Answers To Your Questions About Panic Disorder
Answers to your questions about panic disorder.
Panic Disorder is a serious condition that around one out of every 75 people might experience. It usually appears during the teens or early adulthood, and while the exact causes are unclear, there does seem to be a connection with major life transitions that are potentially stressful: graduating from college, getting married, having a first child, and so on. There is also some evidence for a genetic predisposition if a family member has suffered from panic disorder, you have an increased risk of suffering from it yourself, especially during a time in your life that is particularly stressful.
A panic attack is a sudden surge of overwhelming fear that comes without warning and without any obvious reason. It is far more intense than the feeling of being “stressed out” that most people experience. Symptoms of a panic attack include:
hot flashes, or sudden chills
tingling in fingers or toes
fear that you’re going to go crazy or are about to die
You probably recognize this as the classic “flight or fight” response that human beings experience when we are in a situation of danger. But during a panic attack, these symptoms seem to rise from out of nowhere. They occur in seemingly harmless situations–they can even happen while you are asleep.
In addition to the above symptoms, a panic attack is marked by the following conditions:
The answer to this is a resounding YES — if they receive treatment.
What Are Some Coping Mechanisms In The Moment
First things first: Breathe. Youre probably hyperventilating, but stabilizing your breathing can quickly calm your bodys fight-or-flight response.
Try counting your breaths. One deep breath in, one deep breath out. Count up to 10 and then start again until your breathing is back to normal.
Other quick coping strategies include:
- recognizing that what youre experiencing is a panic attack
- finding an object to focus on
What Are The Symptoms Of Panic Disorder
Panic attacks can happen in other types of anxiety disorders, too. Generally, if you have 4 or more panic attacks and if you always worry about having another, you have panic disorder. Symptoms of a panic attack may include:
- Pounding heart
- Chills or hot flashes
- Chest pain and other symptoms that mimic a heart attack
Panic disorder can be upsetting and disabling. An attack can last from a few minutes to an hour or sometimes longer.
The symptoms of a panic attack may look like other mental health conditions. Always see your healthcare provider for a diagnosis.
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How It Feels After A Panic Attack
A more likely possibility is that you had a single panic attack that leaves you feeling generally anxious, tired, and frayed. While panic attacks can be scary, they’re not dangerous. But the fear they may cause you can be more unsettling than the attack itself. That’s especially true if you’ve never had one before. When it’s your first episode, you may think you’re having a stroke or a heart attack.
How do you tell if it’s a panic attack or high anxiety? It’s tricky. It helps to talk to your doctor, but a closer look at your symptoms often can give you some clues.
A true panic attack tends to have clear, intense, physical symptoms — a pounding heart, shortness of breath, and so on.
Anxiety can give you some of these, but they tend to be milder. Instead, you’ll have more mental symptoms like a racing mind, lots of worries you can’t stop, and a hard time focusing. You might also feel restless and have a hard time sleeping.
What Causes Sleeping Panic Attacks
Even though the panic attack is said to occur while you sleep, the idea that it’s a “sleeping panic attack” may be a little misleading. Its very difficult to sleep throughout the course of these panic attacks, and the actual attack usually wakes you up, causing significant fear and disorientation.
There are many possible causes of panic attacks, generally speaking. Often, panic attacks during the day are caused by an interaction between your bodily sensations and your thoughts. During the night, however, this might not necessarily be the trigger, given that youre somewhat disconnected from your bodily and mental processes. There are, however, additional issues that may affect those who suffer from nocturnal panic attacks. These issues include:
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How Panic Disorder Is Diagnosed
Steven Gans, MD is board-certified in psychiatry and is an active supervisor, teacher, and mentor at Massachusetts General Hospital.
Do you suspect that you are experiencing the symptoms of panic disorder? Finding out whether or not you have panic disorder begins with a diagnosis. The following describes how panic disorder is diagnosed.
Support For The Family
When a person has panic attacks, his or her entire family is affected.
If someone in your family has panic attacks, you may feel frustrated, overworked , or socially isolated because the person restricts family activities. These feelings are common.
Family therapy, a type of counselling that involves the entire family, may help.
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Close Your Eyes And Breathe
Whenever you find yourself having a panic attack, take a moment to lie down, close your eyes, and take a deep breath in. Then out. In. Then Out. In. Out. Breathing deep naturally helps slow your heart rate to help you calm your anxiety. Taking the time to focus on your breath helps move your mind into the present inside of the past or future. Find time each day to get that quiet moment to yourself just to breathe. The more you practice mindful breathing, the fewer panic attacks youll have.
Treatment For Panic Disorder
Research shows that the most successful treatment for panic disorder is a combination of antidepressant medication and cognitive behavioral therapy . Many clinicians recommend CBT as the first-line treatment, with medication added if necessary to make the patient comfortable enough to participate in CBT.
In treating someone who has panic disorder with CBT, the clinician starts by working with the patient to think more flexibly about his anxiety. Rather than viewing the physical symptoms as dangerous, he practices tolerating them, knowing that they arent harmful.
To help the person disconnect the negative feelings associated with attacks, the therapist induces those physical sensations the patient does jumping jacks or stair climbing to get the heart racing, spinning to get dizzy, breathing through a coffee straw to get shortness of breath. Were exposing you to the actual, physical feelings of a panic attack, one symptom at a time, Dr. Bubrick explains.
