Anxiety: Get the right treatment or self help, based on your symptoms.

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This is a very long and detailed article on anxiety and its purpose is to not only explain anxiety to you, but show you how to choose the correct treatment based on your own symptoms of anxiety.

I will be talking to you about the cause of your anxiety, the symptoms of anxiety and shall also cover anxiety treatment and self help. If this is your first time on my site, my name is Elaine (I’m the psychologist behind MoodSmith) and had anxiety myself in the past.

This page will talk about

anxiety dr Your brain and the different pathways that create anxiety,
How your brain learns to be anxious,
Your symptoms and where they come from,
The various treatments available for anxiety, and how to select the best anxiety treatment for you.

What is Anxiety?
What causes Anxiety?
Your 3 brains and the Science of Anxiety

How your brain learns and the function of automatic processes
What are you teaching your brain?
Your anxious brain
Your stress and relaxation response

Anxiety Symptoms
Anxiety Treatment and Self Help
How do I know what type of Anxiety Disorder I have?
Generalised Anxiety Disorder
Social Anxiety
Panic Attacks
Agoraphobia
Phobias
Health Anxiety
OCD
What is Anxiety?
Anxiety is the response you get when your brain detects a ‘threat.’ Once a threat is detected, your stress response is activated, and it is this ‘stress response’ that gives you the uncomfortable feelings in your body, and causes your mind to race.
In order to understand what anxiety is, I find it useful to draw from evolutionary psychology as it allows me to see that anxiety is an adaptive response that should be useful, but our intelligence gets in the way! Let me explain.
In the very short video above, I start by showing you how your brain should respond when it detects a threat. Threat detected, brain gives you the energy to prepare for danger and you calm down when the threat has passed.
If you think how we have evolved over time, we were once prey to other bigger, faster animals.
Those early humans who could detect ‘threats’ quickly and respond appropriately were more likely to survive, and therefore more likely to pass on their adaptive ‘threat detection system’ to their children.
As we evolved, we lost the threat from predators, but kept our threat detection system. It’s like we still have this primitive threat detection system, but are now using it to detect threats in the office, or wherever we happen to be!
The system that helped primitive man out when he was under threat, being chased by a large predator, is the same system that is reacting to modern day ‘threats’ such a feeling under pressure at work!

How does this threat detection system create anxiety?
In primitive man, the stress response is activated once a threat (predator) is detected. The stress response gives him the energy to fight the predator or run away – hence why we talk about the fight or flight response.
Once he is out of harms way, his body calms down again. This quick burst of energy, in my mind is not anxiety, rather it is more akin to fear and this is an important difference, as I shall explain now.
Modern day man detects a threat, such as worrying about money and his stress response gets activated. He still gets this big burst of energy, but what he is now experiencing is anxiety, as opposed to fear.
Fear is where there is a real danger present ( a real threat ) and anxiety is where you are worried about a ‘threat’ that may occur in the future.

What causes Anxiety?
There are different pathways in your brain that can result in the anxiety you experience, but each involve an alarm bell being set off to activate your stress response. I touch on the pathways in the video below.
The alarm bell can be activated by a ‘thinking’ route, where your thoughts and worries can make you anxious, and by a quicker route, where your brain remembers to be anxious.

Would you like my help?
Retrain Your Brain: Anxiety Masterclass
I have an online course that is available to start now
Find out more

Your 3 brains and the science of anxiety
I FEEL ANXIOUS
for no reason
read about your reptilian brain

in the same situations
read about your mammalian brain

in my thoughts and worries
read about your thinking brain

For those of you that don’t know me, I am a Dr of Psychology, who specialises in anxiety (on a personal level, I have had anxiety and know the joys of panic attacks!) You can read about me here.
Your brain is captain of your ship. And more than likely, you have never read the instruction manual.
This instruction manual is very important, otherwise your brain may be steering you places that you don’t want to go.
Think of your brain as having evolved in three stages.
It is important that understand all three, as they work together to give you anxiety!
Video taken from my Online Self Help Course for Anxiety
Find out more about the course

Your reptilian brain
This was the first part of your brain to evolve.
It manages things that you don’t have to think about, unconscious processes such as breathing, temperature and the fight or flight response (for those of you that have panic attacks, you have probably already read about the stress response.)
It is your survival instinct
It always watches out for you, but can over react to day to day things
Your reptilian brain is very basic, it doesn’t think, rather it acts on an instinctual basis.
Can it kill me or will I kill it?

