"One day, without any warning or reason, I felt terrified. I was so afraid, I thought I was going to die. My heart was pounding and my head was spinning. I would get these feelings every couple of weeks. I thought I was losing my mind."
"The more attacks I had, the more afraid I got. I was always living in fear. I didn't know when I might have another attack. I became so afraid that I didn't want to leave my house."
"My friend saw how afraid I was and told me to call my doctor for help. My doctor told me I was physically healthy but that I have panic disorder. My doctor gave me medicine that helps me feel less afraid. I've also been working with a counselor learning ways to cope with my fear. I had to work hard, but after a few months of medicine and therapy, I'm starting to feel like myself again."
What is Panic Disorder?
People with panic disorder have sudden and repeated attacks of fear that last for several minutes. Sometimes symptoms may last longer. These are called panic attacks. Panic attacks are characterized by a fear of disaster or of losing control even when there is no real danger. A person may also have a strong physical reaction during a panic attack. It may feel like having a heart attack. Panic attacks can occur at any time, and many people with panic disorder worry about and dread the possibility of having another attack.
A person with panic disorder may become discouraged and feel ashamed because he or she cannot carry out normal routines like going to the grocery store or driving. Having panic disorder can also interfere with school or work.
Panic disorder affects about 6 million American adults and is twice as common in women as men. Panic attacks often begin in late adolescence or early adulthood, but not everyone who experiences panic attacks will develop panic disorder. Many people have just one attack and never have another. The tendency to develop panic attacks appears to be inherited.
Signs & Symptoms
People with panic disorder may have:
- Sudden and repeated attacks of fear
- A feeling of being out of control during a panic attack
- An intense worry about when the next attack will happen
- A fear or avoidance of places where panic attacks have occurred in the past
- Physical symptoms during an attack, such as a pounding or racing heart, sweating, breathing problems, weakness or dizziness, feeling hot or a cold chill, tingly or numb hands, chest pain, or stomach pain.
Panic disorder is generally treated with psychotherapy, medication, or both.
Psychotherapy. A type of psychotherapy called cognitive behavior therapy is especially useful for treating panic disorder. It teaches a person different ways of thinking, behaving, and reacting to situations that help him or her feel less anxious and fearful.
Medication. Our doctors may also prescribe medication to help treat panic disorder. The most commonly prescribed medications for panic disorder are anti-anxiety medications and antidepressants. Anti-anxiety medications are powerful and there are different types. Many types begin working right away, but they generally should not be taken for long periods.
Antidepressants are used to treat depression, but they also are helpful for panic disorder. They may take several weeks to start working. Some of these medications may cause side effects such as headache, nausea, or difficulty sleeping. These side effects are usually not a problem for most people, especially if the dose starts off low and is increased slowly over time.
Another type of medication called beta-blockers can help control some of the physical symptoms of panic disorder such as excessive sweating, a pounding heart, or dizziness. Although beta blockers are not commonly prescribed, they may be helpful in certain situations that bring on a panic attack.
Some people do better with cognitive behavior therapy, while others do better with medication. Still others do best with a combination of the two. Our doctors review the different treatment options that they feel are be best for each individual. If they feel that medication may be necessary, they will discuss the pros and cons of different medications as well as the possible side effects. We will work with you to tailor a treatment plan that is right for you. It is important that you feel thoroughly educated, have enough time to think about your options and feel that you and your doctor are working as collaborators.
More Resource Articles
Gardening and Mental Health: A Brief Overview
Gardening enhances general well-being, reduces stress, and improves mood.
Managing COVID-19 Anxiety Without Benzodiazepines (Part 4)
Part 4 of a series on taking care of stress and anxiety without benzodiazepines in the time of COVID-19.
Managing COVID-19 Anxiety Without Benzodiazepines (Part 3)
Globally hundreds of millions of people are experiencing high levels of stress and anxiety in the face of the COVID-19 pandemic. Benzodiazepines such as alprazolam (Xanax), clonazepam (Klonopin), lorazepam (Ativan) are being widely prescribed by doctors to help people manage their symptoms, and there has been an increase in the illicit market for benzodiazepines.
Kava and l-theanine for COVID-19 Anxiety (Part 2)
This is the second post in a series of non-pharmacologic management of anxiety during the COVID-19 pandemic. In the first post, I commented on the limited efficacy of benzodiazepines for anxiety and highlighted the medical and psychiatric risks associated with benzodiazepine use, which are greater during the COVID-19 pandemic. In this post, I briefly review the evidence for kava-kava and l-theanine, two natural products widely used for stress and anxiety.
