about separation
 Recurrent physical complaints, such as stomachaches, associated with
separation or anticipated separation
Phobias
A phobia is an intense fear related to a specific situation or object. It is out of
proportion with the actual risk present. Fear of spiders, known as arachnophobia, is a classic
and common phobia. While most house spiders are perfectly harmless, few people would be
willing to let one crawl onto their hand and many rush out of the room in terror when they
see one, even if they know for a fact it is not dangerous.
Phobias are extremely common and generally pose no significant challenges to
everyday life. A fear of snakes is not generally going to keep you from doing your job, taking
care of your children, or having drinks with friends. But phobias do pose a problem when
they are directed at objects or situations that are difficult or inconvenient to avoid in
everyday life. Phobias of thunderstorms, heights, or elevators are some common examples.

11
Fear of, say, spiders may be a harmless phobia, but if the sight of elevators elicits panic in
you, you may have an unhealthy phobia—one that may cause problems in personal or
business life
or emergency situations.
Some people also suffer from several phobias, which together can severely
limit their life.
Others have severe phobias that prevent them from doing things they really
need to do. For instance, fear of injections can prevent people from accepting needed
medical therapy or fear of elevators can prevent people from going places they need to go in
order to do their jobs. In these cases, the fear is so overwhelming, it overshadows very real
and rational concerns about not receiving needed treatment or losing one’s job.
People with phobias know their fears are irrational. Telling them that a spider
is not dangerous or that it is “probably more frightened of you than you are of it” is of no
help whatsoever. They may, however, associate greater risk associated with their feared

12
object than is realistic. People who fear flying, for instance, may believe it is actually more
dangerous than it really is.
Panic Attack Symptoms
If you’ve never had a panic attack, it may not be possible for you to imagine or understand how
intense they can be. When you are having a panic attack, your whole body is in five-alarm mode,
convinced that you are in life-threatening danger.
Panic attacks usually start abruptly, with a sudden surge of overwhelming, intense fear that peaks
within seconds or minutes. They can come seemingly from nowhere. In fact, some people have panic
attacks upon waking from sleep or while in a deeply relaxed state.
Symptoms of a panic attack can include any of the following:
 Pounding heart or palpitations
 Ringing in the ears
 Sweating, sometimes profuse
 Trembling or shaking
 Feeling like you are choking or not getting enough air
 Difficulty controlling your breathing
 Chest pain or discomfort
 Nausea or abdominal distress
 Feeling dizzy, lightheaded, faint, or unsteady on your feet
 Feeling very hot or cold (or alternating between the two)
 Numbness or tingling in the extremities
 Feeling detached from yourself or reality, like you’re in a dream
 Feeling like you are losing control or going crazy
 Intense feeling that you are about to die
While an individual panic attack usually lasts only a few minutes, some people experience episodes of
repeated panic attacks that can last for hours, with intense feelings of anxiety in between.
Panic Disorder
Panic disorder occurs when people experience recurrent or unexpected panic
attacks. The frequency and severity of such attacks varies widely, from several attacks daily
to the occasional mild attack every few weeks or months. An important characteristic of the
condition is that people fear having another attack and may avoid objects or situations that
they think may provoke one. There are many reasons why fear of panic attacks develops.
The attacks themselves are decidedly unpleasant and often make people feel like they are
dying, going crazy, or losing control.

