Why am i nervous for no reason

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Learn about panic disorder, a condition which causes recurring and regular panic attacks

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Panic disorder - Illnesses & conditions

The main aim in treating panic disorder is to reduce the number of panic attacks and ease the severity of symptoms.

Psychological therapy and medication are the two main types of treatment for panic disorder.

Depending on your individual circumstances, you may need one of these treatment types or a combination of the two.

If you're offered psychological therapy, it will probably be in the form of cognitive behavioural therapy (CBT). If this doesn't work, medication may be recommended.

Before starting any form of treatment, your GP will discuss all of the options with you, outlining the advantages of each type and making you aware of any possible risks or side effects.

No single treatment works for everyone and you may need to try a number of treatments before finding one that works for you. The treatment that's recommended will depend on your general level of health, the severity of your condition and your personal preferences.

It's important you understand what your treatment will involve. If you don't understand something your GP has told you, ask them to explain it in more detail.

Cognitive behavioural therapy

Psychological therapy has proven long-term benefits and it's recommended for treating panic disorder. It will usually take the form of cognitive behavioural therapy (CBT).

CBT is thought to be one of the most effective psychological treatments for panic disorder. It involves having regular sessions with a therapist.

The therapist may discuss with you how you react when you have a panic attack and what you think about when you're experiencing an attack.

Once you and your therapist have identified any negative thoughts and beliefs, you can work on replacing them with more realistic and balanced ones. Your therapist can also teach you ways of changing your behaviour, making it easier for you to deal with future panic attacks.

For example, they may be able to show you breathing techniques that can be used to help keep you calm during a panic attack.

The National Institute for Health and Care Excellence (NICE) recommends a total of seven to 14 hours of CBT to be completed within a four month period. Treatment will usually involve having a weekly one to two hour session.

NICE also recommends that in certain situations a shorter programme of CBT may be appropriate. This can involve a reduced number of hours of CBT with ‘homework’ being set between sessions so that you can practice what you've learnt after each session.

You should visit your GP regularly while you're having CBT so that they can assess your progress and see how you're doing.

Support groups

Support groups can provide useful information and advice about how you can effectively manage your panic disorder. They're also a good way of meeting other people who've had similar experiences of the condition.

Panic attacks can sometimes be frightening and isolating, so it can be helpful to know that other people are experiencing the same feelings and emotions as you.

Anxiety UK and Triumph Over Phobia (TOP UK) are UK-based charities that provide information and support for people with anxiety disorders.

Support groups often involve face-to-face meetings where you can talk about your problems and difficulties with others. Many can also provide support and guidance over the telephone or in writing.

Ask your GP about support groups for panic disorder near you. You can also use the services directory to find anxiety services in your area.


Antidepressants are often associated with depression, but they can also be used to treat a number of other psychological conditions.

Antidepressants can take two to four weeks before becoming effective. It's therefore important to continue taking them, even if you feel they're not working. You should only ever stop taking prescribed medication if your GP specifically advises you to do so.

Selective serotonin reuptake inhibitors (SSRIs) and tricyclic antidepressants are two types of antidepressants that are often recommended for treating panic disorder.

When starting a new type of medication, you should be regularly assessed by your GP at two, four, six and 12 week intervals. This will allow you to discuss any issues that you have with your medication, and enables your GP to assess which treatment is most effective. It will also provide you with the opportunity to try a different type of medication if you want to.

Selective serotonin reuptake inhibitors (SSRIs)

Selective serotonin reuptake inhibitors (SSRIs) are a type of antidepressant that work by increasing the level of a chemical called serotonin in your brain.

They're the most commonly prescribed type of antidepressant for treating panic disorder. They're usually started at a low dose before gradually being increased as your body adjusts to the medicine.

Common side effects of SSRIs include:

  • nausea
  • headaches 
  • low sex drive (loss of libido)
  • blurred vision
  • diarrhoea or constipation
  • dizziness
  • dry mouth 
  • loss of appetite
  • sweating
  • feeling agitated
  • insomnia (sleep problems)
  • abdominal pain

When you first start taking SSRIs, your feelings of anxiety and panic may get slightly worse. In most cases, this is temporary and your symptoms will start to return to normal levels within a few days of taking the medicine.

Speak to your GP if you feel that your symptoms have got worse and that they're not showing signs of returning to normal levels after a few days.

After you start to take a SSRI, you should visit your GP after two, four, six, and 12 weeks so that they can check on your progress and see whether you're responding to the medicine. Not everyone responds well to antidepressant medicines, so it's important that your progress is carefully monitored.

If your GP feels it necessary, you may require regular blood tests or blood pressure checks when taking antidepressants. If after 12 weeks of taking the medication you don't show any signs of improvement, your GP may prescribe an alternative SSRI to see if it has any effect.

The length of time that you'll have to take a SSRI for will vary depending on how well you respond to the treatment. Even if you feel that your panic disorder has been successfully treated, it's likely that you'll need to keep taking the medication for at least six to 12 months.

If you stop taking your medication before this time, the risk of your symptoms recurring may be increased. Some people may have to take SSRIs for longer than the usual six to 12 month period.