Managing Anxiety During COVID-19 (Part 1)
This post is the first in a series on the management of anxiety during the COVID-19 pandemic. Millions of people have been relying on benzodiazepines such as alprazolam (Xanax), clonazepam (Klonopin), lorazepam (Ativan) and other prescription drugs to manage symptoms of stress and anxiety. While some medications are safe and effective treatments of anxiety, they have limited overall efficacy and potentially serious safety concerns.
Parenting In a Pandemic
The coronavirus pandemic has thoroughly changed the time spent with our families. With parents and children working and learning from home, many of us are getting more family time than we ever expected. Furthermore, the coronavirus threatening public health as well as the current conditions breeding economic and political uncertainty are significant stressors on parents and children alike.
The Relationship Between Immune Health and Mental Health
The importance of cultivating a strong immune system has become evident as we navigate the coronavirus pandemic. It is no secret that a strong immune system can help defend against illnesses, but there may also be a hidden benefit to mental wellbeing.
COVID-19 Pandemic Fatigue
It's hard to believe that we are nearly one year into the COVID-19 pandemic. The initial panic and hoarding of toilet paper have worn off, yet for many the psychological impacts of the pandemic are still very much present and may last longer than the pandemic itself.
Locus of Control and COVID-19
The COVID-19 pandemic is causing enormous stress for countless millions of people in all world regions. There has been no crisis of comparable magnitude within living memory. Individuals, communities, and entire populations are acutely aware of "loss of control" over their health, their finances, and their daily activities. The impact of "loss of control" on our mental health is made even worse by uncertainty over the future that is unprecedented in modern times...
Lifestyle Choices for Good Mental Health During COVID-19
Simple lifestyle choices can enhance mental health
Because of widespread unemployment and the closing of mental health clinics due to the pandemic, millions of individuals struggling with anxiety, depression, and insomnia do not have access to, or cannot afford psychotherapy or medications. These circumstances may continue for months or even years, depending on how soon effective antivirals and vaccines become available...
Attention Deficit Hyperactivity Disorder
Attention deficit hyperactivity disorder (ADHD) is one of the most common childhood disorders and can continue through adolescence and adulthood. Symptoms include difficulty staying focused and paying attention, difficulty controlling behavior, and hyperactivity (over-activity)...
Bipolar disorder, also known as manic-depressive illness, is a brain disorder that causes unusual shifts in mood, energy, activity levels, and the ability to carry out day-to-day tasks. Symptoms of bipolar disorder are severe. They are different from the normal ups and downs that everyone goes through from time to time...
Everyone occasionally feels blue or sad. But these feelings are usually short-lived and pass within a couple of days. When you have depression, it interferes with daily life and causes pain for both you and those who care about you. Depression is a common but serious illness...
An eating disorder is an illness that causes serious disturbances to your everyday diet, such as eating extremely small amounts of food or severely overeating. A person with an eating disorder may have started out just eating smaller or larger amounts of food, but at some point, the urge to eat less or more spiraled out of control. Severe distress or concern about body weight or shape may also signal an eating disorder...
Generalized Anxiety Disorder
All of us worry about things like health, money, or family problems. But people with generalized anxiety disorder (GAD) are extremely worried about these and many other things, even when there is little or no reason to worry about them...
Post-traumatic Stress Disorder
When in danger, it's natural to feel afraid. This fear triggers many split-second changes in the body to prepare to defend against the danger or to avoid it. This "fight-or-flight' response is a healthy reaction meant to protect a person from harm. But in post-traumatic stress disorder (PTSD), this reaction is changed or damaged. People who have PTSD may feel stressed or frightened even when they're no longer in danger...
Social Phobia (Social Anxiety Disorder)
Social phobia is a strong fear of being judged by others and of being embarrassed. This fear can be so strong that it gets in the way of going to work or school or doing other everyday things...
Obsessive Compulsive Disorder
Everyone double checks things sometimes. For example, you might double check to make sure the stove or iron is turned off before leaving the house. But people with obsessive-compulsive disorder (OCD) feel the need to check things repeatedly, or have certain thoughts or perform routines and rituals over and over. The thoughts and rituals associated with OCD cause distress and get in the way of daily life...