13
People may also fear the social embarrassment associated with panic attacks,
worrying that they may do or say something seemingly “crazy” during an attack or behave
inappropriately out of a need to escape a situation producing an attack (e.g., walking out in
the middle of a dinner party or important meeting). As a result, people with panic disorder
may turn their lives upside down in an effort to avoid things that may trigger panic or
situations they cannot easily escape from. Some may refuse to leave their homes, resulting
in another anxiety disorder known as agoraphobia.
Agoraphobia
Agoraphobia is the fear of being exposed to any situation that produces
significant anxiety or panic. Such situations include taking public transportation or airplanes,
going over bridges, using highways, being in very open or enclosed spaces, being in crowds,
or simply being outside of the home alone.
Generally, the more difficult it is to escape the situation, the greater the
likelihood it will produce agoraphobia. In addition to feeling significant anxiety in such
situations, people with agoraphobia often worry that something terrible might happen (e.g.,
the cruise ship might sink) or that they will be unable to escape or have no one to help them
should panic set in.
Because of their anxiety, people with agoraphobia actively avoid certain situations, and their
fear of these situations is out of proportion with any actual risk that might be present.
Social Anxiety Disorder (SAD) or Social Phobia
People with SAD have an intense fear of social situations, especially if they
believe they will be judged or scrutinized by others. So, while a party may produce anxiety, a
party in which the person is the guest of honor might produce anxiety so overwhelming it
becomes difficult to even enter the room.
While many people feel nervous or awkward in social situations, especially if
they do not know the people present, people with SAD can be so overwhelmed with anxiety
that they avoid social situations of all kinds. For some, even going to school or work can be a

14
major challenge. When they are able to force themselves into social situations, people with
SAD are frequently so paralyzed with fear that they cannot enjoy themselves or even
function normally.
Often, people with SAD worry excessively that others will see them in a
negative light, perceiving them as anxious, weak, crazy, boring, stupid, awkward, or
otherwise unlikable or offensive. Their anxiety feeds into the disorder, since a common
concern is that their fear will be obvious to others. While some judgment of others does
occur in social situations and people with SAD do typically appear nervous in social
situations, their fear of negative judgments is out of proportion with the amount of
judgment that is likely to be really going on.
Obsessive Compulsive Disorder (OCD)
While OCD and related disorders have their own category in the DSM V
separate from other anxiety disorders, excessive anxiety remains a key feature of this
condition. People with OCD have repetitive and persistent thoughts (obsessions) that are out
of their control and cause significant distress and anxiety.
A common obsession in OCD is fear of contamination. In order to relieve the
anxiety produced by these thoughts, people with OCD engage in compulsive behaviors, such
as repetitive hand-washing. If they try to stop these compulsions, the obsessive thoughts
and their accompanying anxiety rapidly become unbearable, no matter how much they may
try to ignore or suppress them. Often the compulsive behaviors must be performed
according to strict rules in order to relieve the distress, and these rules may change over
time. So, for instance, a person obsessively worried about carrying germs on his hands may
need to wash his hands for 10 minutes with antibacterial soap but over time, this may
increase to 15 minutes and require the use of a specific brand of antibacterial soap.
Once a compulsive behavior is performed, a person with OCD will temporarily
experience relief, but very soon the anxious obsessions will intrude once again, and he will
have to start over. OCD can quickly take over people’s lives, forcing them to literally spend
hours a day washing their hands or engaging in other compulsive behaviors.

15
Post-Traumatic Stress Disorder (PTSD)
PTSD is another disorder associated with significant, overwhelming anxiety
that is not officially categorized as an anxiety disorder. Instead, it is included in another
category of disorders known as trauma and stressor-related disorders.
In PTSD, a trauma causes people’s natural stress response to go out of whack.
They may find themselves constantly in a state of fight or flight or they may be very easily
brought to this state. The classic example is the war veteran who is immediately driven into
fight or flight every time he hears a loud noise because it brings him back to the trauma of
war. Understandably, people with PTSD avoid objects and situations that may trigger
memories of traumatic events and thus produce the overwhelming fear, anxiety,
helplessness, or horror they experienced in the past.
Anxiety Associated with Medical Conditions
There are several medical conditions that produce biological changes in the
body that can result in anxiety. These include:
 Heart disease
 Diabetes
 Anemia
 Infection
 Thyroid problems, such as hypothyroidism or hyperthyroidism
 Asthma
 Irritable bowel syndrome and other types of gastrointestinal distress
 Some rare forms of cancer, which stimulate the release of stress hormones
 Premenstrual syndrome
It can be difficult to determine whether there is an underlying medical cause
for your anxiety. You may not be having any symptoms other than anxiety itself. That’s why
it’s important to see your doctor if you experience a surge in your anxiety that does not
appear to have any identifiable cause.
Of course, the stress of being seriously ill can also produce anxiety. It is pretty
normal to feel excessive anxiety if you are diagnosed with a serious disease. That doesn’t
mean you have to suffer in silence, however. Your doctor should be able to prescribe
treatments to help relieve your anxiety while you come to terms with your diagnosis.

