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Main Line Pediatrics

Are You Sick?

Panic Attack

Is this your symptom?

  • Anxiety, or feeling fearful or nervous
  • Panic attacks

Symptoms

People with anxiety may have short-lived symptoms for minutes, hours, or days. Some people have longer lasting symptoms for months to years.

Common symptoms are:

  • Anxiety, worry
  • Fear
  • Feeling irritable
  • Feeling nervous
  • Feeling restless
  • Trouble focusing or concentrating
  • Trouble sleeping

Physical symptoms can also occur with anxiety. These are:

  • Feeling tired, low energy
  • Headache
  • Muscle tension and tightness
  • Nausea or stomach discomfort
  • Rapid heart rate and sweating
  • Shortness of breath or hyperventilating
  • Trembling

Cause

Everyone feels nervous, fearful, or anxious at some point in their lives. For example, it is normal to feel nervous before a big test or when speaking in public. It is normal to feel somewhat fearful when walking down a dark street or being alone in an empty building. After the cause is gone, those nervous feelings often go away.

However, for some people, the nervous feelings do not go away. Instead, those feelings get worse. They may even keep a person from going to work and doing usual activities. If this happens, the cause is often an anxiety disorder. Examples are:

  • Generalized anxiety disorder
  • Panic disorder (panic attacks)
  • Phobias
  • Post-traumatic stress disorder
  • Social anxiety disorder

Treatment

Mild or normal anxiety of life can often be treated with simple measures. Healthy living habits can help.

  • Avoid caffeine: Avoid drinks with caffeine, like coffee, colas, and tea. These can make anxiety worse.
  • Eat healthy: Eat a well-balanced diet.
  • Get enough sleep : Most people need 7-8 hours of sleep each night. Being well-rested improves your mood and your sense of well-being.
  • Exercise : Take a daily walk.
  • Talk: Share how you are feeling with someone. Make sure that your spouse, family, or friends know how you are feeling.

It is important to not drink too much alcohol. A single "drink" of alcohol is one shot, a small glass of wine, or a can of beer.

  • Men should not have more than 2 drinks per day.
  • Women and people over 65 should not have more than 1 drink per day.

There are a number of things that people can do to decrease stress.

  • Try a calming activity. For example, go for a walk, spend time with friends, or read a book.
  • Learn how to relax through meditation or yoga.
  • Take a class on how to better manage stress.

People with anxiety disorders and more serious problems with anxiety can also get benefit from:

  • Counseling
  • Medicines
  • Support groups
  • Psychotherapy

When to Call for Panic Attack

When to Call for Panic Attack

Call 911 Now

  • Severe trouble breathing (struggling for each breath or can't speak)
  • Lips or face are blue
  • Acting violently
  • You think you have a life-threatening emergency

Call Doctor or Seek Care Now

  • Trouble breathing lasts more than 10 minutes
  • Dizziness lasts more than 10 minutes
  • You have a history of alcohol or drug abuse and are feeling very shaky (hands are shaking)
  • You feel weak or very sick
  • You think you need to be seen, and the problem is urgent

Contact Doctor Within 24 Hours

  • You want to talk with a mental health worker, psychiatrist, or counselor
  • You think you need to be seen, but the problem is not urgent

Contact Doctor During Office Hours

  • Anxiety symptoms keep you from working or going to school
  • Feeling anxious or nervous off and on for weeks or months
  • Trouble falling to sleep or staying asleep
  • Taking herbal medicine
  • Taking thyroid medicine
  • Taking medicine for anxiety and not getting better
  • Drinking too much coffee or other drinks with caffeine
  • Alcohol or drug use
  • You have other questions or concerns

Self Care at Home

  • Normal anxiety and nervous feelings

Call 911 Now

  • Severe trouble breathing (struggling for each breath or can't speak)
  • Lips or face are blue
  • Acting violently
  • You think you have a life-threatening emergency

Call Doctor or Seek Care Now

  • Trouble breathing lasts more than 10 minutes
  • Dizziness lasts more than 10 minutes
  • You have a history of alcohol or drug abuse and are feeling very shaky (hands are shaking)
  • You feel weak or very sick
  • You think you need to be seen, and the problem is urgent

Contact Doctor Within 24 Hours

  • You want to talk with a mental health worker, psychiatrist, or counselor
  • You think you need to be seen, but the problem is not urgent

