Anxiety is a normal reaction to imminent threat and when it attacks, it may feel like it’s never going to end. Hence, the question, “how long can anxiety last?”

But what exactly is anxiety?

Our body releases stress hormones like cortisol and norepinephrine (or adrenaline). This is as a way to get us ready to either fight, or flight. 

It can become an mental illness when the reaction becomes excessive and has a strong negative impact on life. Worries turn into intrusive thoughts, you feel stuck and your mood takes a strong dive.

Normal anxiety does not influence your ability to function. Some anxiety symptoms can be confused with another medical condition. 

These symptoms might look like 

• difficulty breathing, 
• trouble sleeping, 
• extreme distress, 
• muscle tension 
• and unexpected panic attacks.

When people feel anxiety symptoms on such a scale, that is usually when these questions get asked. 

How long does anxiety last? How much time do you have before it escalates into something worse? How will you know if your anxiety is justifiable or not?

Types of Anxiety

Before explaining whether anxiety ever goes away, we need to explain the types of anxiety. The DSM-5 (or diagnostic and statistical manual) from the APA (American Psychiatric Association) recognizes 7 types of anxiety. 

These anxiety disorders are:

Generalized anxiety disorder 

An excessive worry or anxiety about daily life, characterized by 

• anxious feelings, 
• difficulty concentrating, 
• trouble sleeping, 
• and so on.

Separation anxiety disorder

An excessive worry to lose your caretaker, mother or father (the important attachment figure)

Selective mutism

Children who can’t speak in situations due to fear, while they can at home

Specific phobia

A specific anxiety disorder about something exterior (f.e. Animals, needles, water..)

Social phobia or social anxiety disorder

An excessive fear of social situations and potential judgement

Panic disorder

Anxiety with unexpected panic attacks, feelings of impending doom, anxious thoughts

Agoraphobia

Fear of going outside their private home (f.e. The park, elevator, street).

Some sources might say that there are other anxiety disorders.They would consider post traumatic stress disorder or obsessive compulsive disorder to be anxiety disorders.

Before mental health professionals used to categorize these under anxiety disorders. Today they are considered other mental disorders. It does not mean that these can’t go with an intense fear though.

Does anxiety disorder ever go away?

Anxiety usually has a build-up. These disorders start in childhood, adolescence or early adulthood (20 – 31 years old). The median age of onset is:

• Separation anxiety disorder and specific phobias: 7 years old
• Social anxiety disorder (SAD): 13 years old
• Agoraphobia (no panic attacks): 20 years old
• Panic Disorder: 24 years old
• Generalized anxiety disorder (GAD): 31 years old.

As mentioned before, it is normal to feel anxious from time to time. Learning how to cope with it, or getting treatment is essential as the consequences of untreated anxiety are ample. 

Untreated anxiety can lead to: 

• a higher risk of substance abuse, 
• depression 
• and various physical consequences f.e. heart problems, lowered immune system, gastrointestinal disorders, memory problems and migraines.

A study reports the highest prevalence for social anxiety disorder, generalized anxiety disorder and social anxiety with adults between 18 and 34 years old. 

The peak of prevalence for people with panic disorder is between 35 and 49 years old. 

After, anxiety seems to decrease with all people, to the point that 65+ers don’t report much anymore. So yes, anxiety does go away, however you will need a lot of patience. 

What is the difference between an anxiety attack and a panic attack?

The DSM-5 from the American Psychiatric Association (the APA) does not speak of anxiety attacks. It is not recognized. 

What you define as an anxiety attack might be the symptoms of generalized anxiety disorder (at least if it is general). You probably feel a strong worry and excessive thoughts going around in your head. You might feel stress, heart palpitations, and be highly irritable.

Furthermore, your thoughts are out of control and you have no room to focus on other things anymore. Your sleep might also be suffering as you can not seem to stop worrying.

We could say that the difference between what you describe as the above “anxiety attack” and a “panic attack” is that you can pinpoint a source. During a panic attack you might not be able to. 

Also a panic attack comes with stronger physical symptoms. And lastly, feelings of anxiety are more of a gradual constant feeling, while panic is abrupt. It has a peak and goes down again.

Try to remember that panic attacks always blow over. You are having physical symptoms, however it is not a heart attack and it does not last. 

A panic attack has the following official symptoms, according to the DSM-5:

• palpitations, a pounding heart, or an accelerated heart rate
• Sweating
• Trembling or shaking
• Sensations of shortness of breath or smothering
• Feeling of choking
• Chest pain or discomfort
• Nausea or abdominal pain
• Feeling dizzy, unsteady, lightheaded or faint
• Derealization (the feeling that this is not reality) 
• Or depersonalization (being detached from yourself)
• Fear of losing control or  “going crazy”
• Fear of dying
• Paresthesias (numbness or tingling sensation)
• Chills or heat sensations

Remember, feeling all things is incredibly normal during a panic attack. They are of course not fun to feel.

How long can anxiety last?

Anxiety is a strong stress reaction about a future event. If stress is in your life for a longtime, that anxiety will as well. In short, anxiety can go on for hours or days. The attack can come after this buildup. That is why it is very important to take care of yourself. 

However an attack, or a panic attack, is a sudden reaction. This fight or flight response has a peak and goes down again. A panic attack takes about 10 minutes to peak, after the body winds down.

Anxiety before a panic attack

Most people who have a panic attack don’t have it for the rest of their lives. We only speak of a panic disorder when you have recurrent panic attacks, without a cause for more than 6 months.

Many people who have a first panic attack, are scared to have another panic attack. This is very normal as the first one is usually not a great experience. This is called anticipatory anxiety, it is anxiety about something that hasn’t happened yet, but could. 

