Understanding and Getting Help for Panic Disorder Symptoms and Attacks

Understanding Panic Disorder

Panic disorder is a type of anxiety disorder characterized by sudden, intense feelings of fear and panic that reach a peak within minutes. These panic attacks seem to strike out of the blue, with no obvious trigger or cause. This unexpected, intense fear and terror can be highly debilitating for those suffering from panic disorder.

People experiencing a panic attack may feel like they are losing control, having a heart attack, or even dying. Physical symptoms often include a pounding heart, sweating, trembling, shortness of breath, numbness or tingling, chills, nausea, and dizziness. Understandably, these symptoms can feel extremely frightening.

Panic attacks themselves are not dangerous physically, but the level of fear experienced can make a person feel like they need emergency medical care. Some people with panic disorder develop agoraphobia, avoiding places where they fear a panic attack could occur. This avoidance behavior can severely limit daily activities.

Symptoms of Panic Disorder

The primary symptom of panic disorder is the repeated, unexpected panic attack. Panic attacks involve a combination of intense physical and emotional symptoms that develop abruptly and peak within minutes. Common symptoms include:

• Racing heartbeat
• Shortness of breath
• Trembling or shaking
• Sweating
• Chills or hot flashes
• Nausea or abdominal pain
• Dizziness, lightheadedness, or faintness
• Numbness or tingling sensations
• Feelings of unreality or detachment
• Fear of losing control or "going crazy"
• Fear of dying

These panic attack symptoms are the body's fight-or-flight response kicking in even when no real danger is present. The flood of stress hormones leads to the observed symptoms as the body prepares to respond to an emergency.

When to See a Doctor

People having severe or repeated panic attacks should seek medical help. A doctor can check for any underlying health condition and provide an accurate diagnosis. Blood tests and other diagnostic tests may be used to rule out other potential causes of symptoms.

A psychiatrist or psychologist can provide counseling, therapy, and medications if appropriate to help manage panic disorder symptoms. Cognitive behavioral therapy is often used to help identify triggers for panic attacks and develop strategies to alter thought patterns that fuel anxiety.

Ignoring repeated panic attacks and not seeking help can lead to complications like depression, substance abuse, phobias, and an inability to leave the house or go to work. Seeking professional mental health support is important for overcoming panic disorder.

Causes of Panic Disorder

Medical researchers do not know exactly what causes panic disorder, although they believe genes, brain chemistry, and environmental factors play a role. Some possible causes and risk factors include:

Genetics

Panic disorder appears to run in families. Those with family members who have anxiety disorders or depression are more likely to develop panic disorder. Certain gene variants may increase susceptibility.

Brain Chemistry

Neurotransmitters like norepinephrine, serotonin, and gamma-aminobutyric acid (GABA) regulate emotions, and abnormalities in these systems may prompt panic attacks. Medications that alter brain chemistry can help control panic disorder.

Environmental Factors

Stressful or traumatic life events like abuse, death of a loved one, divorce, or job loss can trigger panic attacks, especially in those already prone to anxiety. Even positive transitions like a promotion can be stress-inducing.

Substance Use

Caffeine, cannabis, stimulants, and medications that contain stimulants may trigger or worsen panic attacks. Withdrawal from substances can also cause anxiety symptoms.

Medical Conditions

Certain illnesses linked to panic disorder include heart disease, respiratory illnesses, hyperthyroidism, hypoglycemia, and vertigo caused by inner ear disturbances. Panic attacks can also occur after surgery.

Mental Health Issues

Anxiety, depression, bipolar disorder, sleep disorders, PTSD, and phobias can increase risk for panic disorder. Panic attacks are associated with many mental health conditions.

Triggers for Panic Attacks

While panic attacks may seem random and spontaneous, in many cases specific triggers can set them off. Being aware of potential triggers can help people with panic disorder avoid or manage them. Common triggers include:

Stress

High stress levels increase risk for panic attacks. Things like work pressure, financial problems, divorce, illnesses, and major life changes all provoke stress. Learning stress management skills is important.

Anxiety

Generalized anxiety disorder (GAD) involves chronic worrying about many areas of life. This constant anxiety can make a panic attack more likely. Treating the underlying GAD can help.

Phobias

A phobia involves an intense, irrational fear of something specific like flying, heights, or animals. Facing one's phobia can trigger panic attacks. Gradually exposing yourself to feared situations helps overcome phobias.

Caffeine

Caffeine from coffee, tea, soda, energy drinks, and chocolate stimulates the body. This can prompt anxiety, insomnia, and nervousness that precipitate a panic attack. Limiting or avoiding caffeine may help.

Medications

Certain prescription and over-the-counter medications like prednisone, stimulants, thyroid medications, asthma inhalers, and decongestants can cause anxiety-like side effects that lead to panic attacks.

Drug Withdrawal

Quitting alcohol, benzodiazepines, and antidepressants abruptly can cause withdrawal symptoms like tremors, sweating, and increased heart rate and anxiety. These feelings of panic serve as a trigger.