16
In other cases, people with medical illnesses may experience anxiety as a side
effect of the medication they are taking. Some of the medications most likely to produce
anxiety as a side effect (either while you are taking it or for a period after you stop taking it)
are:
 Asthma medicines (e.g., albuterol)
 Blood pressure medicines (e.g., methyldopa)
 Hormones, including oral contraceptives
 Steroids (e.g., prednisone)
 Thyroid medicines
 Antidepressants (especially when first taking or stopping them)
 Decongestants (e.g., pseudoephedrine)
 Drugs containing caffeine (including some headache tablets and weight loss
preparations)
 Stimulants (including those taken for attention deficit/hyperactivity disorder)
Drugs that are used to treat anxiety, such as the benzodiazepine class of drugs
(e.g., Valium, Xanax), can also have the opposite effect and produce anxiety. This is most
likely to occur if the drugs are used improperly or for too long. That’s why it’s important to
follow your doctor’s instructions carefully if you are prescribed an anxiety-relieving drug.
Anxiety Associated with Substance Abuse
Just as with medications, several illicit drugs can produce anxiety. It is also
quite common to experience significant anxiety while undergoing withdrawal from a
substance of abuse, including alcohol. Drugs of abuse that can cause anxiety include:
 Cocaine
 Crystal meth
 Marijuana
 Speed
 Alcohol
 Ecstasy (MDMA)

17
III. DIAGNOSING STRESS AND ANXIETY
As mentioned previously, everyone experiences some degree of anxiety and
stress. If you didn’t, you wouldn’t bother to get out of bed in the morning. But some of us
reach a point in our lives when stress and anxiety start to get out of control. Maybe a loved
one has died. Perhaps you’ve lost your job or need to move. Even positive changes, like
marriage, promotion, or the birth of a much-wanted child, can produce enormous stress.
This added stress may be more than you can cope with, at least temporarily.
For others, anxiety may appear seemingly out of nowhere, with no clear
source of new stress. Maybe you woke up one morning with a panic attack or found yourself
beginning to worry excessively about your health or the safety of those you love.
Whatever your story, if you start to find that stress and anxiety are affecting
your quality of life, if you just aren’t able to enjoy the things you once did because of
intrusive worries or anxiety symptoms, it’s time to talk to your doctor. Don’t hesitate, as left
untreated, anxiety disorders often get worse and harder to treat.
Dealing with Anxiety Attack Symptoms: Mindfulness Exercises
If you’d like to see if mindfulness meditation is something that you can use as a tool against your
stress and anxiety, try the following simple mindfulness exercise:
1. Find somewhere quiet and comfortable to sit.
2. Close your eyes and take deep, slow breaths.
3. Gently, pay attention to your breath is as you breathe in and out.
4. If you are distracted by a noise, feeling, or thought, simply acknowledge it without judgment.
Naming it in your mind helps. Then gently bring your attention back to your breathing.
The key to mindfulness is to be gentle with yourself. It’s normal for your mind to wander or for you to
become distracted. In fact, gently bringing your mind back to your breathing is the practice. In other
words, without your mind wandering or becoming distracted there is no practice. So, be kind to
yourself. Don’t get frustrated or discouraged when your mind wanders, and bring yourself back to
your breathing gently, without force.