When you and your GP decide that it's appropriate for you to stop taking SSRIs, you will gradually be weaned off them by slowly reducing your dosage. As with antidepressants, you should never stop taking SSRIs unless your GP specifically advises you to.

Stopping your medication straight away without being weaned off, or without seeking advice from your GP, may result in withdrawal symptoms such as:

  • dizziness
  • numbness and tingling
  • nausea and vomiting
  • headache
  • anxiety
  • sleep disturbances
  • sweating

These symptoms can also occur if you miss a dose of medication, or if your dose is reduced. The symptoms are usually mild, but they can be severe if the medication is stopped suddenly.

For some people, this means having to take SSRIs on a long-term basis. For others, a course of CBT can help to reduce the risk of their symptoms recurring.

Contact your GP if you experience troublesome side effects that don't ease.

Tricyclic antidepressants

If SSRIs aren't suitable, or if your symptoms don't improve after a 12 week course of SSRIs, your GP may try prescribing a different type of antidepressant.

Tricyclic antidepressants work in a similar way to SSRIs. They regulate the levels of the chemicals noradrenaline and serotonin in your brain, which has a positive effect on your feelings and mood.

Imipramine and clomipramine are two tricyclic antidepressants that are often prescribed to treat panic disorder. Tricyclic antidepressants aren't addictive.

SSRIs are usually prescribed before tricyclic antidepressants because they have fewer side effects. Common side effects of tricyclic antidepressants include:

  • constipation
  • difficulty urinating
  • blurred vision
  • dry mouth
  • weight gain or weight loss
  • drowsiness
  • sweating
  • lightheadedness
  • skin rash

The side effects should ease after seven to 10 days as your body starts to get used to the medication. However, see your GP if they become troublesome and don't ease.


Pregabalin is another medication that’s often used to treat panic disorder. It’s an anticonvulsant that's also used to treat epilepsy (a condition that causes repeated seizures). However, it's also been found to be beneficial in treating anxiety.

Side effects of pregabalin can include:

  • drowsiness
  • dizziness
  • increased appetite and weight gain
  • blurred vision
  • headaches
  • dry mouth
  • vertigo – the sensation that you, or the environment around you, are moving or spinning

Pregabalin is less likely to cause nausea or a low sex drive than SSRIs.


Clonazepam is another medication that’s often used to treat epilepsy and is also sometimes prescribed for panic disorder.

It can cause a wide variety of side effects including lethargy (lack of energy), abnormal eye movement (nystagmus), confusion and allergic reactions.


You may be referred to a mental health specialist if treatments such as attending a support group, CBT and medication don't improve your symptoms of panic disorder.

A mental health specialist will carry out an overall reassessment of your condition. They'll ask you about your previous treatment and how effective you found it. They may also ask you about things in your life that may be affecting your condition, or how much support you get from family and friends.

The specialist will be able to devise a treatment plan for you, which will aim to effectively treat your symptoms. The type of mental health specialist that you'll be referred to will depend on your individual situation. For example, you may be referred to a:

  • psychiatrist – a trained medical doctor who specialises in mental health; a psychiatrist is one of the only mental health specialists who is able to prescribe medication
  • clinical psychologist – who is trained in the scientific study of human behaviour and mental processes and focuses solely on the assessment and treatment of mental health conditions; a clinical psychologist will help you to find ways of effectively managing your anxiety and panic attacks

How to stop winding yourself up: 10 recommendations from Dale Carnegie's book

Contents of the article

Excitement and anxiety accompany us everywhere: at home and at work, on the bus and in the store, in line and in traffic jams. There is practically no person who does not face excitement. But some people can pull themselves together and survive an unpleasant moment, while others begin to wind themselves up even more, turning simple anxiety into chronic stress. We've summarized the tips from psychologist Dale Carnegie in How to Stop Worrying and Start Living? to change your perspective and reduce stress. nine0003

Tip 1. Distinguish between the past and the present

To stop overthinking yourself and worrying about problems that may happen in the future, you need to live in the present. Dale Carnegie proposes to mentally install an "iron curtain" that will delimit the past and the future, preventing a person from regretting old mistakes once again or thinking about tomorrow's difficulties.

Advice 2. Answer the Questions

At the height of your panic attack, ask yourself three questions from Willis Carrier's magical formula from Dale Carnegie's book. nine0003

  1. What is the worst thing that can happen in this situation?
  2. How can this problem be solved?
  3. Will I be able to cope with these difficulties?

If you honestly answer these questions for yourself, you will understand that even in the worst case scenario, you will be able to cope with trouble.

Tip 3. Think about the harmful effects of stress

In times of stress, you must constantly remember the harm that anxiety can do to your body. The author of the book cites the sad fact that business people who live in chronic stress die early. Therefore, it is important to take care of yourself and stay calm. nine0003

Tip 4. Think positively

Cheerful thoughts can reduce anxiety and calm down quickly. To do this, you need to develop positive thinking in yourself, try to maintain a good mood and look at life with a smile.