Contact Doctor During Office Hours

  • Anxiety symptoms keep you from working or going to school
  • Feeling anxious or nervous off and on for weeks or months
  • Trouble falling to sleep or staying asleep
  • Taking herbal medicine
  • Taking thyroid medicine
  • Taking medicine for anxiety and not getting better
  • Drinking too much coffee or other drinks with caffeine
  • Alcohol or drug use
  • You have other questions or concerns

Self Care at Home

  • Normal anxiety and nervous feelings

Care Advice

Care Advice for Mild Anxiety and Nervous Feelings

  1. What You Should Know:
    • Anxiety is a normal and common reaction. You may feel this way before a big test. It may also be caused by a problem at work or a hard decision you need to make.
    • Some people have anxiety disorders. The anxiety does not go away. Instead, it seems to get worse over time.
    • Anxiety and anxiety disorders can be treated and controlled.
  2. Tips for Healthy Living. There are things you can do to live healthy and feel better:
    • Avoid caffeine: Avoid drinks with caffeine like coffee, colas, and tea. These can make anxiety worse.
    • Eat healthy: Eat a well-balanced diet.
    • Get enough sleep : Most people need 7-8 hours of sleep each night. Being well-rested improves your mood and your sense of well-being.
    • Exercise : Take a daily walk.
    • Talk: Share how you are feeling with someone. Make sure that your spouse, family, or friends know how you are feeling.
  3. Avoid Triggers of Anxiety:
    • Alcohol: Men should not have more than 2 drinks a day. Women and people over 65 years should not have more than 1 drink a day. A single "drink" of alcohol is one shot, a small glass of wine, or a can of beer. Reason: too much alcohol can make anxiety worse. It can also cause problems with sleeping. You need to be well-rested to feel your best!
    • Caffeine: Avoid drinks with caffeine like coffee, colas, and tea. Reason: caffeine is a stimulant. It can make anxiety worse.
    • Diet pills: Avoid diet pills. Reason: diet pills are stimulants.
    • Herbal drugs: Talk to your doctor before taking any herbal supplements. Reason: some have side effects.
    • Smoking: Stop or reduce your smoking. Reason: nicotine is a stimulant.
  4. How to Reduce Stress:
    • Try a calming activity. For example, go for a walk, spend time with friends, or read a book.
    • Learn how to relax through meditation or yoga.
    • Take a class on how to better manage stress.
  5. Call Your Doctor If:
    • Anxiety or panic attacks occur often
    • Anxiety makes it hard to work or do normal activities
    • You want to talk with a mental health worker, psychiatrist, or counselor
    • You feel like harming yourself
    • You think you need to be seen
    • You get worse

What to Do for a Panic Attack

  1. What You Should Know:
    • A panic attack starts very quickly and the symptoms are very intense.
    • A panic attack is usually brief, lasting just 10-20 minutes.
    • The main emotional symptoms are a rapidly rising sense of fear and anxiety.
    • The physical symptoms can be just as intense. Symptoms may include trouble breathing, fast breathing, rapid heart rate, and dizziness. Some people also get tingling in the hands and face.
  2. Helping Someone Who Is Having a Panic Attack:
    • Speak calmly.
    • Reassure the person that panic attacks are not harmful.
    • Acknowledge how scary this must feel.
    • Ask them what they have done in the past that has helped.
    • Encourage the person to take slow deep breaths of air using abdominal breathing. Take 1 breath every 5 seconds (12 breaths a minute). By focusing on their breathing, the person is taking control of the panic attack.
  3. Call Your Doctor If:
    • Anxiety or panic attacks occur often
    • Anxiety or panic attacks make it hard to work or do normal activities
    • You want to talk with a mental health worker, psychiatrist, or counselor
    • You feel like harming yourself
    • You think you need to be seen
    • You get worse

Additional Resources

  1. National Alliance on Mental Illness (NAMI)
    • The NAMI Helpline is an online resource for finding community mental health programs.
    • National toll-free phone number: 800-950-NAMI (6264). Available Monday through Friday from 10 am to 6 pm Eastern Time.
    • Website: NAMI.
  2. Substance Abuse and Mental Health Services Administration (SAMHSA)
  3. Anxiety and Depression Association of America (ADAA)
    • The ADAA is a resource for finding treatment for anxiety and depression disorders.
    • There is a FIND HELP link on the home page.
    • Website and Find a Therapist: ADAA.
  4. Call Your Doctor If:
    • You have more questions.

And remember, contact your doctor if you develop any of the 'Call Your Doctor' symptoms.

Disclaimer: this health information is for educational purposes only. You, the reader, assume full responsibility for how you choose to use it.

Copyright 2023.

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