Although it can get you into trouble in terms of anxiety, it is a very useful instinct to have.
If you are in danger, your brain reacts instantly, rather than relying on the slower, more intelligent part of your brain, where you would have to stop and think what to do.
There is not time to weigh up all your options and decide the appropriate course of action if you have just stepped out in front of a bus.
This part of your brain is always on guard for you, even though you are not aware of it. Everywhere you go, it keeps an eye on potential danger.
It regulates things that you do not have to even think about, like your heart rate, and the fight or flight response.
It can however, protect you a little too much, as it really can’t tell the difference between a real danger or you just mulling over a ‘threat’ in your head.
In order to recover from anxiety, that occurs for no reason, you have to learn to calm down your instinctual reactions.

What does it feel like?
To give you an idea of what this part of your brain can do, think of maybe having a really scary dream. When you wake up, even though you know it was just a dream, your heart is still pounding, you might be sweating, and turn the light on ‘just in case.’
Or another example would be the intense physical feelings you get when watching a scary movie.
You react to the movie as if it where real.
This primitive part of your brain really can’t tell the difference.

Your reactions to the scary movie in terms of physical sensations, are down to the primitive part of your brain.
If you avoid scary movies in the future or think about the movie later, in the cold light of day, and still feel some fear, this is to do with other parts of your brain taking over and I shall talk about this now in terms of your mammalian brain.

Important Points to note
Your reptilian brain reacts to dangers, that are not really there. Your imagined dangers, your worries.
Your reptilian brain reacts without thinking, but then doesn’t do much else. On it’s own, its okay.
But when this interacts with your mammalian brain, this 2nd part of the brain can start to attach emotions. It remembers your fear.

The following is a copy of a webinar, even though the webinar was on panic attacks, and I would recommend watching it to answer some questions about anxiety.
My online anxiety course I refer to in the video can be found here

Your mammalian brain
Here, you can find your emotional responses.
Like the reptilian brain, these emotional responses occur without any effort on your part, outside of your control.
They occur automatically.
This can help to explain why you feel anxious for no reason, giving for example a presentation, driving your car, or just out with friends. It has a lot to do with how your brain attaches emotion to certain memories
Your mammalian brain is better know as The Limbic system or your feeling brain
This was the second brain to evolve, and this one has emotions (unlike the Reptilian Brain.)

If you want to recover from anxiety, you need to know about your mammalian brain.
Your mammalian brain includes the amygdala, which is fundamental to understanding and treating anxiety.
The amygdala is left out of many treatment models.
If you have tried things in the past to help with anxiety and think that ‘it failed,’ take heart, you maybe didn’t have the right tools.
You will have read previously (or if not, go back and read it now ) that your reptilian brain protects you from the basis of it’s survival instinct.
Your mammalian brain can do quite a bit more, in that it has emotions. Not only that, it can attach feelings to what has happened.
For example, say you had a bad time with your boss and had difficulty getting through a presentation at work.
Your mammalian brain can attach the feeling (maybe embarrassment, stress, anger or panic ) to the event; your boss and the presentation.
It can do more than that, it can form emotional memories. Now when you recall your boss or the presentation and are telling people about your bad experience, you can feel it too.
If that occurs again and again, your brain is very quick to learn, and the next time you give a presentation in front of your boss, images and feelings, drawn from your emotional memory, are there for you. You panic!

All of this happens outside of your awareness. It occurs unconsciously, automatically.Think of it this way, your digestive system is doing something right now, out of your awareness with no conscious effort on your part. You know it is working, as you can digest food and visit the bathroom.
Your emotional memory, amygdala and mammalian brain is sort of like that, it can do things, without you being aware of it. It can trigger fear.
You will know that your reptilian brain produces the fight or flight response. ‘Will it kill me, or do I kill it?’
This is such a primitive part of your brain, but gets activated now that your brain has matched ‘boss’ ‘presentation’ and ‘fear’ together, but it is really not helpful to have such a strong reaction each time you have to do a presentation in front of your boss.
Neuroscience points the way, letting you know that you can ‘unmatch’ this, or learn a different way for your brain to behave.If this is currently happening to you, it is just your brain.
Your mammalian brain is non verbal, it speaks to you by releasing chemicals.In order to fully recover from anxiety, you need to know what your brain does with this. How it learns, and that is more to do with your rational, intelligent brain.

Your thinking brain
This is what sets humans apart; intelligence.
Unfortunately, it is also responsible for a large amount of unnecessary suffering, depending on how you use your brain.
If you think a lot, plan for the worst case scenario. Or you might get stuck in certain thought patterns. Maybe you keep going over situations that have occurred in the past, or that might occur in the future, you need to look here.
If you have tried to get over anxiety or panic before and didn’t succeed, it might have been that you just tackled one of the above areas.You need to Retrain Your Brain to encourage a different style of learning, and to decrease the things that are keeping you anxious.

