Anxiety and Panic: A Complete, Evidence-Based Guide

Anxiety and panic attacks are among the most common mental health concerns worldwide. While anxiety presents as persistent worry and tension, panic attacks involve sudden, intense fear with distressing physical sensations. Understanding their symptoms, triggers, and treatment options is vital for early intervention and long-term well-being.

Understanding Anxiety and Panic Attacks

Anxiety is a sustained state of excessive worry, restlessness, and anticipation of danger. It can affect thinking, behaviour, and physical health.

Panic attacks are abrupt, overwhelming episodes of fear that peak within minutes. Even when the threat is absent, the body reacts as if it is in extreme danger.

Both experiences can occur independently or coexist as part of recognised disorders.

Generalised Anxiety Disorder (GAD) and Panic Disorder

Generalised Anxiety Disorder (GAD)

Characterised by:

• Persistent worry about routine matters

• Difficulty controlling anxious thoughts

• Restlessness, fatigue, and poor concentration

• Muscle tension and sleep disturbances

GAD develops gradually and often spans months or years if untreated.

Panic Disorder

Defined by:

• Recurrent, unexpected panic attacks

• Continuous fear of future attacks

• Avoidance of situations perceived as risky

Panic disorder can severely limit daily functioning but responds well to timely treatment.

Symptoms of Anxiety and Panic Attacks

Common Anxiety Symptoms

• Excessive and uncontrollable worry

• Irritability

• Difficulty focusing

• Uneasy stomach or gastrointestinal discomfort

• Sleep disturbances

• Muscle stiffness

Common Panic Attack Symptoms

• Rapid heartbeat

• Chest tightness or pain

• Shortness of breath

• Dizziness or trembling

• Sweating or chills

• Fear of losing control or dying

• Numbness or tingling sensations

Symptoms can mimic cardiac or respiratory conditions, creating additional fear.

Foods That Cause Anxiety and Panic Attacks

Certain foods and lifestyle choices can aggravate symptoms in vulnerable individuals:

• Caffeine: Stimulates the nervous system, triggering palpitations and restlessness.

• Sugary Foods: Rapid glucose spikes and crashes can heighten irritability and anxiety.

• Processed Foods: Additives, preservatives, and high sodium levels burden the nervous system.

• Alcohol: Interferes with neurotransmitters, worsening anxiety during withdrawal phases.

• Fried and High-Fat Foods: Affect digestion, sleep quality, and inflammatory pathways.

Adopting a balanced diet with whole grains, lean proteins, magnesium-rich foods, and hydration supports emotional stability.

Medicine for Anxiety and Panic Attacks

Treatment depends on severity, coexisting conditions, and medical history. Common categories include:

1. SSRIs (Selective Serotonin Reuptake Inhibitors)

First-line for GAD and panic disorder.
Examples include:

• Sertraline

• Escitalopram

• Paroxetine

2. SNRIs (Serotonin–Norepinephrine Reuptake Inhibitors)

Used for chronic anxiety symptoms.
Examples:

• Venlafaxine

• Duloxetine

3. Benzodiazepines

Fast-acting for acute panic but not recommended long-term due to dependency risk.
Examples:

• Clonazepam

• Alprazolam

4. Beta-Blockers

Useful for physical anxiety symptoms like trembling or palpitations.

5. Psychotherapy

Evidence supports Cognitive Behavioural Therapy (CBT) as the most effective non-pharmacological treatment for both GAD and panic disorder.

Medical supervision is essential before beginning any treatment.