18
Talking to Your Doctor
Talk to your doctor about the anxiety symptoms and stress symptoms that are
negatively affecting your life. You can be sure that you’re not the first to need help and
certainly won’t be the last. In today’s world, problems with anxiety and stress are reaching
epidemic proportions, so there is no need to be ashamed or embarrassed. We all need a
little help now and then coping with life’s curve balls.
Once you’re ready to talk with your doctor about your anxiety and stress, it’s a
good idea to come to your appointment prepared to answer the following questions:
 What is an anxiety definition and a stress definition?
 What are your symptoms?
 How long have you been experiencing these symptoms?
 How do these symptoms affect your daily life?
 Have you experienced any significant life change (good or bad) recently?
 What are the sources of stress in your life?
 How do you like to relax?
 What do you do for fun?
 Is there anyone in your life you feel comfortable confiding in?
 Do you feel as though you may have a social anxiety disorder?
 Do you believe you may have had panic attack symptoms?
Diagnostic Questionnaires
Your doctor may also ask you to fill out some standard questionnaires
designed to help diagnose anxiety problems and evaluate how severe it is. Some common
questionnaires include:
 Generalized Anxiety Disorder 7-item (GAD-7) scale
 Hamilton Anxiety Rating Scale (HAM-A)
 Zung Self-Rating Anxiety Scale (SAS)
 Primary Care PTSD Screen (PC-PTSD)
 Life Event Checklist (LEC)
 Patient Stress Questionnaire
 State-Trait Anxiety Inventory (STAI)
 Beck Anxiety Inventory (BAI)
 Hospital Anxiety And Depression Scale-Anxiety (HADS-A)
Some doctors use their own rating scales that they or the medical center they
work with have developed. You may be asked to fill out these questionnaires on your own or
a doctor or nurse may ask the questions while you provide the answers.

19
Anxiety Tests and Diagnostic Tests
In addition to questionnaires and rating scales, your doctor may order some
diagnostic tests. Typically, these are to ascertain that your symptoms are caused by anxiety
and not an underlying medical condition. Tests your doctor might order include:
 Thyroid function test
 Blood levels of iron and sugar
 Glucose tolerance test
 Lung function test
 Electrocardiogram (ECG) to evaluate the electrical activity of your heart
 Endoscopy to look for stomach issues
Your doctor may order several tests or no tests at all. This all depends on the
symptoms you have, your medical history, and your risk factors for other illnesses. Don’t
hesitate to ask your doctor why he or she chose to order certain tests and not others.

20
IV. MANAGING STRESS AND ANXIETY
Once you have confirmed with your doctor that your symptoms are indeed
caused by stress and anxiety, it’s time to look for solutions. There is no magic pill that makes
anxiety disappear, but there are several ways to control stress and treat anxiety so that you
can go back to feeling like yourself again. Let’s start with the things you can do right now to
help yourself feel better. Next, we’ll explore how a professional can help you even more if
you’re not able to cope on your own.
Making Changes
Often, symptoms of uncontrolled stress and anxiety are your body’s way of
telling you that your life is out of balance. You may not be able to really feel like yourself
again until you make some substantial changes.
Take a look at your life. What is really important to you? What can you let go
of? Are you doing too much? Expecting too much from yourself? If you’re not sure where to
start with some of these questions, you may benefit from talking with a professional. We will
explore the role of therapy in managing stress and anxiety in Chapter 5 (below). In the
meantime, here are some stress and anxiety busting tools you can try.

21
Among the popular stress relievers is yoga, which incorporates deep breathing with
meditation. See below.
 Breathing exercises: Probably the No. 1 thing you can do to relieve stress
and anxiety is to learn breathing exercises. When you are anxious, you
naturally take quick, shallow breaths. This actually worsens your anxiety and
creates a vicious cycle that can lead to a panic attack. You can counteract this
by consciously breathing deeply and slowly.
 Guided imagery: You can ramp up the relaxation response by combining
calm breathing with guided imagery exercises. To try guided imagery, find a
quiet place and visualize a relaxing setting, such as sitting quietly by a calming
river or relaxing on the beach with the sun on your face, while breathing slowly
and deeply. Guided imagery usually works best if the guide—the person who
describes the scene—is someone other than yourself, especially when you are
first trying it. A therapist can act as a guide, but if you don’t have one, there
are several guided imagery audio recordings available online, and many of
them are free. Once you practice a few times with the help of a guide, you will
likely find that you can bring yourself into a relaxed state on your own.
 Deep relaxation: Similar to guided imagery, deep relaxation involves following
along with a guide who talks you through relaxing your whole body, moving
from one body part to another. It is often combined with guided imagery in that
after your body is relaxed, you may imagine yourself in a calm and soothing
setting. As with guided imagery, deep relaxation audio programs are
frequently available online free of charge. Both of these techniques work best
if your practice them regularly, not just when you’re feeling anxious. That way,

