Panic Disorder: Facing the Fear and Anxiety

Panic disorder causes physical symptoms of panic attacks

Medically reviewed by Michael MacIntyre, MD

Panic disorder involves recurrent and frequent panic attacks. These attacks do not have a clear cause. They involve a sudden onset of fear or a sense of loss of control and are accompanied by a variety of physical symptoms like rapid heartbeat, sweating, nausea, and trouble breathing.

After the panic attack is over, the person worries about the next panic attack, wondering where and when it will occur. This can have a devastating impact on their life. Having one panic attack or an occasional panic attack does not mean you have panic disorder; not everyone who has a panic attack develops panic disorder.

This article will explore how panic disorder is defined, signs and symptoms, treatment, and coping techniques.

Defining Panic Disorder

In panic disorder, individuals have panic attacks that seem to come out of nowhere, with no specific triggers. Because the attacks happen frequently, a person becomes very concerned about another panic attack occurring and has marked fear about subsequent panic attacks taking place.

Panic disorder typically starts after age 20, but the disorder and/or panic-like symptoms can be seen in children.

It is estimated that in any given year, 2% to 3% of Americans live with panic disorder, and twice as many women than men are diagnosed. This disorder can drastically impact your life and interfere with work, friendships, and social relationships.

Nervous System Responses

The sympathetic nervous system communicates the fight-or-flight stress response in the body. Meanwhile, the parasympathetic nervous system helps to calm the body down. The brain uses these systems to change involuntary body functions, such as heart rate, digestion, and hormone secretion.

Symptoms: What Happens in Panic Disorder?

In panic disorder, a person has recurring and unexpected panic attacks. The main features of these panic attacks are sudden feelings of fear, discomfort, or loss of control, with no clear or specific trigger or danger to the person.

Symptoms of a panic attack can include:

• Fast or pounding heartbeat

• Sweating

• Chills

• Shaking

• Weakness or dizziness

• Trouble breathing

• Chest pain, stomach pain, or nausea

• Hands may become numb or tingly

• A feeling of impending doom or fear of death

Other signs and symptoms of panic disorder can include:

• Intense worry about the next panic attack and where and when it will occur

• Avoiding places or situations where panic attacks have occurred in the past
  

Takeaway

If you or a loved one are experiencing panic attacks, contact the Substance Abuse and Mental Health Services Administration (SAMHSA) National Helpline at 800-662-4357 for information on support and treatment facilities in your area.

Other Disorders Linked to Panic Disorder

A person living with panic disorder may develop agoraphobia due to their fear of when or where the next panic attack will occur. This occurs in about 1 in 3 people with panic disorder. Agoraphobia involves anxiety and fear about being in places or situations that may cause panic and where escape is not possible.

Other anxiety and mood disorders can be linked to panic disorder, which is itself an anxiety disorder. Other disorders can include:

• Bipolar disorder

• Obsessive-compulsive disorder (OCD)

• Generalized anxiety disorder (GAD)

• Post-traumatic stress disorder (PTSD)

• Major depressive disorder (MDD)
  

What Causes Panic Disorder?

In panic disorder, panic attacks have no specific cause or trigger. They are random and unpredictable, which is also what causes the fear of their recurrence.

It is not known what causes panic disorder, but in some people, it may have a genetic component. It’s not clear why some people in a family might live with panic attacks and not others.

Some scientists also suspect that areas of the brain and various biological systems or processes may be overactive and react too strongly or too often, causing panic attacks and panic disorder.

Stress and environmental factors may also be involved in panic attacks. More research needs to be done on how the brain and body interact, especially in panic attacks and panic disorder.

Therapy Techniques

Cognitive behavioral therapy (CBT) is the most research-supported treatment for panic disorder. It is considered to be the first-line treatment for panic disorder and includes components like:

• Psychoeducation (education about the condition)

• Cognitive restructuring (challenging and changing incorrect beliefs)

• Exposure to feared bodily sensations

CBT can instruct you on different ways of thinking and reacting to feelings and thoughts before or during a panic attack, which can help reduce or prevent future attacks. In therapy, you’ll also learn coping and relaxation techniques.

Medications Used in Panic Disorder

Different classes of medications can treat panic disorder, including:

• Antidepressants: Selective serotonin reuptake inhibitors (SSRIs) such as Lexapro (escitalopram) and Zoloft (sertraline), and the selective serotonin-norepinephrine inhibitor (SNRI) Effexor XR (venlafaxine hydrochloride)

• Beta-blockers: Such as Inderal (propranolol)

• Antianxiety medications: Like benzodiazepines, which include Klonopin (clonazepam) and Xanax (alprazolam)

Antidepressants can help treat symptoms of panic disorder, but they can take several weeks to start working. Some people experience side effects like nausea or trouble sleeping, but these usually go away after a short period, especially if you’re on a low dose.

Beta-blockers help to treat physical symptoms of panic disorder, like sweating and rapid heartbeat. While these are not common prescriptions for panic disorder, sometimes a provider may think it’s helpful.

Benzodiazepines can quickly target physical symptoms of anxiety in panic disorder, but these medications can become addictive. People can build up a tolerance to the drug, needing more of it to get the same effects.

If you are on medication for panic disorder, tell your provider about any side effects that you experience. Sometimes, you have to try more than one medication to find the one that works for you. Getting enough sleep, eating a healthy diet, and exercising regularly can also help with panic disorder and boost your overall health and wellness.

Strategies to Cope Through Recurrent Panic Episodes

There is no cure for panic disorder, but there is treatment. The symptoms can be treated, and coping techniques can be taught. This helps to reduce the risk of a full-fledged panic attack from occurring and can help to mitigate symptoms of panic disorder. Even without being cured, you can still find it possible to live a happy and full life.

Recurrent panic attacks are part of living with panic disorder, and while there is treatment, you can also use coping strategies to help reduce symptoms and supplement your treatment. Some ways to cope with recurrent panic attacks can include:

• Learn about the disorder: Learn the signs and symptoms of panic attacks and treatment options.

• Talk with someone: Tell a trusted friend or family member how you’re feeling, and ask for added support if you need it.

• Find professional help: While talking to supportive friends and family is beneficial, a professional trained in treating panic disorder can provide treatment.

• Develop healthy habits: Get enough sleep, eat a healthy diet, and participate in regular exercise

Providers Who Diagnose and Treat Panic Disorder

The first step in treating panic disorder is getting an accurate, appropriate diagnosis. If you are experiencing symptoms of panic disorder or panic attacks, tell a healthcare provider.

A healthcare provider will take a complete family and medical history and perform a physical exam. They can order tests to rule out physical ailments that may be causing your symptoms.

If no physical cause that they are able to treat is found, your provider will likely refer you to a mental health professional like a psychologist, psychiatrist, or clinical social worker. While some mental health professionals can diagnose panic disorder and provide treatment such as psychotherapy, only psychiatrists can prescribe medication.

Summary

Panic disorder involves repeated episodes of panic attacks with no discernible cause. The panic attacks involve a sudden onset of fear or a feeling of impending doom, accompanied by physical symptoms like sweating, rapid heartbeat, dizziness, nausea, and trouble breathing.

The unpredictability of the panic attacks can cause additional anxiety or fear, leading to a vicious cycle. Treatment typically consists of cognitive behavioral therapy and/or medication. Tell your healthcare provider if you are experiencing symptoms of panic disorder, as many avenues of help are available.

Read the original article on Verywell Health.