Your thinking brain
This is the brain that most of you will associate as being your own mind or your brain.
Your thinking brain is conscious.That said, you would think that it is under your control, but for many of you, it can feel that it has a mind of its own.
I am going back to the example I used when I was telling you about your mammalian brain – where you got anxious during a presentation with your boss. (read it here, if you haven’t already done so.)
If you immediately forgot about the presentation, everything is well and good in your world. But this is not the normal response for your thinking brain.
Your thinking brain is intelligent, much more so than your reptilian (which is instinctual, gets you ready to fight your boss), and your mammalian (which stores your bad feelings with the memory of your boss and the presentation.)
Your thinking brain searches for meaning. It will desperately try to make sense of what happened at the presentation and fuel your thought processes to look for answers.
Was I nervous before I went in? What happened? It will also allow you to tell your friends about it, and/or and go over and over it again in your mind.

Would you like my help?
Retrain Your Brain: Anxiety Masterclass
I have an online course that is available to start now
Find out more

Your 3 brains in action
Your thinking brain, rather than being in control, can feel like it is at the mercy of your reptilian and mammalian brain, as it cannot rationalise what has happened.
Reptilian Brain: gave you your fight or flight response
Mammalian Brain: allowed you to attach the fear and anxiety to the memory
Thinking Brain: now worries about it happening again, and you actually start to create, not only a learning curve, but anticipatory anxiety.
You are not aware of it, but you are forming a habit in your brain as your brain assembles all of this information together.
You are, in fact, forming a neural pathway (a network) in your brain connecting all of these things together. Unfortunately, it is an anxiety based learning that is forming in your brain.
How your brain learns

When you pay attention to something, over and over again, you learn – and your brain learns
Your brain
You can only do one thing at a time. If you don’t believe me, try this:
Count from one to ten in your head while you are reading what I am writing. You struggle.
You will struggle more if I tell you to stop reading, count to ten in your head, and recite the alphabet backwards at the same time.
Could you do it? No.
Your brain cannot actively process and give your full attention to more than one thing at a time.
You will of course, be able to do more than one thing at a time, we all multi-task. To be able to do this, your brain has to learn how to make most of the things that you do, automatic.
This is where you can run into trouble, as you may well have AUTOMATIC PROCESSES that not only explain your anxiety, but also KEEP YOU ANXIOUS.
Due to the nature of these automatic processes, you will be repeating them all the time.

Your brain and automatic processes
When you paid attention to spelling and reading in school, with practice, it became real – you are reading this page.
Not only can you read it without trying, you can also understand it.
You may not know what is happening in your brain to allow you to read and understand, you just know you understand. It became automatic.
It became real.
When you pay attention to something, your brain learns by creating neural pathways or connections. You can think of these pathways as building blocks. The building blocks for reading this page started when you were 4 or 5 years old.
Practicing reading built up and strengthened the building blocks until now you can read this page with no difficulty. Everything to do with reading, spelling and understanding is stored in your brain
The more you practiced, the stronger the association became, until your practice paid off; reading became automatic. Practice makes perfect.
It is the same with anxiety; everything to do with anxiety will have its own neural pathways (building blocks) in your brain.

It is not the anxiety that is the problem, but how you habitually think, and how you habitually react, that creates problems in your life.
How? Because your thoughts, and the things that you do, affect the structure of your brain.
In order to reverse this, you can Retrain Your Brain

Would you like my help?
Retrain Your Brain: Anxiety Masterclass
I have an online course that is available to start now
Find out more

What are you teaching your brain?
Your habitual thoughts and reactions may have taught your brain to be anxious. Once taught, these habitual thoughts and reactions make sure that you stay anxious.
Ask yourself this:
Are your thoughts helpful to you or are your thoughts harmful to you?
If you discover you are your own cheerleader, you can stop reading.
If you are like the rest of us (myself included), you may well have found that your thoughts do not help you out all the time
For example:
You are late for work and it will take you one hour to get there.
If you accept this situation and are nice and calm you might enjoy the hours journey
More than likely you might be upset, annoyed, or giving out to yourself inside your head,
“I should have got up earlier:, “I should have taken another route”, and you may feel anxious when stuck in traffic etc.
These thoughts are related to how you respond to what is actually happening: you are late for work.
Unfortunately they may be part of a well-trodden path in your brain, sort of like a script, or a switch that turns on, giving you:
Negative self talk;
Feelings of anxiety or anger;
Worry about what will happen.
If this is how you usually react, this well-trodden path in your brain gives you stress, automatically
These ‘pathways or connections’ that become automatic, can be very powerful: you can slip back into the anxiety habit and not know why.
It’s why organizations, schools and the emergency services run drills, over and over again. In a crisis, they don’t think. They do what they have been trained to do, what has been drilled to become automatic. They have a well-trodden automatic path that allows them to respond without thinking.
Your anxiety has become a well-trodden path, always available to you in certain (or maybe all) situations.

