Learn More About Panic Disorder
Panic disorder is a type of anxiety characterized by recurring panic attacks and a fear of future attacks. Panic attacks cause symptoms like rapid heartbeat and shortness of breath. Fortunately, a full recovery from panic disorder is possible with the right treatment. Below you’ll find a host of articles and resources to help you understand and deal with panic disorder.
Understanding Panic Disorder
Key Terms
A panic attack is a sudden, intense wave of fear or discomfort that peaks within minutes. Your heart may race, you might feel dizzy, short of breath, or like you’re going to die, even if there’s no real danger. These episodes are very physical and can happen without warning.
In panic disorder, someone might have anticipatory anxiety about possibly having another panic attack. It can happen even when they feel okay in the moment. The constant worry about when the next attack might come can be just as distressing as the attacks themselves.
The fight or flight response is the body’s natural reaction to danger. Your heart beats faster, breathing changes, and muscles tense up to prepare you to escape or defend yourself. In panic disorder, this system activates even when there’s no actual threat, leading to overwhelming symptoms.
Interoceptive sensitivity being very aware of changes inside your body. People with panic disorder often notice small shifts, like feeling lightheaded or warm, and misread them as something dangerous. That fear can trigger a full panic attack.
Avoidance behavior is when someone starts staying away from places, people, or activities that they link to panic attacks. This might help them feel safer in the short term, but over time, avoidance can make the fear grow stronger and harder to face.
These are feelings of disconnection that can happen during a panic attack. Depersonalization is feeling cut off from yourself, like watching yourself from the outside. Derealization is feeling like the world around you isn’t real. Both are temporary but can be scary.
FAQs
What causes panic attacks?
Panic attacks may be triggered by stress, trauma, or even occur “out of the blue,” without an obvious cause. Some people are more prone to them due to genetics or brain chemistry.
What does a panic attack feel like?
People often report rapid heartbeat, chest pain, shortness of breath, dizziness, and an overwhelming sense of fear or doom.
Are panic attacks dangerous?
They can feel life-threatening, but they aren’t physically dangerous. However, recurring panic attacks can significantly disrupt your life.
What’s the difference between panic attacks and anxiety attacks?
Panic attacks are very intense, start and peak within minutes, resolve within about 20-30 minutes, and often arise with no known cause. Having recurrent panic attacks means you may have diagnosable panic disorder. An anxiety attack is a way of describing strong anxiety, but not a diagnosis. Anxiety attacks are less intense, build more slowly, may last much longer, and are often triggered by more obvious cues.
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Types of Panic Attacks
Key Terms
These attacks come on without any clear warning or trigger. You could be watching TV or relaxing when one suddenly hits. Panic disorder is diagnosed when someone has more than one unexpected panic attack, plus significant worries about, or attempts to avoid, another panic attack.
These attacks have an obvious cue or trigger, like driving, giving a presentation, or stressful life events. Many people with panic disorder have a combination of unexpected and expected panic attacks.
This is not a separate diagnosis but a pattern seen in panic disorder. People wake up suddenly from sleep in a state of panic, often with symptoms like chest pain, rapid heartbeat, or choking sensations.
FAQs
Can children have panic attacks?
Yes, children can experience panic attacks, though they might describe their symptoms differently or have trouble explaining their fear.
Why do panic attacks happen during sleep?
Nocturnal panic attacks often stem from underlying anxiety or stress, even if you’re not consciously aware of it.
Can panic attacks happen at work?
Yes. Work stress or performance anxiety can contribute. It’s important to develop coping strategies to manage these moments.
Signs and Symptoms
Key Terms
The core symptom of panic disorder is having repeated panic attacks. These are intense episodes of fear that peak quickly and come with strong physical symptoms like a racing heart, sweating, and dizziness. They can feel like something terrible is happening, even when the person is safe.
People with panic disorder often develop a fear of their own fear. This means they start to dread the feelings of anxiety themselves. This fear creates a cycle where the worry about a panic attack can actually help trigger one.
This is a thinking pattern where someone assumes the worst possible outcome. For example, feeling a tight chest and instantly thinking “I’m having a heart attack” instead of “I’m anxious.” These thoughts increase panic and make symptoms feel more dangerous.
People with panic disorder often pay very close attention to changes in their body, like their heartbeat or breathing. This hypervigilance can make normal sensations feel scary, which leads to more fear and possibly a full panic attack.
To prevent panic attacks, people may start avoiding certain places or activities like driving, exercising, or going to the store. Avoidance may feel safer in the short term, but over time it reinforces the belief that those situations are dangerous.
A very common panic symptom is the sensation of not being able to breathe or getting enough air. This is often caused by hyperventilation, which happens when people breathe too fast during panic, making them feel lightheaded or even more panicked.
Chest pain during panic attacks is a major reason people think they are having a heart attack. It’s caused by muscle tension and changes in breathing. Even though it feels serious, it’s not dangerous, but it can be very scary.
When the body goes into panic mode, your brain focuses on survival. Vision may narrow, like you’re looking through a tunnel, because your body is preparing for a threat. This is part of the fight or flight response and adds to the sense of danger.
During a panic attack, racing thoughts may come rapidly and feel out of control. The mind may jump to worst-case scenarios or go blank entirely. This mental chaos can make people feel like they are losing control or going crazy.
FAQs
What are the common signs of a panic attack?
