Panic attacks and panic disorder

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A panic attack is a sudden and overwhelming surge of fear and anxiety that can strike without warning. It triggers intense physical reactions even when there’s no real danger or apparent cause. The experience can be terrifying, leaving the individual feeling as if they are losing control or facing imminent doom.

Symptoms of Panic Attacks

Panic attacks can manifest with various symptoms, and their intensity typically peaks within a few minutes. Common signs include:

  • Rapid, pounding heart rate
  • Sweating and trembling
  • Shortness of breath or a tight sensation in the throat
  • Chills and hot flashes
  • Nausea and abdominal cramping
  • Chest pain and headache
  • Dizziness, lightheadedness, or faintness
  • Numbness or tingling sensations
  • Feeling of unreality or detachment from surroundings

Following a panic attack, individuals may feel fatigued and emotionally drained.

Understanding Panic Disorder

While many people experience one or two panic attacks in their lifetime, recurrent and unexpected panic attacks may indicate a condition called panic disorder. Those with panic disorder often live in constant fear of having another attack, which can severely impact their quality of life.

Causes of Panic Attacks

The exact causes of panic attacks and panic disorder are not fully understood, but some factors may contribute to their development:

  • Genetics and family history
  • High-stress levels
  • Sensitivity to stress and negative emotions
  • Changes in brain function

Risk Factors and Complications

Panic disorder often emerges during late adolescence or early adulthood, and it appears to affect more women than men. Several risk factors may increase the likelihood of developing panic attacks or panic disorder:

  • Family history of panic attacks or panic disorder
  • Major life stressors, such as the loss of a loved one or a traumatic event
  • Major life changes, like divorce or parenthood
  • Smoking or excessive caffeine consumption
  • History of childhood physical or sexual abuse

Left untreated, panic attacks and panic disorder can lead to complications such as specific phobias, social isolation, depression, anxiety disorders, and an increased risk of suicidal thoughts.

Seeking Help and Treatment

If you or someone you know experiences symptoms of panic attacks or panic disorder, seeking medical help is crucial. A healthcare professional can provide an accurate diagnosis, rule out other health conditions, and recommend appropriate treatment options.

Treatments for panic attacks may include psychotherapy, cognitive-behavioral therapy (CBT), and medications to manage symptoms. Learning coping strategies and relaxation techniques can also be helpful.

Preventing Panic Attacks

While there is no foolproof way to prevent panic attacks, certain lifestyle choices may reduce their frequency and severity:

  • Engage in regular physical activity
  • Practice stress-reduction techniques, such as mindfulness and meditation
  • Avoid excessive consumption of caffeine and stimulants
  • Seek professional help if experiencing excessive stress or anxiety

Remember, it’s essential to reach out for support and not hesitate to seek professional guidance to manage panic attacks effectively.

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If you experience symptoms of panic attacks, panic disorder, or any condition that resembles panic attacks, it’s essential to seek evaluation and diagnosis from your primary care provider. To pinpoint the cause, your doctor may perform:

  • A complete physical exam
  • Blood tests to check thyroid function and rule out other conditions
  • Tests on your heart, such as an electrocardiogram (ECG or EKG)
  • A psychological evaluation to understand your symptoms, fears, stressful situations, and family history
  • A psychological self-assessment or questionnaire
  • Inquiry about alcohol or other substance use

Criteria for Panic Disorder Diagnosis

Not everyone who experiences panic attacks has panic disorder. The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) outlines the criteria for panic disorder:

  • Frequent, unexpected panic attacks
  • At least one attack followed by one month or more of ongoing worry about another attack, fear of the consequences of an attack, or significant changes in behavior due to panic
  • No connection of panic attacks to drugs, other substances, medical conditions, or other mental health conditions

If you have panic attacks but not a diagnosed panic disorder, seeking treatment is still beneficial to prevent further complications.


Effective treatment can reduce the intensity and frequency of panic attacks and improve daily functioning. The primary treatment options include psychotherapy and medications, which may be used individually or in combination based on your preferences and severity of panic disorder.


Psychotherapy, particularly cognitive-behavioral therapy (CBT), is a recommended first-choice treatment for panic attacks and panic disorder. Through CBT, you can learn that panic symptoms are not dangerous and gradually face fears in a safe environment. This process helps in resolving panic attacks and overcoming situations that trigger them.

It may take time to see results, but symptoms can reduce within weeks, and significant improvement can occur within months. Occasional maintenance visits may be scheduled to control panic attacks or treat recurrences.


Medications can help manage panic attack symptoms and associated depression, if present. Some effective medications include:

  • Selective serotonin reuptake inhibitors (SSRIs) – e.g., fluoxetine (Prozac), paroxetine (Paxil, Pexeva), and sertraline (Zoloft)
  • Serotonin and norepinephrine reuptake inhibitors (SNRIs) – e.g., venlafaxine (Effexor XR)
  • Benzodiazepines (short-term use) – e.g., alprazolam (Xanax) and clonazepam (Klonopin)

Your doctor may adjust medications or combine them for better results. Keep in mind that medications may take weeks to show improvements and may have side effects. Discuss potential risks with your doctor.

Lifestyle and Home Remedies

While professional treatment is crucial, self-care steps can help manage panic attack symptoms:

  • Adhere to your treatment plan to regain control of your life
  • Join a support group to connect with others facing similar issues
  • Avoid triggers like caffeine, alcohol, smoking, and recreational drugs
  • Practice stress management and relaxation techniques (e.g., yoga, deep breathing, progressive muscle relaxation)
  • Engage in regular physical activity for a calming effect on mood
  • Ensure sufficient sleep to prevent daytime drowsiness

Alternative Medicine

Some dietary supplements have been studied for panic disorder treatment, but more research is needed to understand their risks and benefits. Consult your doctor before trying any supplements, as they may interact with prescription medications or cause dangerous effects.

Preparing for Your Appointment

If you experience panic attack symptoms, schedule an appointment with your primary care provider. Before the visit, prepare:

  • A list of your symptoms, their onset, and frequency
  • Personal information, including past traumatic events and major stressors
  • Medical history, including other physical and mental health conditions
  • Details of medications, vitamins, and supplements you take
  • Questions to ask your doctor

Consider having a trusted companion to offer support and help you remember important information during the appointment.

Questions to Ask Your Doctor

During your appointment, ask your doctor:

  • What might be causing my symptoms?
  • Is an underlying medical condition contributing to my symptoms?
  • Do I need any diagnostic tests?
  • Should I see a mental health professional?
  • What can I do to manage my symptoms?

If referred to a mental health professional, inquire about:

  • The diagnosis of panic attacks or panic disorder
  • Recommended treatment approaches, including therapy and medications
  • Group therapy benefits
  • Possible medication side effects and duration
  • Monitoring of treatment progress
  • Self-care steps to manage the condition
  • Additional resources or websites for information

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