The course I refer to in the video can be found here

You were not born anxious.
Things had to be repeated ( or practiced) in order for you to feel anxiety when it is not necessary. You certainly did not do this on purpose.
Your brain is primed to pay more attention to negative experiences rather than positive ones, as the negative ones may harm you.
As I said before, it is not the anxiety that is the problem but how you think about it and how you respond to it.
If in the above example, you worry about being late, and feel stressed, anxious or angry at being stuck in traffic, your brain is alert to this negative situation.
The dangers that your brain is responding to, are no longer life-or-death situations, but day-to- day experiences.
Deadlines;
Money worries;
Work/school;
Relationships.
All the ‘self-talk’ that goes on inside your head.

Your anxious brain is always on the look out for possible ‘danger.’ When there is no real danger there, your mind takes over, and worries, races; you expect the worse.
Physical symptoms, maybe even panic attacks develop. The pathway in your brain for anxiety becomes stronger. It is able to connect your worries with the physical symptoms in your body.
If you worry about a meeting, or dread going somewhere in case you have anxiety, your brain pays attention to this. New pathways are created relating to anxiety. Now if someone mentions the ‘meeting’ or the place ‘you dread going’ your anxiety pathway is activated, and your brain can give you everything related to anxiety.
Your worries, the physical symptoms, they all appear automatically. Just like reading this page.
You can now feel anxiety in many situations and not know why.
You have your own automatic pilot for anxiety.
What your brain pays attention to becomes real.
You are now living with an automatic stress response

What is a stress response and a relaxation response, and why they are important?
Let’s take an example of sitting in your favourite armchair after dinner.
If your brain and body is working well for you, it will do the following:
Your rest and digest nervous system will give you a relaxation response, to relax your body and help you to digest your food. You feel comfortable and relaxed. The relaxation response is what helps you to kick back and unwind from your day.
Suddenly there is an extremely loud bang in the other room.
Your brain takes over and gives you a stress response to make you feel alert and able to move quickly to see what has happened.
One second you are almost asleep and the next your heart is pounding and you are in the other room. Does that sound familiar? One second you feel ok and the next you feel stress or anxiety?
You see that your dog knocked over a stool and you calmly walk back to your favorite armchair.
Soon your heart rate has slowed down and you are feeling comfortable again, as your nervous system has replaced the stress response with a relaxation response (rest and digest.) You fall asleep.
This is how our nervous system should work for us, giving us stress when we need it, and relaxation at other times. However, if you experience any form of stress, you will be feeling the effects of the stress response in many situations where you do not need to.
You may find it difficult to kick back and relax, and feel the benefits of the relaxation response as you are on constant high alert – getting the stress response too often when it is not needed.
Your brain is primed for stress and associates the small things in life with stress. Each time you encounter them, your brain gives you stress.

I would like to reassure you that science shows that you can change the way your brain is working for you. Your brain changes during your life depending on the thoughts that you have and how you react to all the different experiences that you encounter in your life.

Anxiety Treatment and Self Help
If you have already had your anxiety diagnosed, you might be offered the following treatments.
If you attended your doctor you could be offered medication or referred to someone like me ( a psychologist) for talking therapy, but a stepped care approach to anxiety treatment could be implemented.
Step 1: Use of Self Help for Anxiety.
This can include general self help material such as books and use of guided self help materials such as CCBT; Computerised Cognitive Behavioural Therapy. I have been working in psychology for almost 20 years and specialise in anxiety and find that self help is enough for most people.
Step 2: Psychological Anxiety Treatment.
You might attend a psychologist for CBT- Cognitive Behavioural Therapy. CBT is the most well known anxiety treatment, however CBT works best for what is known as cortex based anxiety. This simply means that it works best for anxiety that is mostly the result of your thinking brain; i.e. your thought processes and your worries.
However, if you find that your anxiety can arise for seemingly no reason or you get anxious in the same situations, you might have what is known as amygdala based anxiety; this occurs mostly where you experience anxiety automatically or in situations where your brain has remembered to be anxious.
Amygdala based anxiety requires a difference type of treatment, one which focuses on helping you to unlearn the stress response in situations where you experience anxiety.
I found that many people benefit from receiving both types of anxiety treatments, which is why I cover both in my online self help course.