22
your body learns how to relax and you can call up the memory of that
relaxation when you need it, such as when someone cuts you off in traffic.
 Meditation: Another technique that incorporates deep breathing to help you
relax is meditation. Meditation refers to any of many contemplative exercises
that help you learn to rest your mind. There are many meditation techniques
available, but probably the most studied for the purpose of improving mental
health is mindfulness meditation. Based partly on Buddhist teachings,
mindfulness meditation involves sitting quietly and acknowledging your
thoughts, feelings, and sensations without judgment.
 Yoga and Tai Chi: While all exercise is helpful for controlling stress and
anxiety, you may find yoga and Tai Chi particularly beneficial because they
also incorporate deep breathing and meditation. While yoga practices vary
widely, it is essentially an ancient Indian practice involving stretching and
holding certain poses while breathing deeply. Similarly, Tai Chi is an ancient
Chinese practice that involves coordinating deep breathing with slow
movements. Look for local, inexpensive yoga and Tai Chi classes. Many
community recreation centers offer them. You can also check online for
instructional videos, but it’s usually best to start out with a live teacher, who
can make sure you are practicing correctly and not in danger of hurting
yourself.
 Controlling negative thought patterns: When anxiety and stress start to get
the better of you, it’s easy to fall into a negative spiral of fear in which you
associate certain places or situations with anxiety and worry constantly about
your health, safety, and success. On the road to recovery, it’s important to
recognize and break these patterns. You may need the help of a professional
therapist to do this, but it’s worth trying to work on this on our own as well. The
first step is to recognize negative thoughts when they occur. Any thought that
creates a negative body reaction—feelings of tension or fear—is a negative
thought. These include thoughts like I’m going to die, I’m not good enough, or I
can’t do this. You can recognize these thoughts by the effect they have on
your body, making you tense up, increasing your heart rate, or making you
sweat or feel nauseous. That’s when you try to break the cycle. First, realize
that these are your thoughts and you have control over them. Allow yourself to
release the negative energy and replace the thought with something positive,
like I’ve been through this before and survived, I’m as good and valuable as
anyone else, or I can try, and it’s ok to fail sometimes. Feel the difference in
your body as you replace the negative with positive.
 Making lifestyle changes: There’s no escaping it. A healthy body promotes a
healthy mind. There is plenty of evidence that exercising regularly and eating
well will help relieve anxiety. You may feel like hiding in your home, watching
TV, and munching on chips, but over the long term this will make you feel
worse. Start with baby steps. Replace those chips with apple slices or carrots.
Take a relaxing walk in a quiet park. Find what exercise you like and stick to it.
If you can find a buddy to do it with you, that’s ideal. Switch packaged foods
for fruits and veggies. Don’t deny yourself your favorite treats, but save them
for special occasions. In particular, you might find it beneficial to avoid sugar,
as this can lead to rebound low blood sugar levels, which can produce anxiety
symptoms. It’s also a good idea to limit caffeine intake, since it is a stimulant
and can trigger anxiety. Caffeine can be found in coffee, tea, cola, chocolate,
and many weight loss or energy supplements. Drugs and alcohol can also

