<unk> nic disorder can be effectively treated with a variety of interventions, including psychological therapies and medication. Cognitive-behavioral therapy has the most complete and longest duration of effect, followed by specific selective serotonin reuptake inhibitors. A 2009 review found positive results from therapy and medication and a much better result when the two were combined. Lifestyle changes Caffeine may cause or exacerbate<unk> nic anxiety. Anxiety can temporarily increase during withdrawal from caffeine and various other drugs. Increased and regimented aerobic exercise such as running has been shown to have a positive effect on combating<unk> nic anxiety. There is evidence that suggests that this effect is correlated to the release of exercise-induced endorphins and the subsequent reduction of the stress hormone cortisol. There remains a chance of<unk> nic symptoms becoming triggered or being made worse due to increased respiration rate that occurs during aerobic exercise. This increased respiration rate can lead to hyperventilation and hyperventilation syndrome, which mimics symptoms of a heart<unk> , thus inducing a<unk> . The benefits of incorporating an exercise regimen have shown the best results when<unk> ced accordingly. Muscle relaxation techniques are useful to some individuals. These can be learned using recordings, videos, or books. While muscle relaxation has proved to be less effective than cognitive-behavioral therapies in controlled trials, many people still find at least temporary relief from muscle relaxation. Breathing exercises In the great majority of cases, hyperventilation is involved, exacerbating the effects of the<unk> . Breathing retraining exercise helps to rebalance the oxygen and CO2 levels in the blood. David D. Burns recommends breathing exercises for those suffering from anxiety. One such breathing exercise is a 5-2-5 count. Using the stomach (or diaphragm)—and not the chest—inhale (feel the stomach come out, as opposed to the chest expanding) for 5 seconds. As the maximal point at inhalation is reached, hold the breath for 2 seconds. Then slowly exhale, over 5 seconds. Repeat this cycle twice and then breathe 'normally' for 5 cycles (1 cycle = 1 inhale + 1 exhale). The point is to focus on breathing and relax the heart rate. Regular diaphragmatic breathing may be achieved by extending the out-breath by counting or humming. Although breathing into a<unk> per bag was a common recommendation for short-term treatment of symptoms of an acute<unk> , it has been criticized as inferior to measured breathing, potentially worsening the<unk>  and possibly reducing needed blood oxygen. While the<unk> per bag technique increases needed carbon dioxide and so reduces symptoms, it may excessively lower oxygen levels in the bloodstream. Capnometry, which provides exhaled CO2 levels, may help guide breathing. Therapy According to the American Psychological Association, "most specialists agree that a combination of cognitive and behavioral therapies are the best treatment for<unk> nic disorder. Medication might also be appropriate in some cases." The first<unk> rt of therapy is largely informational; many people are greatly helped by simply understanding exactly what<unk> nic disorder is and how many others suffer from it. Many people who suffer from<unk> nic disorder are worried that their<unk> s mean they are "going crazy" or that the<unk> nic might induce a heart<unk> . Cognitive restructuring helps people replace those thoughts with more realistic, positive ways of viewing the<unk> s. Avoidance behavior is one of the key aspects that prevent people with frequent<unk> s from functioning healthily. Exposure therapy, which includes repeated and prolonged confrontation with feared situations and body sensations, helps weaken anxiety responses to these external and internal stimuli and reinforce realistic ways of viewing<unk> nic symptoms. In deeper level psychoanalytic approaches, in<unk> rticular object relations theory,<unk> s are frequently associated with splitting (psychology),<unk> ranoid-schizoid and depressive positions, and<unk> ranoid anxiety. They are often found comorbid with borderline personality disorder and child sexual abuse.<unk> ranoid anxiety may reach the level of a persecutory anxiety state. Meditation may also be helpful in the treatment of<unk> nic disorders. There was a meta-analysis of the comorbidity of<unk> nic disorders and agoraphobia. It used exposure therapy to treat<unk> tients over a period. Hundreds of<unk> tients were used in these studies and they all met the DSM-IV criteria for both of these disorders. A result was that thirty-two percent of<unk> tients had a<unk> nic episode after treatment. They concluded that the use of exposure therapy has lasting efficacy for a client who is living with a<unk> nic disorder and agoraphobia. The efficacy of group therapy treatment over conventional individual therapy for people with<unk> nic disorder with or without agoraphobia appears similar. Medication Medication options for<unk> s typically include benzodiazepines and antidepressants. Benzodiazepines are being prescribed less often because of their potential side effects, such as dependence, fatigue, slurred speech, and memory loss. Antidepressant treatments for<unk> s include selective serotonin reuptake inhibitors (SSRIs), serotonin noradrenaline reuptake inhibitors (SNRIs), tricyclic antidepressants (TCAs), and MAO inhibitors (MAOIs). SSRIs in<unk> rticular tend to be the first drug treatment used to treat<unk> s. Selective serotonin reuptake inhibitors (SSRIs) and tricyclic antidepressants appear similar for short-term efficacy. SSRIs carry a relatively low risk since they are not associated with much tolerance or dependence, and are difficult to overdose with. TCAs are similar to SSRIs in their many advantages but come with more common side effects such as weight gain and cognitive disturbances. They are also easier to overdose on. MAOIs are generally suggested for<unk> tients who have not responded to other forms of treatment. While the use of drugs in treating<unk> s can be very successful, it is generally recommended that people also be in some form of therapy, such as cognitive-behavioral therapy. Drug treatments are usually used throughout the duration of<unk>  symptoms and discontinued after the<unk> tient has been free of symptoms for at least six months. It is usually safest to withdraw from these drugs gradually while undergoing therapy. While drug treatment seems promising for children and adolescents, they are at an increased risk of suicide while taking these medications and their well-being should be monitored closely.
Panic attack
Substance use disorder
Heat syncope
Dysautonomia
Shark attack
Hyperparathyroidism
Heat stroke
Hyperthyroidism