If you would like my help?
Retrain Your Brain: Anxiety Masterclass
I have an online course that is available to start now
Find out more

Medications
SSRI’s
You might have been offered what is called an SSRI which stands for Selective Serotonin Reuptake Inhibitors, but the first point of treatment is generally therapy, as opposed to medication. SSRI’s usally take about 4 to 6 weeks before they ‘kick in’ and are to help to treat your anxiety by increasing your levels of serotonin.
Benzodiazepines
You might also have heard of these medications being shortened to ‘benzos.’ They can quickly help with the physical symptoms of anxiety for some people, as they act as a sedative. They can be highly addictive, and it’s best that these are used short term only.

Read more on anxiety treatment

At the moment your brain is not actively paying attention, it is functioning on automatic pilot, giving you anxiety when you do not need it. This is all happening in the background, passively, with no control on your part.
I do not want to fill your head with miracle cures; rather I want to offer a no nonsense, practical explanation to why you feel stressed, burned out, and anxious.

I want to show you how to pay attention differently. To give you control over what is happening. To help you to create new building blocks in your brain. Ones that are more helpful to you.
Many of you reading this will not be aware that I have my own private practice, where I am well respected for the work I do with anxiety, stress and burnout.
Living a peaceful life is something I had to work to get. I had to learn to ‘let go’. I had to learn to take responsibility for my own anxiety, and stop looking for the quick fix, in order for me to be in control and learn to live more peacefully.
But more importantly I had to decide that this is what I wanted. When anxiety becomes automatic, that unwelcome friend somehow feels normal, and we stop thinking or wanting to be different. As I said earlier, what your brain perceives to be real, is not always the case; it is how we create it.
If you want to step out of automatic pilot mode, say goodbye to your unwelcome anxiety and take control of what is happening, then I invite you to have a look at my Retrain Your Brain Program.
Anxiety Symptoms

Start with a test
Anxiety Test
Panic Disorder Test

What happens in your brain when you keep googling your symptoms
There is nothing physically wrong with you, the symptoms of panic and anxiety are harmless if experienced appropriately. However, long term effects of stress may damage your health. Read more.
I’m a doctor of psychology and have experienced both anxiety and panic attacks. My purpose in telling you this, is to normalize your experience, as you may feel alone with what is happening
Anxiety, in one form or other, will be experienced by most of us at some stage.
The problem is we do not speak about it – there is still stigma. I want to break down that stigma.
In order to for me to ensure that you fully understand the symptoms that you are experiencing, I first need to explain your nervous system. It’s a bit long winded, but it is really important that you understand.

Your nervous system
The Autonomic Nervous System (ANS) is made up of
The sympathetic nervous system SNS, and
The parasympathetic nervous system PNS
Symptom
Heart
Coronary blood vessels
Lungs
Eyes
Sweat glands
Salivary Glands
Bladder
Digestion
Mental
Endocrine Pancreas
Kidneys
Sympathetic
Heart beats faster
Dilates
Bronchial muscles relax
Pupils dilate
Increases sweating
Dry mouth
Relaxes bladder
Decreases activity
Increased alertness
Inhibits insulin
Decreased urine
Parasympathetic
Heart rate slows down
Constrict
Muscles constrict
Pupils constrict
No effect
Watery
Constricts
Increases activity
None
Stimulates insulin
Increased urine