Anticipatory anxiety makes you think in loops. Worrying about a potential panic attack can make you stop from living your best life. You might think about losing control 

• when driving, 
• when you are shopping 
• or in public transportation. 

This can paralyze you and make you avoid such situations. 

The trick of letting these thoughts go, is noticing them. You don’t have to listen to these thoughts. Try to ask yourself “Is this an assumption or a fact?”, “is this realistic?”.

If this actually is something that could happen, there is no shame in preparing and doing what you can do. After you can let it go, as you’ve done what you could. 

Repeat or cyclical anxiety attacks

Anxiety can become a vicious cycle by avoidance behavior. While avoiding situations can help, it can also turn around and bite you. Too much avoidance can lead to unfunctional behavior and a spiral of “I told you so”. We (and animals) are strongly predisposed to avoid something if we know there could be potential negative consequences.

This reflex can stop you from attaining your goal, because you much rather would like to avoid suffering. Imagine this scenario. A mouse needs to push a button to receive cheese.

The cheese is a great reinforcer. Now the mouse gets shocked with electricity when he pushes that button. The stress and anxiety that that mouse goes through is enough for it to not to push that button again. 

Humans are not different. We would rather avoid (or not take action) than being punished. People with anxiety disorders are more sensitive to this mechanism.

You can learn to break this cycle by exposure therapy or cognitive behavioral therapy. It takes practice, as our life is a bit more complex than just pushing a button to get cheese.

What should I do after an anxiety attack?

After a panic attack, you should take note of what happened. Experiencing panic attack symptoms can be traumatic events for some. It can be extremely uncomfortable and make you doubt if you feel anxious about whether you have another medical illness (like a heart attack). Feeling anxious after a panic attack is normal, you went through a lot. 

Try to identify what triggered your anxiety so you can work on that in the future. 

Further, you should take this time to use some relaxation techniques and focus on something else. Try to do something you enjoy. Take a bath, do something creative. Your body has just been through a lot. It thought it was protecting you from a serious threat.  

Some people would suggest some mindfulness exercises like the 333 rule. Pay attention and name three things you see, three things you hear and lastly go back to your body. Pay attention to three parts of your body, for example 

• how your feet are grounded on the floor, 
• how your hair is moving in the wind and how your clothes feel on your skin.

The other lifestyle implementations can be a great way to calm your body at this stage or to recuperate the needed energy and hydration levels. 

If panic attacks or anxiety attacks are a frequent visitor in your life, seek treatment. You don’t need to live with this.

How to prevent anxiety attacks

Preventing panic attacks is not impossible. Panic is a very extreme form of anxiety and a survival response, induced by stress. It is essential to know what is stressing you out.

This is not to avoid this situation in the future, but to prepare yourself. Your body and brain needs to learn that nothing bad will happen when you go shopping or enter that train. That can only happen with practice, practice and practice. 

Mental health professionals can help if needed or go with a friend or family member to confront these situations. When a panic attack happens, assure yourself that it is just anxiety, and that you don’t have to listen to your thoughts. 

Further, it is essential to avoid drugs and caffeine. The effects of these addictive substances can play a number on your heart rate and your breathing. It can feel similar to the symptoms of a panic attack and this way inducing a panic attack.

What you can do yourself 

These lifestyle changes can help you control your anxiety and your stress levels. You can try the next interventions to focus on your mental and physical well being.

• Practice deep breathing
• Try mindfulness
• Get enough sleep
• Get some exercise or physical activity
• Don’t abuse alcohol and recreational drugs
• Avoid using alcohol and recreational drugs as a coping mechanism
• Reduce your stress levels
• Notice your triggers
• Accept that life is scary sometimes, and we don’t have everything under control
• Don’t fight or avoid these scary thoughts or situations
• Take action towards your goals and don’t be stopped by your fear or worry
• Eat a balanced and full diet
• Talk about it with friends, family or at a support group

When to seek help

You should seek help when these lifestyle changes are not enough for you anymore to lower your stress and anxiety levels. Further, if you have suicidal thoughts, you should seek out urgent medical advice.

A mental health professional can provide medical treatment in the form of medication and/or therapy. You can always call 911 if needed. Talking helps, there is no need to be alone with your difficulties.

How to treat anxiety disorders

Anxiety disorders and panic disorders should be treated by therapy, or by therapy in combination with medication. 

Medication

Anxiety disorder can be treated with medication. Medication approved for treatment of anxiety disorder is:

• SSRI’s (selective serotonin reuptake inhibitors), f.e.
• SNRI’s (serotonin and norepinephrine reuptake inhibitors)
• MAO’s (monoamine oxidase inhibitors)
• Azapirones, like Buspirone 
• Tricyclic antidepressants 
• GABAergic medication like benzodiazepines, pregabalin and gabapentin
• Beta-blockers

A healthcare provider can provide medical advice on what is best and what you would need. Do not stop these medications without asking your healthcare provider. It also can take up to 4 to 6 weeks to notice an effect of these. 

Cognitive behavioral therapy

Talk therapy or cognitive behavioral therapy is usually recommended in combination with medication. Cognitive behavioral therapy can help you spot the pattern and help you how to cope better with your anxiety. They do this by focussing on behavioral change. 

Conclusion

Having an anxiety disorder, panic attacks or a panic disorder is not fun. Anxiety does not have to dictate your life. A panic attack will calm down eventually and can not hurt you. Your body is just going through stress to protect you from, what it thinks, is an upcoming threat.

You don’t have to live with this intense fear, anxiety sufferers can seek appropriate treatment. There is anti anxiety medication available, and also therapy.