Understanding Panic Attack Disorder

Reviewed by Whitney White, MS CMHC, NCC., LPC

Published 12/10/2020

It’s estimated that nearly 3% of US adults had panic disorder in the last year. While that number may appear to be small, many people have experienced a panic attack at some point in their lives. However, a panic attack disorder means an individual is experiencing panic attacks often.

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When it comes to panic attack disorder, it has more to do with fear than anything else. While some attacks can be short, they may also last for several minutes. During a panic attack, an individual may also experience sudden anxiety. Some individuals have also reported an out of control heart rhythm, excessive sweating, feeling that they can't think clearly, or even trouble to breathe. Panic attack disorder is notorious for striking without any obvious trigger, making it highly unpredictable when an attack will take place or the damage that it will do. In fact, many people experiencing panic attack disorder are always worried about when the next episode may come. Panic disorder has a significant impact on an individual’s quality of life as it can lead to other mental health disorders and issues in social or work life.

Signs And Symptoms Of Panic Disorder

Many individuals that experience panic attack disorder reports the following signs and symptoms:

  • Unforeseen panic attacks that repeat themselves, characterized by heavy anxiety and overwhelming fear
  • Intensifying fear of death, a feeling that one is losing control, and a sense of impending doom
  • Connecting places, times, people and other artifacts associated with panic attacks in the past, and consciously avoiding them.

Meanwhile, physical symptoms reported include:

  • Pounding or racing heart
  • Breathing difficulties
  • Dizziness
  • Sweating
  • Trembling
  • Chills
  • General weakness
  • Tingling sensation in the hands

In more serious cases, symptoms may also include:

  • Chest pain
  • Nausea
  • Stomach pain

If you are experiencing any of these symptoms, talk to your doctor right away. Many of these symptoms are shared with other medical conditions including both heart and thyroid conditions. Your doctor can also help you differentiate between panic attacks and the panic disorder.

Typically, you will undergo a full physical exam, including various medical tests such as an electrocardiogram and blood work that will help rule out any underlying medical conditions such as thyroid or heart-related ailments. In addition to a physical exam, your doctor will also give you a psychological evaluation to discuss all of your symptoms, concerns, fears, and the nature of situations that you may be avoiding, all of which will help confirm your diagnosis.

For proper diagnosis, it can be helpful for an individual to also disclose any substance abuse history, including the nature and frequency of consuming alcohol.

Criteria For Diagnosis Of Panic Disorder

The DSM-V manual prescribes just how panic disorder should be diagnosed separately for people that may only be experiencing panic attacks. Criteria for diagnosis is that:

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  1. The patient is experiencing frequent panic attacks, that are also unexpected.
  2. One of the attacks is followed by over a month of persistent worry about a second attack. Lingering fear about the consequences of a second attack, particularly experiencing loss of control, experiencing a heart attack, or a feeling like one is losing control and going crazy. Behavioral changes should be significant, including avoiding situations that may trigger a panic attack.
  3. Poor correlation between the incidence of panic attacks and the propensity to substance abuse, that is, panic attacks aren't being caused because someone is indulging in a drug habit, or because of another health or medical condition. For example, obsessive-compulsive disorder and social anxiety disorder or social phobia may also induce panic attacks in some cases.

Scientists agree that if panic attacks are not treated or addressed, they may take panic disorder as they worsen.

Panic Disorder Treatment

Treatment for panic disorder is aimed at improving the quality of life of the patient. Ideally, the treatment plan will help reduce the frequency and intensity of panic attacks. Two main treatment options have been identified: psychotherapy and medications. You may prefer one form of treatment to another, and many people utilize both therapy and medication together. A lot depends upon patient preference, their history of treatment, the severity of the disorder, and the availability of professional therapists who are well versed in treating panic disorders.

Psychotherapy

Psychotherapy should be simply understood as talk therapy or working with a licensed counselor or therapist. Psychotherapy is widely recognized as a highly effective treatment that should initially be resorted to in cases of panic attacks and panic disorder. Psychotherapy will work by helping you understand your situation and teach you how to cope with them.

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In particular, cognitive behavioral therapy will help an individual understand, through personal experience, that panic attack symptoms do not have to be dangerous. Often, therapists will recreate panic attack symptoms in a safe setting, repeatedly. This can help an individual become accustomed to the physical sensations of panic. Once these sensations are not associated with threats, the panic attacks begin to resolve in the sense that they are not as triggering. It has been demonstrated that even longstanding fears associated with situations traditionally avoided can be gradually overcome with this method. As a result, individuals can reintegrate into such experiences. For example, individuals can overcome stage fright or something similar that they may have always avoided in the past owing to panic attacks.

Psychotherapy may also involve investments in the form of time and personal energy. While some people may see results in a matter of weeks, others may take several months before progress is visible. The length of treatment depends on the type of therapy and your unique situation.

Medications For Panic Disorder

Medication will also help to reduce panic attack symptoms. These medications could be the same as what has been diagnosed for some individuals with depression as well. Luckily, a few different types of medication are effective in panic attacks.

Selective Serotonin Reuptake Inhibitors (SSRI’s)

SSRIs come with a lower risk of concerning side effects and are considered to be generally safe. However, SSRI antidepressants are unlikely to be the first recommendation when it comes to treating panic attacks.

Serotonin and Norepinephrine Reuptake (SNRI’s)

SNRIs are another class of antidepressants used with panic disorders.

It’s important to discuss any preexisting conditions or pregnant with your doctor to understand possible side effects and associated risks.

What Causes Panic Attacks

Even with all the tools available to modern research, we do not know the exact reasons behind panic attacks or when they will occur. Research shows that panic tendencies may be inherited. Then, it is also recognized that events can be important triggers. Such events can include a major life change, such as marriage, graduation, job change, etc. Such events may trigger panic attacks, but they don’t explain all the occurrences.

Additionally, health issues may also cause or exacerbate panic attacks. That is another reason why a complete health checkup is important when diagnosing and throughout one’s treatment. Certain health conditions that may trigger panic attacks include:

  • Various heart conditions. 
  • Hyperthyroidism. A condition when the thyroid glands are overactive.
  • Hypoglycemia. Characterized by lower blood sugar levels over the long-term period.
  • Stimulant Indulgence. Examples include excessive intake of caffeine, or substance abuse, for example, cocaine or heroin.
  • Withdrawal. Stopping medication without tapering may also contribute to panic attacks because the body can be expected to react abruptly when a long-term medication is suddenly withdrawn.

Recovering From Panic Attacks

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Surprisingly, beyond the standard treatment process, there is a lot that you can do on your own as well. Here are some ways additional ways you can recover from panic attacks:

  • Learn about panic disorders, so you can uncouple yourself from your situation and put things in perspective.
  • Try not to dismiss or avoid your symptoms, always trying to decipher situations you suspect behind your panic attacks.
  • Develop a conscious breathing regimen, the core of all yoga practices.
  • Reinvent a way to think more effectively, so you disconnect and disengage from your own traditional negative patterns and thought repetition. This way, you may be able to replace negative feelings with positive ones.
  • Work with the therapist you have come to respect, so it is easier to follow their advice, including the medication prescribed.
  • Develop a support group among well-wishers, friends, and family.
  • Always be optimistic about tackling the situation, realizing that you are in a marathon.
  • Deploy stress-relieving techniques, including journaling, because your fight is going to generate additional stressors.

Take this free test that will help you evaluate your symptoms and conditions. This test can help prepare you with information and expectations for your consultation with a doctor about the symptoms you’ve been experiencing. Take the first step towards getting help today!