Advice 5. Start acting

When a person is inactive, bad thoughts begin to creep into his head. The best way to get rid of them is to keep yourself busy. So the brain will switch to action, and psychological stress will decrease. nine0003

Tip 6. Get rid of the habit of being nervous

Surely you have met people who, for any reason, begin to worry. For them, anxiety for no reason has already become a habit, which is still better to get rid of. To do this is simple - create a new useful habit - do not worry about trifles.

Advice 7. Do not worry about what has already happened

Many people continue to reproach themselves for past mistakes that cannot be corrected. In this situation, you need to accept the inevitable and let go of the past. Just say to yourself, “What happened that should have happened” and calm down. nine0003

Advice 8. Set an acceptable level of emotions

To control excitement and anxiety, you need to mentally set a "limiter" to your emotions. Just assess the situation and determine the acceptable level of experience, beyond which you can not go.

As you can see, Dale Carnegie's recommendations are quite simple and easy to apply in everyday life. The main thing to do is to firmly decide to change your thinking. You can also study the nature of stress and master relaxation techniques - see the instructions in the free online course "Stress Management". nine0003

what to do — blog of the medical center ON Clinic

We answer the most important questions: how not to be nervous, how to calm down and what are the consequences of stress.

What happened?

Nothing, but all the time you are in a state of anxiety. You feel like something is about to happen. It's actually normal to feel anxious. If a person were not afraid of anything and did not worry about anything, he simply could not recognize a potentially dangerous situation and, as a result, protect himself. Another question is that constant anxiety is tiring and significantly reduces the quality of life. Constant anxiety causes many unpleasant symptoms, such as abdominal pain or intestinal upset. We have found effective ways to help control the unpleasant manifestations of anxiety. nine0003

So what should I do? Can do yoga?

You can do yoga, you can just go to the park and take a walk in the fresh air. People who move a lot experience less anxiety than sedentary people. No wonder the World Health Organization recommends more than 150 minutes of moderate aerobic exercise per week. For example, you can dance or ride a bike five times a week for 30 minutes. The main thing is that you enjoy your time. nine0003

I am already doing breathing exercises. Will it help?

Of course. Breathing exercises refer to relaxation methods, the purpose of which is to calm down in stressful situations. Deep breathing reduces the number of heartbeats per minute and lowers blood pressure. Exercises can be performed in any convenient position and place. Here is an example of such an exercise: slowly and effortlessly inhale air through your nose (at this time you can count to five), and then exhale through your mouth (also count to five). nine0003

What can you say about meditation? The magazines write that it is useful

Indeed, meditation is also one of the methods of relaxation. It is not a universal remedy, but meditation helps in stressful situations and is an adjunct treatment for anxiety disorder.

In such cases, my grandmother drank valerian. And will it help me?

Your choice. Existing data on the benefits of valerian are conflicting. Valerian is considered safe (in recommended doses), but drinking it for more than two weeks is not recommended: the effect on the body with long-term use has not been studied. It is also important to understand that all sedatives, in particular valerian, have side effects. In any case, you should consult your doctor before starting medication (especially if you are already taking other medications). nine0003

What about music?

There is no exact answer. It is too early to say that music has a calming effect. However, there are some studies. In one of them, the authors concluded that, in preparation for surgery, listening to certain music reduces anxiety better than some sedatives.

What else can you do?

Sleep well and enough (ideally waking up without an alarm) - lack of healthy sleep worsens the situation and makes anxious people even more anxious. Eat a balanced diet and take rest breaks. Also, do not withdraw into yourself: communication with loved ones, stable and deep social contacts help to feel safe. Hobbies and learning a skill, such as drawing or a new language, help you enjoy life more and increase your self-esteem. nine0003

What better not to do?

Do not abuse coffee and cigarettes: they will make things worse. The same goes for alcohol: although it can temporarily reduce anxiety, but all attempts to eradicate anxiety with the help of alcoholic beverages are a direct path to alcohol addiction.

What if none of the methods help?

Go to the doctor. Anxiety that persists for a long time can be a sign of an anxiety disorder. In addition to relaxation techniques and regular exercise, your doctor may suggest psychotherapy, such as cognitive behavioral therapy. This method helps to identify and change beliefs that prevent you from adequately perceiving reality. With the help of cognitive behavioral therapy, you can learn to control your emotional state and act consciously. In some cases, medication may be needed, such as antidepressants. nine0003

Can the stomach hurt due to stress?

Yes. Many people want to go to the toilet before important events, such as before a job interview or public speaking. This is believed to be due to the body's "fight or flight" response. During stress, digestion processes in the stomach and small intestine slow down, and the muscles of the large intestine, on the contrary, begin to contract more strongly, so there is a need to go to the toilet. Usually this condition passes quickly. Relaxation techniques will also come in handy. If the bowel behaves unpredictably several times a month, it may indicate irritable bowel syndrome (IBS). Only a doctor can rule out other causes of such symptoms and make a diagnosis. nine0003

What is irritable bowel syndrome?

Irritable bowel syndrome is a condition that sometimes causes pain, diarrhea or constipation, flatulence and bloating. Unpleasant symptoms bother for at least three months and are not associated with the quality of food and pathological changes in the intestines. IBS is not a dangerous condition: it does not affect life expectancy and does not provoke other diseases.

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