23
trigger anxiety, so seek professional help if you find yourself unable to limit
these or give them up altogether.
 Manage your stress: Every life has stress. The key is to manage it before it
takes over. A healthful diet and regular exercise routine are integral to stress
management. Most people also do better with a regular routine of eating,
sleeping, and exercise. Some other techniques for managing stress include
learning to say “no,” both at work and in your personal relationships. If you
have relationships that cause you far more stress than happiness, maybe it’s
time to re-think them. Determine your personal boundaries and stick with them
without shame or guilt.
Some people find relief with journaling. Pick up a blank diary and see if writing
down your thought and feelings helps you feel less burdened. Sometimes seeing what you’re
thinking and doing written down on paper helps you identify where you might make some
changes. This is just for you. There is no need to show it to anyone. That way you can be
completely honest about what you write. Don’t hold back. The point of the exercise is to get
everything out on the page so you no longer have to hold onto it in your head. It’s not about
being right or wrong or good or bad. It’s just about release.
While journaling is a solitary activity, it’s important that you not let yourself be
isolated all the time. Even if your anxiety is triggered when you are around other people, it’s
very important for mental health to have social connections. You don’t need to surround
yourself with admirers. Just having one or two people that you feel comfortable with and
can talk to about your problems with can be very helpful. Reach out to family, friends, a
member of the clergy, or a professional therapist if you are feeling isolated. If you’re not
ready to talk face-to-face, look for online anxiety support groups, but make it a long-term
goal to develop real-life connections as well.
If you’re not used to unburdening yourself to others, it’s time you learned to
communicate about feelings. Ironically, the first step to good communication is to take the
time to really listen to other people. Pay attention to both what they are saying and how
they are behaving.
Acknowledge what you hear and observe. This sets the stage for good rapport.
When it’s your turn, explain how you have been feeling and what you think the triggers are.
Be careful not to lay blame on the other person. This is about you and only you. Ask for help

24
and advice. Be clear about your needs without being confrontational. If you continue to
struggle with communication, a professional therapist can help you.
V. SEEKING PROFESSIONAL HELP
Sometimes all the self-care in the world isn’t enough, and you need to seek
help from a professional for your stress and anxiety. Whether you have been diagnosed with
an anxiety disorder or just feel like you can’t cope, therapy can be extremely beneficial.
Don’t hesitate.
If you haven’t tried a counseling or therapy session to work through stress and anxiety,
consider taking the time to try. See below for tips on how to choose among the many different
types of specialized therapists.
If you have never visited a therapist before, it may seem daunting, but it’s
actually very commonplace and quite simple. Most of the time, you’re just sitting and talking
with another person who is there to help, or with a group of people who understand what
you are going through, if you choose a group therapy approach.

25
Choosing a Therapist
 Ask your doctor for a referral
 Ask friends or family if they can recommend someone
 Check the Anxiety Disorders of America (ADAA) website for a local therapist
 Look for someone who specializes in what you are suffering from (e.g., social anxiety,
OCD, panic). Don’t be shy to ask therapists about their specific areas of expertise or focus
 Check credentials. Did this therapist go to a reputable school? Is he or she accredited by
respected medical or psychological organizations (such as the American Psychological
Association)? Is he or she affiliated with a respected university or hospital?
 Meet once with the therapist to see if you have good rapport. No matter how well-trained a
therapist is, if you don’t feel comfortable, then it’s not a good fit.
 Remember that therapists vary tremendously in their training and approaches. You don’t
have to stick with the first person you see. Shop around, if you need to, to find someone
you can trust. Remember, only medical doctors or nurses with certain types of training can
prescribe medication, but therapists can work with doctors or nurses to prescribe
medication, if it is needed.
Choosing a Therapist
Generally, your best bet for choosing a therapist is to ask for your doctor for a
referral. (See box, right) You may also need to check with your insurance company to find
out which types of therapy, if any, are covered under your health care plan. There are many
types of therapy that are particularly good for treating stress and anxiety. These are
described below.
 Cognitive behavior therapy (CBT):In CBT, a therapist helps you identify and
change negative thoughts (i.e., cognitions) and behaviors that are contributing
to your anxiety. For instance, imagine that every time you go to work, you get
stressed out by traffic. By the time you reach the office, you’re so wound up
that you have a panic attack. Pretty soon, you’re scared to go to work because
you associate it with panic. A CBT therapist’s job would be to help you first
identify this pattern, then make changes to break it. You might learn deep
breathing exercises you can use during traffic pileups or you might simply
learn to accept that delays are unavoidable and that you will get there when
you get there. More deep breathing can be helpful to break the connection
between panic and the office setting. You might also learn to avoid that
morning coffee and instead do 2 minutes of meditation at your desk before
starting your day.
 Exposure therapy: Exposure therapy goes hand-in-hand with CBT.
Frequently, certain situations or things become associated with fear so intense
that it’s impossible to simply face it head-on. In fact, doing so can make things
worse. To continue the example from above, you might have panic attacks at
work that are so severe that you become afraid to go to work. Forcing yourself
through the door only produces wave upon wave of panic that leaves you
dizzy, nauseous, and trembling. In such a case, exposure therapy can be
helpful to gradually re-introduce you to the office environment with little or no
fear. You might start simply by talking about the office. At the same time, you