You are normally not aware of the operating of the autonomic nervous system, ANS. It works away, in the background, away from your conscious thought.
It works with no effort on your part, like a reflex, adapting and responding to your immediate environment.
It is useful to understand how it works, if you want to understand anxiety and the symptoms that we experience.
You may be more familiar with the sympathetic nervous system, being called, “fight or flight.”
It is activates when we perceive are in some sort of danger.
Example: If, late at night, you see a crowd of young teenagers coming toward you.
They are loud and not familiar to you. This scenario might activate the SNS to prepare you to either run away or stand and face whatever happens. You are getting prepared for danger.
Activation of the sympathetic nervous system
- Release of adrenaline and noradrenaline
- Increase heart rate and blood pressure
- Increases blood flow to skeletal muscles
- Inhibits digestive functioning
When the young teenagers come closer and you see they are members of a local community, collecting for “bob – a – job” week, you immediately relax.
You do not consciously decide to relax, you relax as your parasympathetic nervous is activated – rest and digest
Parasympathetic nervous system activation
- Lowers heart rate, breathing and blood pressure
Let me explain in more detail.
When we are relaxed and ready to kick back and unwind from our day, the parasympathetic nervous system (PNS) enables us to do this, by relaxing our body, slowing down the heart rate and blood pressure.
When this happens we can easily relax into our favorite armchair and feel content. This is why some people refer to the PNS as the rest and digest system. Our body slows down and is able to concentrate on digesting our dinner and the removal of waste from the body.
This is not how we want to feel when meeting a bull, as we are not in a state to deal with it.
This is the beauty of the the sympathetic nervous system (SNS) (also know as fight or flight), it takes control of everything you need in the blink of an eye.
One second you are relaxed and content, and the next your heart is pounding out of your chest and you are no longer in that sleepy relaxed state. You are wide awake.
Does this sound familiar? Exactly like panic attack symptoms? Often you can feel ok, and then, out of the blue, your chest hurts, your heart is pounding.
With anxiety, you may have chest pain, difficulty relaxing or sleeping, your mind is racing and you have tummy troubles. With panic attacks, you may struggle to breathe, be sweating, shaking, and think you might die.
Although distressing, it is just your autonomic nervous system thinking that it has detected a threat and activates your SNS to help you out.
Your sympathetic and parasympathetic nervous system are part of the autonomic nervous system (ANS). The ANS responds automatically when needed.
Think of your brain as constantly scanning wherever you are for possible danger. Once it detects something, anything, that might cause your harm, it protects you by activating the SNS when you need to be alert and ready to take action.
- Once this happens, your mind is sharper, you become more focused.
- Your bowels and bladder can empty making you lighter and able to run or fight.
- Your senses and vision are no longer sleepy, but sharp and taking in more information.
- Blood gets diverted to your heart to help it pump faster
It then activates the PNS (the rest and digest) when the danger has passed to allow you to relax.
This necessary and adaptive system is responsible for the anxiety symptoms that you experienceIf you experience them in front of a bull, you would expect that to happen.
If you are experiencing any of the symptoms mentioned, when it is not necessary, think of your brain as being set to a higher alert to danger than you actually need.
Breathing difficulties and anxiety

Many people feel that they can’t breathe properly during a panic attack or when experiencing high anxiety.
It may feel like you are gasping for breath or can’t get enough air into your lungs.
You may also feel like you are suffocating or being smothered.
Normally you don’t have to think about breathing, you do it automatically. The autonomic nervous system makes sure of this.
The key to restoring your breathing to normal, is being able to calm down your nervous system.
During high emotions the sympathetic nervous system produces a “fight or flight” response, as explained above. It is trying to protect you from danger (although there is no danger there.) It is the sympathetic nervous system that causes your breathing to change. It may also speed up and cause rapid shallow breathing.
You hyperventilate. You are still breathing. Your breathing has just changed rapidly and it feels uncomfortable, but you are still breathing.
Having difficulty breathing is one of the most frightening symptoms of panic attacks. The important thing to understand is that this response is due to you getting a fear response in situations where you do not need. Your nervous system has become over sensitized.
Chest pain and tightness

