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Harvard Medical School
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General Medical Questions
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Question : What exactly is a panic attack? It feels like I’m uncomfortable and scared of everything. I need to return to work. Any helpful advice?
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The Trusted Source
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Howard LeWine, M.D.

Michael Craig Miller, M.D., is Senior Editor of Mental Health Publishing at Harvard Health Publications. He is an assistant professor of psychiatry at Harvard Medical School. Dr. Miller is in clinical practice at Beth Israel Deaconess Medical Center, where he has been on staff for more than 25 years.

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January 14, 2014
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A panic attack is a wave of intense fear. Added to the fear are uncomfortable physical symptoms, such as:

  • A pounding heart
  • Sweating
  • Trembling
  • Shortness of breath
  • Chest discomfort
  • Stomach upset
  • Lightheadedness

Panic attacks often come with no warning. But sometimes they have a specific trigger.

People with panic attacks may avoid situations where an attack might start. In particular, they’ll keep away from places such as theaters or airplanes. Places where it would be hard to get away quickly.

Panic attacks are common. But the symptoms of an attack don’t last. That is, they have a beginning and an end.

But what you describe — being scared of everything — doesn’t sound like a panic attack. Your anxiety and fear sound more constant.

Thus, you may have “generalized anxiety disorder. With this disorder, a person has nearly constant feelings of worry or anxiety. These feelings are either unusually intense or out of proportion to the reality.

You may feel that you have always been a worrier. Or the anxiety may be triggered by a crisis. Or you may have extra stress at work or in your family. Although the crisis eventually goes away and the stress passes, an unexplained feeling of anxiety may last months or years.

Symptoms of generalized anxiety disorder include:

  • Restlessness
  • Irritability
  • Poor concentration
  • Muscle tension
  • Sleep problems

A wide range of anxiety-related physical symptoms may seem like symptoms of heart disease, respiratory illness, digestive diseases and other medical illnesses.

I recommend speaking with your primary care doctor. He or she can evaluate whether there is any medical illness contributing to how poorly you feel.

If all that checks out, get a referral to a mental health professional who can discuss your treatment options. There are many very effective treatments — such as medicine and psychotherapy — for both panic and generalized anxiety.

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