26
would practice breathing and deep relaxation techniques that counteract the
anxiety this causes. Once you’re comfortable talking about the office, you
might look at a picture of it, or start the drive over to it. Again, you only push
yourself as far as you can cope, all the while practicing strategies that reduce
your fear. After a few weeks, you should be able to walk through the door with
levels of anxiety that you can manage, and eventually you should be able to
go there anxiety-free.
 Interpersonal therapy (IPT): IPT aims to unpack the interpersonal issues that
may be contributing to your stress or anxiety. Perhaps you never felt cared for
by your parents, leading to a lifetime of feeling unsafe. Perhaps your
relationship with your spouse is unstable and leading to constant stress.
These are the kinds of things an IPT therapist can help you uncover and work
through.
 Acceptance and Commitment Therapy (ACT): ACT therapy borrows from
Buddhist tradition to help you learn to accept how things are and live in the
moment. That doesn’t mean that you should not make an effort to change,
only that change is not possible without first seeing and accepting reality as it
is. For instance, before you can repair a troubled relationship with your
mother, you must first accept feelings you may have that she failed to care for
you properly as a child. Denying those feelings actually impedes positive
change, and it serves no purpose to beat yourself up about them. An ACT
therapist will help you first to recognize and accept your thought and feelings
without judgment and then commit to making positive changes in your life.
 Dialectical Behavioral Therapy (DBT): Like ACT, DBT also incorporates
Buddhist principles of mindfulness and acceptance. A DBT therapist will help
you learn to recognize and tolerate negative thoughts and feelings without
judgment. You will also learn skills to improve your interpersonal relationships
and regulate your emotions. While on the surface ACT and DBT sound quite
similar, the techniques and approaches used to achieve results are often very
different.
 Eye Movement Desensitization and Reprocessing (EMDR): EMDR can be
very effective to reduce the fear and anxiety associated with a specific
memory or thought. An effective therapy for uncomplicated PTSD, a person
makes very specific, rapid eye movements with the guidance of a professional
while remembering a distressing event. These eye movements appear to help
the brain process the distress, eventually reducing it.
 Other Approaches: There are several other approaches to managing stress
and anxiety that you might want to explore. Biofeedback, for instance, involves
learning to control your body’s own response to stress and relaxation in order
to calm yourself. Biofeedback techniques include listening to your own heart
rate and trying to slow it down. You can also use a device that measures how
much sweat your fingers are producing (known as electrodermal activity or
EDA), as sweating is a sign of arousal.
A newer form of biofeedback is called neurofeedback, in which you are hooked up
to a computer that measures your brain waves. The computer produces signals that
indicate when your brain waves are reaching a state associated with relaxation, and
you then try to reproduce this state. For instance, the computer might show a still
image of an airplane while you are anxious, and the airplane might begin to move as