This can feel like someone has put a belt around your chest and tightened it.
It can also feel like something is pressing down on your chest, or squeezing it . Your heart may be beating out of your chest.
Chest pains such as these are usually why people, like yourself, attend their doctor, afraid that something has happened to their heart.
If you have been given the all clear, the pain that you are experiencing is down to breathing too fast (hyperventilation). Anxiety causes our heart to beat faster than is needed and we overwork our chest muscles, which leads to the sensations that you experience.
Chest pain may cause you to feel alarmed and fear that you are having a heart attack. This fear often makes you panic more.
As explained previously, you hyperventilate during a panic attack. When you hyperventilate on a regular basis, you are over breathing. You are using the chest muscles more often than normal. If these muscles are over worked too often you will begin to feel chest pain.
Dizziness and Feeling Lightheaded
As you breathe in normally, you are breathing in oxygen and breathing out carbon dioxide. When you are breathing too fast or overbreathing during a panic attack, the levels of carbon dioxide in your blood starts to lower (as you are breathing it out too quickly.)
When this happens, your blood vessels will start to constrict which leaves you feeling dizzy.
Heart palpitations
This is one of the more frightening panic attack symptoms as you may feel that your heart is about to give up.
Your autonomic nervous system controls, amongst others, your breathing and your heart rate. You don’t have to think about it. Your nervous system is explained above.
During high emotions such as a panic attack, your sympathetic nervous system responds to prepare for fight or flight. It is the sympathetic nervous system that is causing your heart to race.
Although unpleasant, it won’t harm you.
Muscle tightness and pain
Again this is due to breathing faster than is necessary. Carbon dioxide drops which results in tingling and tightness.
Think of it this way. This response is very adaptive when necessary. If you fall and damage your leg, where part of your leg has been cut open, your body will immediately get a stress response and your muscles will immediately tighten.
This is very helpful around the area where your leg is cut, as it applies something like an automatic tension to the area.
Your body is trying to protect you, although getting this symptom when nothing has actually happened to you is understandably worrying.
During a Stress Response the large skeletal muscles contract, in the neck and shoulder muscles, to prepare you for action.
This is what causes your neck, back and muscles to ache. It can also give you a headache.
Fear of dying or losing control
You might have found that your thought processes have changed since experiencing anxiety or panic attacks.
Typically thoughts include:
- I’m going to die
- I’m going crazy
- I’m going to lose control
- Something terrible is happening
- I’m going to have a heart attack
It’s natural to think thoughts such as these in the beginning. The symptoms you experience in your body, come from a primitive part of your brain. It reacts first, and thinks later. If your brain thinks you are in danger, it will not wait for you to think about it and decide what to do. Rather it reacts for you, trying to keep you safe.
Development of an anxious brain
We get into trouble, when we use our more modern part of the brain, the part that thinks and analyses. When you feel anxiety, when there is no danger present, you start to think about it and try to work out what happened. Nothing happened, it was just the primitive part of your brain reacting as your nervous system is overworked.
If you are not able to dismiss the anxious symptoms or fearful event that caused the symptoms, you might start to replay this over and over in your mind – like a movie, that keeps running in your brain, you keep the emotions associated with the event alive. You start to develop an anxious brain.
Think of it it this way. You have been building up a “pocket of knowledge” in your brain relating to panic and anxiety. Without meaning to do so, each time you experience a sensation in your body, you are teaching your brain to check for possible reasons for the symptoms you are experiencing.
For example, it is difficult to ignore a pounding heart, your brain searches for possible reasons. A pounding heart as a symptom of anxiety is not the first thought that comes to mind. You are more likely to be worrying that something serious is happening to you.
This in turn makes you more anxious, and these thoughts are getting hard wired (so to speak) into your brain to match the type of thoughts listed above, with the symptoms of anxiety that you are experiencing.
Which simply means, each time your heart beats fast, you will worry that something serious is happening to you (as opposed to accepting that it is a symptom of anxiety.)The more you do this, the more likely it is that you will have similar thoughts each time you have a panic attack or experience anxiety.
Even when the symptoms have calmed down, you may have taught your brain to worry about what has just happened by thinking about the last time you had a panic attack and what happened then. Was it the same as this time? Will they ever go away? What if?
By now, your brain has become expert at predicting the worst and giving all sort of negative thoughts and fears.
The key is to start to break down the cognitive aspects of anxiety – that simply means the thought processes associated with anxiety. We start to “misinterpret” the sensations we feel in our body, which makes the experience worse. For example, if you are at home watching TV and suddenly realize that your breathing has changed. That it is hard to catch your breath or you are finding it hard to swallow, if you think;
- something terrible is happening
- I can’t breathe
These thoughts start to frighten you and will affect your behavior. You might stand up, try to change your breathing, or go outside in case you need help. This is sending a message to your brain that something really may be wrong. It is your anxious brain.
If you have an anxious brain, frightening and negative thoughts will be part and parcel of your life. It is like taking an unwelcome friend with you everywhere you go.
Sweating and blushing
When the heart is pumping blood around your body during the fight or flight response, your body cools itself by sweating. Blood vessels move closer to the surface of the skin and causes the redness you see – blushing.
Once you are aware that you are sweating and/or blushing, especially if it happens in front of others, your thought processes become preoccupied with what you must look like, and whether the other person notices. This in turn may make you feel more anxiety. Our thoughts are connected to what we feel and can produce symptoms in the body.
This is quite common in social anxiety, and you can read more about this here.
Insomnia and Sleep Problems
Your mind may be racing at night and you may find it hard to “switch off.” This over activity of your thought processes will keep you alert and make sleep difficult. You may then worry throughout the day that you will not sleep at night.
This worry, is called “anticipatory anxiety.” We make ourselves anxious by worrying about anxiety we might have in the future. In this case, the future is bed time.
If your body is alert at night, once you fall asleep, you may wake up frequently in a startled state, due to adrenal.
Other symptoms include
Trembling and Shaking
Tiredness and Fatigue
Digestive Problems, Irritable Bowel Syndrome
Blurred Vision
Urination
Panic Attacks

