Panic Disorder

Mental Health

With around 40 million sufferers in the United States alone, panic disorder is one of the most common mental disorders around today. It is characterized by panic attacks or episodes of fear and terror that cannot be controlled and occur for no apparent reason. You may be reading a book, watching a mild TV program, or driving in your car when suddenly a panic attack occurs.

Panic attacksalsotend to reoccur. This results in persistent fear of panic attacks, so that people who suffer from them may change the things they do to avoid them. It is in this way that living in fear of panic attacks can severely affect the quality of life. For example, if you have a panic attack at the grocery store, you may have someone else do your shopping.  If you have an attack while driving, you may limit your driving. Some people may avoid social situations, and in severe cases, one may even avoid leaving the house altogether. The disorder can disable some people to such an extent that they are unable to attend work or school. Fortunately, this condition is manageable with proper treatment and support.Read on to learn more about panic disorder and some helpful lifestyle tips to help.

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Symptoms

Here is a comprehensive list of panic disorder symptoms:

  • Intense fear
  • Sweating
  • Feeling cold
  • Feeling smothered
  • Trouble breathing
  • Feeling faint
  • Nausea
  • Feeling disconnected
  • Feeling like you want to curl up into a ball
  • Trouble concentrating.
  • Feeling like your brain is shutting down
  • Feelings of doom
  • Trouble hearing (plugged ears)
  • Excessive yawning
  • Headaches
  • Irregular heartbeats (palpitations)
  • Feeling like you need to run or get somewhere quickly
  • Hot flashes
  • Choking sensations
  • Fast heart rate
  • Chest pain
  • Numbness in hands and feet
  • Feeling disoriented
  • Fear of dying
  • Chest pressure
  • Burning sensations
  • Focus is only on the symptoms
  • Passing gas
  • Blurred vision
  • Frequent urination or bowel movements
  • Dry mouth

You may feel like the symptoms will last forever or that you willdie from the attack. A panic attack usually does not last for more than 10 minutes and true panic attacks are in no way life-threatening. The attacks usually come on suddenly and then go away slowly. Some people will feel very tired after the attack or continue to be on edge for hours.

Panic attacks can mimic the symptoms of other disorders and some people feel like they are having a heart attack, stroke, or other life-threatening condition. This is why it is very important that the first time you experience these symptoms, especially with chest pain and pressure, you get emergency medical help right away. If you are given the all-clear, and the emergency professionals say that you are physically okay, make an appointment with your doctor as soon as possible for a full physical examination.

Diagnosis

When you see your doctor, they will take a health history, gather a list of medications, and obtain your family history. The doctor will do a physical examination and order tests to check your physical health. They will look for any conditions that can cause anxiety and panic disorder. These tests may include:

  • Thyroid testing
  • Electrocardiogram (ECG)
  • Testing on your adrenal glands (e.g.,CT scan to check for tumors; 24-hour urine test to check for catecholamines, or the chemicals in your body that can make you anxious)
  • Female hormone levels (e.g., estrogen;progesterone)
  • Test for Lyme disease
  • Electrolytes (e.g., magnesium;potassium; calcium; vitamin; B12 levels)

Other tests will be performed as needed. If your physical health checks out, your doctor may evaluate you for panic disorder. A panic disorder diagnosis is based on the following criteria:

  1. Your panic attacks are unrelated to your health, substance abuse, or other mental health condition.
  2. You have frequent panic attacks that are unexpected and cannot be explained.
  3. At least one panic attack is followed by one month or longer of worry about panic attacks, feeling like you are losing control, or you develop avoidant behaviors.

The doctor may still choose to treat you for panic disorder even if you are not diagnosed with it. Even infrequent panic attacks can develop into a full-blown debilitating panic disorder.

Treatments

Panic disorder usually benefits from a combination of treatments. You may need medication, in the beginning, to help bring the anxiety under control. This, combined with behavioral techniques to control the anxiety, can help relieve the panic attacks. If you only have mild panic disorder, you may only need some therapy and behavioral techniques. Treatments include:

Therapy. A trained counselor or psychologist can help you talk out your feelings. They can also teach you cognitive behavioral therapy techniques to help you control the attacks. These help you overcome the actual fear of fear. Therapy can take months to be effective but lasts longterm.

Medication. Several different medications can help reduce panic attacks and possible underlying symptoms of depression. These include:

  • These help in the shortterm to stop acute panic attacks. They are usually only used during the time it takes for antidepressantsto start working, from 4 to 6 weeks. They are used as little as possible due to side effects and the risk of dependence.
  • Selective serotonin reuptake inhibitors (SSRIs). These block the reuptake of serotonin in the brain and nervous system. This helps to balance the chemicals that make you feel better and calmer.
  • Selective norepinephrine reuptake inhibitors (SNRIs). These block the reuptake of norepinephrine in the brain and nervous system. They are more potent than SSRIs and tend to work well for anxiety.

Your doctor may try a combination of medications to make them more effective. They do have side effects including low libido (sex drive), dry mouth, weight gain, and drowsiness, among others. Make sure you check to see how the medicine is working before driving or working with heavy machinery.

Alternative Treatments and Home Remedies

While they are not a cure, some herbal remedies may help the symptoms of panic disorder. Always make sure you talk to your doctor about using any herbal supplements. Some can interact with other antidepressants and be dangerous. Let your doctor know if you are already taking anything overthecounter for anxiety. A few herbal remedies some have used are:

Inositol. Studies are finding that this B vitamin may help reduce anxiety.

Aromatherapy. Lavender oil, for example, can have a calming effect.

Chamomile tea. Generally safe unless you are allergic.

St. John’s wort. Never use this if you are on prescription antidepressants.

Passionflower.

Kava. Do not use it if you have liver disease.

Valerian.

References

Anxiety and Depression Association of America. (2014, September). Facts and statistics. Retrieved from Anxiety and Depression Association of America: https://www.adaa.org/about-adaa/press-room/facts-statistics

Gorman, J. (2013, February). Panic disorder. Retrieved from National Alliance on Mental Illness: https://www2.nami.org/Content/NavigationMenu/Inform_Yourself/About_Mental_Illness/By_Illness/Panic_Disorder.htm

Hentz, P. (2008, March 18). Separating anxiety from physical illness. Retrieved from Clinical Advisor: https://www.clinicaladvisor.com/features/separating-anxiety-from-physical-illness/article/117767/

Mayo Clinic. (2015, May 19). Panic disorder: Tests and diagnosis. Retrieved from Mayo Clinic: https://www.mayoclinic.org/diseases-conditions/panic-attacks/basics/tests-diagnosis/con-20020825

Tartakovsky, M. (2015, September 3). 15 small steps you can take today to improve anxiety symptoms. Retrieved from Psych Central: https://psychcentral.com/lib/15-small-steps-you-can-take-today-to-improve-anxiety-symptoms/

University of Maryland Medical Center. (2013, March 11). Anxiety disorders. Retrieved from Umm.edu: https://umm.edu/health/medical/reports/articles/anxiety-disorders

U.S. Department of Health and Human Services. (2013). Panic Disorder: When fear overwhelms. NIH Publication No. TR 10-4679. Retrieved from National Institute of Health: https://www.nimh.nih.gov/health/publications/panic-disorder-when-fear-overwhelms/index.shtml

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