27
your brain waves transform toward a more relaxed brain state. Your job would then
be to keep that airplane moving.
If you have severe anxiety that does not respond to standard treatment,
including medication, there are some brain stimulation techniques that are showing
promise. Some of these techniques involve implanting electrodes directly into the brain
while others require only that the stimulation be placed on the scalp in order to reach the
brain. While these techniques can be very effective, they are generally reserved for severe
cases that cannot be effectively treated any other way.
Anti-Anxiety Medication
While therapy can go a long way toward relieving stress symptoms and anxiety
symptoms, some people need the added boost that anti-anxiety medication can provide.
The type of medication prescribed depends largely on how it is to be used in your recovery.
Some medications work by making your body relax so that your mind will follow. These are
useful for providing rapid relief during a period of intense anxiety but are not beneficial, and
may even make things worse, if used long-term. Most often, drugs used for short-term relief
of anxiety are members of the benzodiazepine class of drugs, which includes diazepam
(Valium), alprazolam (Xanax), and lorazepam (Ativan).
Other medications can be helpful when anxiety is a chronic, ongoing problem.
They produce changes in brain chemistry that make anxiety reactions less likely. These
include:
 Selective serotonin reuptake inhibitor (SSRI) antidepressants: these include
fluoxetine (Prozac), paroxetine (Paxil), and sertraline (Zoloft)
 Other types of antidepressants: including venlafaxine (Effexor), bupropion
(Wellbutrin), duloxetine (Cymbalta), amitriptyline (Elavil), imipramine (Tofranil),
and nortriptyline (Pamelor)
These drugs will not work unless you take them daily, as prescribed. You won’t
feel better if you pop one of these pills whenever you feel your anxiety ramping up. In fact,
such use of these drugs may make you feel considerably worse. That’s because you need to
reach a steady blood level in order to feel better, and the increase or decrease in blood
levels that accompany starting or stopping these medications may make you temporarily

28
feel worse. That’s why doctors sometimes temporarily prescribe a benzodiazepine to take
for a few days or weeks when you are starting a new medication for anxiety.
Natural Remedies
There are a host of over-the-counter natural remedies for anxiety and stress.
Talk with your doctor before trying any of them, as they may interact with medication you
are already taking for anxiety or other conditions. Also, be aware that most natural remedies
have not been as well-studied as medications, nor is the natural remedy industry as well-
controlled as the pharmaceutical industry. Some studies suggest that natural remedies may
not even contain the ingredients listed on their labels.
Many remedies that produce relaxation also make you sleepy, so don’t drive a
car or operate heavy machinery until you know how it affects you. If you would like to try a
natural remedy for your stress or anxiety, these are some of the most promising ones:
 Chamomile
 Lavender (the smell of lavender alone helps some people)
 Tryptophan
 Melatonin
 Hops
 Valerian root
 Kava
 Lemon balm
 Passionflower
 Omega-3 fatty acid supplements

29
VI. HOW TO DEAL WITH ANXIETY AND STRESS
Left unchecked, anxiety and stress can wreak havoc on your mental state, your
physical health, and your life. No one wants to spend their time feeling stressed, worried,
exhausted, and unsafe. It’s no way to live. The good news is, no one has to live that way. In
today’s fast-paced and competitive modern world, problems with stress and anxiety have
reached epidemic proportions. That’s the bad news. The good news is that experts in all
areas of health, lifestyle, and medicine are always on the lookout for solutions, and so far
they have uncovered several.
With a little research, you can find solutions for your stress and anxiety.
Whether you need more exercise, a better diet, a stronger social network, breathing
exercises, yoga, or support from a professional, with so many options available for the
management of stress and anxiety, you are sure to find something that helps you.
Often, people experience the greatest relief by trying more than one thing.
Don’t get discouraged. This is not a problem that popped up overnight, and it’s not a
problem that will disappear just as quickly. Controlling stress and anxiety is a learning
process that takes time, but there are strategies that anyone can learn. Breathe easy. Help is
available for you.

Panic attack symptoms and anxiety symptoms

Recommended

Recommended

More Related Content

What's hot

What's hot (19)

Similar to Panic attack symptoms and anxiety symptoms

Similar to Panic attack symptoms and anxiety symptoms (17)

Recently uploaded

Recently uploaded (20)

Panic attack symptoms and anxiety symptoms