Common signs of a panic attack include shortness of breath, racing heart, sweating, shaking, chest pain, nausea, dizziness, and feeling detached from reality.
Why are panic attacks confused with heart attacks?
Panic attacks are very physical experiences, and can include symptoms that also show up in heart attacks, like chest discomfort, shortness of breath, sweating, nausea, a rapid heart beat, and lightheadedness. Panic attacks can also include feelings of losing control or dying. However, while panic attacks are not physically dangerous, heart attacks need immediate medical attention.
What is a panic attack hangover?
A panic attack hangover is the fatigue, muscle soreness, and mental fog that can linger for hours or a day after an intense attack.
Treatments for Panic Disorder
Key Terms
CBT is considered the gold standard for treating panic disorder. It helps you identify and change unhelpful thought patterns that fuel panic, like assuming a racing heart means you’re dying. In therapy, you’ll learn to challenge these thoughts and replace them with more accurate ones. CBT also includes gradual exposure to feared sensations or situations so your brain learns that panic symptoms are uncomfortable but not dangerous. Over time, this reduces fear and avoidance. Sessions are structured and active, usually once a week for a few months.
Interoceptive exposure is a specific part of CBT that helps you get used to the body sensations that come with panic (like dizziness or a fast heartbeat). In treatment, you practice exercises that bring on these symptoms in a safe setting, like spinning in a chair to feel dizzy or breathing fast for a few seconds. The goal is to show your brain that these sensations are not dangerous, and to reduce the fear you associate with them.
In Applied Relaxation, therapists help you identify panic disorder triggers and early anxiety cues. You also learn ways to relax your body, like progressive muscle relaxation. Therapists help you start applying your relaxation skills when panic cues are present, then in real-world, anxiety-provoking situations.
SSRIs are a type of antidepressant often used to treat panic disorder. They help regulate serotonin, a brain chemical involved in mood and anxiety. Common SSRIs include sertraline and fluoxetine (generics for Zoloft and Prozac). These medications are taken daily and can reduce the frequency and intensity of panic attacks over time. They don’t work instantly, it often takes a few weeks to notice improvement, but they are safe for long-term use and have strong research support.
Benzodiazepines are fast-acting medications, like clonazepam or lorazepam (generics for Klonopin and Ativan), can reduce intense anxiety and panic quickly. They work by calming the nervous system. People sometimes use them during the early stages of treatment or for very severe panic attacks. However, because they can be habit-forming and lose effectiveness over time, they are generally prescribed only short-term or for occasional use under close supervision.
Mindfulness practices help train your attention to stay in the present moment rather than getting caught up in fear about what might happen. Meditation can reduce your overall stress level and help you notice anxiety symptoms without reacting to them. With regular practice, mindfulness helps rewire the brain to respond more calmly to panic symptoms. It’s most effective when combined with other treatments like CBT, but it’s a helpful skill on its own too.
FAQs
What is the most effective treatment for panic disorder?
Cognitive Behavioral Therapy (CBT) is often the first-line treatment and includes strategies like gradually facing your fears or challenging catastrophic thinking. It aims to break the cycle of panic by teaching you to recognize and modify the thought patterns that trigger attacks. This approach helps many people gain lasting tools to manage panic symptoms.
Do medications help with panic disorder?
Yes. Selective Serotonin Reuptake Inhibitors (SSRIs) are commonly prescribed to reduce panic symptoms and lower overall anxiety. Benzodiazepines can help with immediate relief but may not be ideal for long-term use. Beta-blockers can ease physical symptoms like rapid heartbeat.
Is medication a long-term solution?
Not necessarily. Many people use medications short-term while building coping skills through therapy. Over time, effective strategies learned in therapy can reduce or eliminate the need for medication. However, some individuals may stay on medication longer if it provides consistent relief and suits their needs.
Living With Panic Disorder
FAQs
Will I have panic attacks for the rest of my life?
Not necessarily. With the right treatment, most people experience fewer and less intense panic attacks over time. Some people recover fully. Even if panic comes back during stressful times, you can learn to manage it in a way that keeps your life on track.
Can panic disorder get worse if I ignore it?
Yes, it can. Without treatment, people often develop avoidance behaviors and may start avoiding work, school, or social situations. The fear can grow over time. But with help, that pattern can be reversed, and daily life can feel safe again.
Is panic disorder dangerous? Can I die from a panic attack?
Panic attacks feel scary, but they aren’t physically dangerous. However, panic disorder can really disrupt your life if it goes untreated. That’s why it’s important to get support and learn how to manage it.
Will this affect my relationships, job, or school?
It might, especially if panic makes you avoid people or situations. But many people with panic disorder have successful relationships, careers, and school lives.
What can I do during a panic attack to make it stop?
Try grounding techniques like focusing on your breath, noticing five things you can see, or placing your feet firmly on the ground. Remind yourself it will pass. Learning these tools through therapy or practice helps you feel more in control over time.
Do I need medication?
Not everyone does, but medication can be helpful for some people, especially when symptoms are severe. Many people benefit from a combination of therapy and medication. A mental health provider can help you figure out what’s best for your situation.
Can panic disorder get better without therapy?
Some people improve on their own using books, support groups, or self-help tools, but therapy, especially Cognitive Behavioral Therapy, has been proven to work well. It helps you change unhelpful thought patterns and face fears in a manageable way.
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