Can the symptoms be due to anything else?
It is always important to go to your doctor to rule out other possible reasons for your symptoms.
Panic attack symptoms can mimic
- Asthma
  Heart Problems, and
- Thyroid Problems.
It is always advisable to link in with Doctors and Psychologists who are expert in the treatment of anxiety as for some people, you may be experiencing adult onset asthma or have thyroid problems and this may be the cause of your problems and not panic attacks.
Are Anxiety Symptoms different in men and women?
Women are more likely than men to experience anxiety disorders. Some studies have found that men and women may experience panic attacks differently.
Women are more likely to experience shortness of breath and the smothering sensation that is a typical symptom of panic. They are also more likely to feel ill.
Men report feeling more pain in their stomach and experienced sweating more than women in some studies.
This is not to say that men do not experience the breathing difficulties and that women to not experience increased perspiration during panic attacks. Both men and women, can, and indeed do, experience both.
How do I know if I have an Anxiety Disorder
All anxiety disorders have a specific set of signs and symptoms and it is important to know what type of anxiety you are experiencing. Ask your self the following questions.

If you haven’t already done so
take my Anxiety Test

How do I know what type of anxiety I have?

Does the anxiety have an underlying medical cause?
If it does, your experience of anxiety may be cured, by treating the medical condition as opposed to the anxiety
Do you have Panic Attacks, and if so, do you only really experience anxiety during an attack?
If so, you may have Panic Disorder.
If you have Panic Attacks (Disorder) and avoid certain aspects of your life out of fear of an attack
or feeling trapped or unsafe, you may have Agoraphobia
Do you only feel anxious when you have to do something in public, such as speak in public, meet friends in public?
If so, you may have Social Anxiety.
If your experience of anxiety is to do with certain things or situations,
you may have a Specific Phobia
Are you overly concerned with obsessive thoughts or about keeping things clean or hoard things.
If you repeat certain things and feel anxious if you cannot, it may be Obsessive Compulsive Disorder OCD.
If your experience of anxiety is more focused on possible health worries
or if you are frequently afraid that you have a serious illness or may become ill, it may be hypochondriasis
If you have answered the following questions and have come to the conclusion that your experience of anxiety is not restricted to those mentioned above
you may well have Generalized Anxiety Disorder.
Signs and Symptoms of GAD
Generalized Anxiety Disorder, or GAD is different from other anxiety disorders in that the person experiences anxiety and worry in relation to a variety of situations. In other disorders, the anxiety may be in relation to something specific, such as phobias, or anxiety in social situations, such as social anxiety.
If you have GAD, you experience worry, nervousness, dread and the symptoms of anxiety, in practically all situations, with no apparent trigger.
What is GAD?
I find it helpful to think of GAD in terms of what we do, how we behave and how we think. In other words, it has “thought part” and a “behavioral part” (what we do and what we do not do.)
The thought part.
Worry is a big part of this. Constant worry about non-specific things. Once we have finished worry about something, we find something else to worry about. We do not do this on purpose, is it seems almost out of our control, as if it is just how we are.
We can however, may various mistakes in out thinking and misinterpret some information or situations, which leads us to worry more or feel more anxiety. You can read more about the effect our thoughts have on anxiety, here.
The behavioral part.
Although we do not mean to, we teach our brain to be anxious or afraid of certain things. Some things we have a natural built in fear response. For example, if we see a snake or something else which might harm us, it is appropriate to feel some fear as this means that we approach the snake with caution until we can decide whether or not it is dangerous.
This is a good, adaptive fear response for us, as it keeps us safe.
We can get the same response when it is not really necessary though. We can feel anxious as we worry too much, or have a general feeling of anxiety constantly. Our brain matches up things that should cause some level of anxiety, like the snake example above.
This means, if we see something that sort of looks like a snake we feel anxious. If we feel enough anxiety in different situations we can teach our brain, so to speak, to match the anxiety with what we are doing. For example, if we wake up in the morning and start to worry about the day ahead, it will become second nature to wake up anxious and start to worry.
Although, we do not mean to, we teach our brain to hard wire that response for us. We can “unlearn” this though!
We worry about what “might happen.” Going over all possible bad outcomes.
Behaviors: What we do to keep ourselves anxious. We avoid things that make us anxious as this helps in the short term, but increases the anxiety long term. How? We are laying more foundations for our brain to see the things that we are avoiding as anxiety provoking situations.
If while lying in bed, we habitually use that time to go through our day or worry about things that may our may not happen this may cause more anxiety. This in turn affects our behavior, what we are doing – we are not able to get to sleep.
These thoughts and behaviors cause anxiety symptoms in the body and once the thoughts, behaviors and symptoms combine, they affect your ability to sleep, the quality of your sleep and your ability to to function during the day.
Generalized Anxiety Disorder is a highly treatable condition.