Smoking

Nicotine from smoking cigarettes can act as a stimulant, while withdrawal between cigarettes may also lead to panic reactions. Quitting smoking can be beneficial.

Hyperventilation

Some people with panic disorder fall into a pattern of hyperventilating due to anxiety. This over-breathing causes physical symptoms that reinforce fears and creates a cycle that can trigger panic attacks.

Agoraphobia

The fear of being trapped or unable to escape can trigger panic attacks. Situations like being in crowds, on bridges, in tunnels, or far from home can provoke these fears in some people with agoraphobia.

Complications of Panic Disorder

Without proper treatment, panic disorder can result in a number of complications that adversely impact a person's life:

Clinical Depression

Many people with panic disorder develop clinical depression as a result of the social isolation, lost opportunities, disruption to their career, and reduced quality of life caused by severe anxiety and fear.

Agoraphobia

Around one-third of people with panic disorder progress to having agoraphobia. This condition involves intense fear and avoidance of places or situations where escape might be difficult or help unavailable if a panic attack occurs.

Substance Abuse

Turning to alcohol or drugs to gain relief from severe anxiety and panic attacks places some people at risk for substance abuse and addiction issues.

Suicidal Thoughts

The depression, despair, and impaired functioning resulting from panic disorder leads some to contemplate suicide. Proper diagnosis and treatment helps lower suicide risk.

Occupational Issues

Many people with untreated panic disorder struggle to maintain employment due to avoidance behaviors, absenteeism, and poor job performance related to their anxiety and panic attacks.

Treatment for Panic Disorder

Panic disorder is highly treatable through a combination of psychotherapy, medications, and self-help strategies. The goals are to identify triggers, alter thoughts and behaviors that fuel attacks, manage symptoms, and improve overall mental health.

Psychotherapy

Cognitive behavioral therapy helps identify distorted thought patterns surrounding fear and change behavioral responses to triggers. Exposure therapy gradually exposes you to feared situations in a safe, controlled way to conquer phobias. Support groups provide connection.

Medications

Antidepressants like SSRIs and SNRIs can help regulate brain chemistry to prevent panic attacks. Benzodiazepines offer short-term relief of acute anxiety symptoms. Beta blockers control some physical symptoms.

Relaxation Techniques

Relaxation skills like deep breathing, meditation, mindfulness, and yoga help lower stress and tension in the body. This calms the mind and reduces the likelihood of panic attacks occurring.

Avoiding Triggers

Preventing exposure to known panic attack triggers like caffeine, medications, or phobia situations can help reduce frequency of attacks and enable better control.

Exercise

Regular aerobic exercise helps the body better handle stress and anxiety. Exercise boosts mood and mental well-being while tiring the muscles so panic is less likely.

Living with Panic Disorder

Making certain lifestyle adjustments enables people with panic disorder to gain greater control over their condition:

Learn Relaxation Skills

Mastering relaxation techniques like controlled breathing, progressive muscle relaxation, and meditation prevents hyperventilation and excessive tension that contribute to panic attacks.

Challenge Anxious Thoughts

Keep a log of negative thoughts surrounding feared consequences of panic attacks. Analyze and challenge the reality of those thoughts to gain a balanced perspective.

Practice Self-Care

Ensure good sleep habits, nutrition, social connection, enjoyable activities, and stress management. Caring for your overall health supports mental health.

Communicate Needs

Let loved ones know how they can help during and following a panic attack. Have strategies prepared for exiting places and getting assistance if needed.

Join a Support Group

Connecting with others experiencing panic disorder reminds you that you are not alone. Groups provide tips on coping and accountability for making progress.

Stick to Treatment

Keep taking medications as directed and stay in therapy even after improvement. Ongoing treatment can prevent relapse and long-term complications.

When to Seek Emergency Help

Most panic attacks will subside on their own within a few minutes. Try using relaxation and breathing techniques first to attempt to regain control. However, contact emergency medical help right away if:

• This is your first ever panic attack
• You have difficulty breathing, chest pain, or fainting
• You are having suicidal thoughts
• The panic attack does not respond to self-help after 10 minutes
• You are unsure if symptoms represent real medical emergency

While panic attacks themselves are not medically dangerous, they can indicate life-threatening conditions requiring prompt evaluation. Do not hesitate to call emergency services for help.

Outlook for Panic Disorder

Panic disorder is a highly treatable condition. Most people achieve significant symptom relief and improved quality of life through professional treatment. Some key points include:

• With therapy, 70 to 90% see reduced anxiety and panic attack frequency
• Certain SSRIs and SNRIs can help prevent recurrent attacks
• Relaxation skills give a sense of control over panic reactions
• Exposure therapy can eliminate phobias and anticipatory anxiety
• Cognitive behavioral therapy modifies thought patterns
• Support groups provide perspective that panic disorder is manageable

While panic disorder can significantly disrupt your life, the long-term prognosis with comprehensive treatment is very good. Most people are able to gain control and go on to live happy, fulfilling lives.

Disclaimer: This article is for informational purposes only and does not constitute medical advice. Always consult with a healthcare professional before starting any new treatment regimen.