We’ve all experienced it — a sudden feeling that your heart is pounding so much it might leap out of your chest, along with feeling hot, dizzy and nauseous.

You may write it off as being stressed, as something you ate, or feeling nervous about a presentation or social event, but when this happens more than once, you may worry that you are experiencing a heart attack or a nervous breakdown.

Many people will go to Accident and Emergency (A&E) when experiencing these symptoms.

Doctors will determine if you are having a heart attack. If this is ruled out, then they may conclude you have had a panic attack.

Panic attacks often occur in the context of anxiety disorders and may occur randomly, without an obvious trigger.

In fact one out of 10 people will experience a panic attack in their lifetime. Panic attacks account for more emergency room visits than any other psychiatric illness. Despite this, few people will go on to develop an actual anxiety disorder.

When experiencing anxiety for the first time, it is important to assess if there may be any obvious causes, such as medications or a medical condition.

For instance, caffeine found in tea or coffee, as well as some tobacco products, can cause anxiety symptoms.

Additionally, some prescription and non-prescription drugs, including steroids, asthma medications and some cough/cold remedies, can cause anxiety symptoms.

Anxiety may also be associated with medical conditions, such as having an overactive thyroid (hyperthyroidism) or hormonal changes associated with the  menopause.


As a result, it is always important when you are experiencing anxiety to speak with your doctor about your concerns. A complete and full assessment will rule out any medical or medication causes of anxiety.

Anxiety disorders are the most commonly-occurring psychiatric conditions, and include panic disorder, social phobia, generalized anxiety disorder, post-traumatic stress disorder (PTSD) and specific phobias.

Panic disorder is characterized by having panic attacks that can be triggered by situations or sensations or that may occur out of the blue. As a result of these attacks, an individual may learn to avoid certain situations, such as crowds, to prevent an attack from occurring.

Specific phobias involve anxiety related to triggers, such as flying, spiders or enclosed spaces.

Social phobia is characterized by feeling fearful and sometimes avoiding social situations.

Generalized anxiety disorder is characterized by excessive worry and associated agitation.

PTSD is less common and perhaps the most complicated. It is associated with the experience of a significant trauma such as war, rape, or any situation where one’s life feels threatened. In the past this was referred to as shell shock or battle fatigue.

Although anxiety disorders may look very different in their presentation, treatments for these conditions are typically the same.

Your doctor or psychiatrist may prescribe an anti-anxiety medication or a psychoactive drug such as valium.

However, it is important to only take these in the short-term as they can be very addictive and can worsen anxiety in the long-term.

The best medications for anxiety are the same that a doctor would give for depression; a class of medications called SSRI’s (selective serotonin reuptake inhibitors) such as Prozac.

These are taken daily and after a two-week period, can lessen the experience of anxiety considerably.

Psychotherapies, especially cognitive-behavioural therapy, have been shown to be the most effective long-term treatments for anxiety disorders.

This treatment often involves facing anxiety-provoking situations and altering thoughts that might act to increase feelings of anxiety.

It is important to note that not all anxiety is bad for us. We’ve all experienced anxiety, and in some ways it can help us to achieve more.

Anxiety can save you from a speeding car by helping you to get out of the way quicker, and it can help you at work by encouraging you to make the extra effort. 

In the end, anxiety is a human experience. However, when it becomes persistent or starts to impact your life in a significant way, it is best to seek professional help.

Dr Shawnée Basden is a clinical psychologist at Bermuda Hospitals Board.