What is panic disorder?
Panic disorder is a condition in which a person has episodes of intense fear or anxiety that occur suddenly, often without warning. Suppose one day you’re getting out of your car to go to work. Suddenly, your chest feels tight. Your heart races. You begin to feel dizzy and faint. You start to choke. You feel as if you could be dying. Was it all in your head? No. Most likely, you had a panic attack.
Panic attacks can last from minutes to hours. They may occur only once in a while, or they may occur quite frequently. The cause, or “trigger,” for these attacks may not be obvious. A diagnosis of panic disorder is usually made after a person experiences at least 2 panic attacks that occur without reason and are followed by a period of at least 1 month of fear that another attack will happen. Panic attacks can lead to phobias if they aren’t treated.
What is a phobia?
A phobia is an extreme, unreasonable fear in response to something specific. There are lots of different phobias. Some of the most common phobias include fear of crowds, bridges, snakes, spiders, heights, open places, or social embarrassment.
A phobia is considered a problem only when it keeps you from living a normal life. An example is being afraid to leave home because you are afraid of one of the things listed above.
Symptoms of panic disorder
What happens during a panic attack?
Panic attacks are associated with physical symptoms that include:
- Shaking or trembling
- Feeling that your heart is pounding or racing
- Chest pain or discomfort
- Shortness of breath
- Feeling that you are choking
- Dizziness or weakness
- An out-of-body feeling
- Tingling or numbness in your hands, arms, feet or legs
- Chills or hot flashes
- Sense of unreality or dreamlike sensations
A person may also have an extreme fear of losing control, going crazy, or dying during a panic attack. It is very rare for a person to have all of these symptoms at once. However, the presence of at least 4 symptoms strongly suggests that a person has panic disorder.
Many of the symptoms that occur during a panic attack are the same as the symptoms of diseases of the heart, lungs, intestines, or nervous system. The similarities between panic disorder and other diseases may add to the person’s fear and anxiety during and after a panic attack. For example, you may believe that you are actually having a heart attack.
Just the fear of having a panic attack is often enough to trigger the symptoms. This is the basis for a condition called agoraphobia. A person who has agoraphobia finds it difficult to leave home (or another safe area) because he or she is afraid of having a panic attack in public or not having an easy way to escape if the symptoms start.
What causes panic disorder?
Doctors do not know what causes panic disorder. Some believe that it could be linked to genetics (runs in families). It could also simply be your body’s response to major stress.
How is panic disorder diagnosed?
Many people who have panic attacks don’t seek medical care because of embarrassment. They may also fear seeking medical attention or fear taking medicine. If you have panic attacks, it is very important to seek medical care and discuss your problem with your doctor. After you have been evaluated, your doctor will be able to tell you if your panic attacks are related to panic disorder or are caused by another problem. Simple treatments are available to help control panic attacks and panic disorder.
Can panic disorder be prevented or avoided?
You can’t prevent panic disorder because doctors aren’t sure what causes it. But you may be able to prevent a panic attack by knowing your triggers. Your doctor can help with that. He or she can help make sure your panic attacks don’t become worse or more frequent. It’s also a good idea to be physically active. Getting exercise is a known stress reliever and may also guard you against panic attacks.
Panic disorder treatment
The two most common ways to treat panic disorder are through counseling and through medicine. Several kinds of counseling are very effective in treating panic attacks and panic disorder. You can ask your doctor about the different kinds of counseling that are available. Counseling does not work as fast as medicine, but it can be just as effective. The combination of both counseling and medicine seems to be an effective treatment for panic attacks and panic disorder.
There are several medicines that can make panic attacks less severe or stop them altogether.
Antidepressants are very effective in preventing anxiety and panic attacks. Often they completely stop the attacks. You don’t have to be depressed for them to help. Side effects are usually mild. Antidepressants will not make you lose control or change your personality. These medicines can be used for as long as necessary, even for years.
Anti-anxiety medicines are another useful medication for panic disorder. As their name suggests, these medicines give relief from fear and anxiety. They should be used only for a short period of time (a few weeks to a few months), unless you absolutely can’t function without them. Never suddenly stop taking either of these medicines. If you need to stop, these medicines should be slowly tapered off over several weeks under your doctor’s supervision.
How long does treatment last?
How long treatment continues depends on you. Stopping panic attacks completely is a reasonable goal. Your doctor will design a treatment plan just for you. A treatment period lasting at least 6 to 9 months is usually recommended. Some people taking medicine for panic disorder are able to stop treatment after only a short time. Other people need to continue treatments over a long period of time, or even for their lifetime.
Living with panic disorder
Panic attacks are often unpredictable, even after your diagnosis. They can make you feel helpless. In addition to your treatment plan, consider these lifestyle changes to help reduce risk of a panic attack.
- Exercise. Physical activity can help you minimize stress. It can also calm your mind.
- Sleep. Not getting enough rest can leave you groggy. It can also cause you to be more emotional. This may make you more prone to anxiety and an attack.
- Skip the alcohol, caffeine, smoking, and any recreational drugs. Any of these can trigger a panic attack or make it worse.
- Join a support group. It’s always good to know you’re not alone. Many times, simply talking about your panic disorder can create a feeling that you have power over it.
Questions to ask your doctor
- What is causing my panic disorder?
- What treatment is best for me?
- Should I take a medicine?
- Will I have to take medicine the rest of my life?
- Is there any kind of therapy I should try?
- How long will I have to be in therapy?
- I’m afraid to leave my house. What should I do?
- Is there a possibility that my panic attacks will come back after treatment?
Copyright © American Academy of Family Physicians
This information provides a general overview and may not apply to everyone. Talk to your family doctor to find out if this information applies to you and to get more information on this subject.