Then, instead of simply tolerating the anxiety and waiting for it to subside, the person is taught how to do deep breathing techniques, to calm the physical symptoms down. Some clinicians dont do the deep breathing, on the grounds that the symptoms will pass on their own. But Dr. Bubrick likes to give kids tools to give them a sense of empowerment, to have them feel that they can control the symptoms.
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Are Phobias Sometimes Diagnosed Along With Panic Disorder
Yes, panic disorder can be diagnosed along with other specific phobias, says Simon A. Rego, PsyD, chief psychologist at Montefiore Health System in New York City. These might include injury phobia, where the person has an intense fear of injury,2 or an animal phobia, where the person is afraid of animals.3
Panic disorder also can be diagnosed along with social phobia and agoraphobia . These all are seen as distinct disorders from panic disorder, Rego says.
What Helps To Manage Panic Attacks
Panic attacks can be frightening, but there are things you can do to help yourself cope. It could help to print off these tips, or write them down, and keep them somewhere easy to find.
During a panic attack:
- Focus on your breathing. It can help to concentrate on breathing slowly in and out while counting to five.
- Stamp on the spot. Some people find this helps control their breathing.
- Focus on your senses. For example, taste mint-flavoured sweets or gum, or touch or cuddle something soft.
- Try grounding techniques. Grounding techniques can help you feel more in control. They’re especially useful if you experience dissociation during panic attacks. See our page on self-care for dissociation for more information on grounding techniques.
After a panic attack:
- Think about self-care. It’s important to pay attention to what your body needs after you’ve had a panic attack. For example, you might need to rest somewhere quietly, or eat or drink something.
- Tell someone you trust. If you feel able to, it could help to let someone know you’ve had a panic attack. It could be particularly helpful to mention how they might notice if you’re having another one, and how you’d like them to help you.
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What Happens Inside Your Body
Your bodyâs âfight or flightâ response is behind these intense physical symptoms. Normally when you encounter a threat — whether itâs a grizzly bear or a swerving car — your nervous system springs into action. The hormone adrenaline floods into your bloodstream, putting your body on high alert. Your heartbeat quickens, which sends more blood to your muscles. Your breathing becomes fast and shallow, so you can take in more oxygen. Your blood sugar spikes. Your senses get sharper.
All of these changes — which happen in an instant — give you the energy you need to confront a dangerous situation or get out of harmâs way quickly.
With random panic attacks, your body goes on alert for no reason. Researchers donât know exactly what triggers them. But the physical effects are real: During a panic attack, the adrenaline levels in the body can spike by 2 1/2 times or more.
Panic attacks may not come as unexpectedly as they seem. The physical changes may start about an hour before an attack. In one study, people with panic disorder wore devices that tracked their heart activity, sweating, and breathing. The results showed lower-than-normal levels of carbon dioxide, a sign of rapid, deep breathing that can leave you breathless, as early as about 45 minutes before the panic attack.
How Many Panic Attacks Are Needed For A Panic Attack Disorder Diagnosis
According to the American Psychiatric Associations Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition , a person must have one or more attacks followed by at least a month of fearing another panic attack. So technically, at least two panic attacks are needed for the panic disorder diagnosis, but typically people with panic disorder report experiencing many more, says Simon A. Rego, PsyD, chief psychologist at Montefiore Health System in New York City.
Every year, nearly 11% of Americans experience a panic attack, and between 2% and 3% of them go on to develop panic disorder.
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How To Get A Diagnosis
If you experience symptoms of a panic attack for the first time, you may want to seek emergency medical care. Most people who have a panic attack for the first time believe theyre having a heart attack. It can be hard to differentiate the symptoms without the help of a medical professional.
While at the emergency care facility, a healthcare professional will perform several tests to see if your symptoms are caused by a heart attack. They may run blood tests to rule out other conditions that can cause similar symptoms, or an electrocardiogram to check your heart function.
If they determine you do not need emergency care, youll be referred back to your primary care provider, if you have one.
Your primary care provider may perform a mental health examination and ask about your symptoms. All other medical disorders will be ruled out before your primary care provider makes a diagnosis of panic disorder.
A mental health professional can also diagnose panic disorder.
If You Think You Have Panic Disorder Self
Many individuals with panic disorder realize they have the disorder after a trip to the emergency room , as panic attack symptoms can easily be mistaken for a heart attack or stroke. An ER can only offer short-term relief or provide a referral to mental health services.
Many people who are concerned about panic disorder visit their primary care provider . Unfortunately, according to Gruner, PCPs can sometimes mistreat panic disorder by prescribing benzodiazepines, such as lorazepam or klonopin . However, current research shows that benzos are a counterproductive long-term treatment approach.
Benzodiazepines can reduce your anxiety in the short-term, but people can become dependent on them to the point where they dont feel safe without it. They usually attribute progress to the benzo, so it can make treatment progress difficult, says Gruner.
Gruner advises individuals to be wary if their PCP prescribes benzodiazepines. There is increased awareness among PCPs now with the problem of prescribing benzos to people with panic disorder, but its not perfect, says Gruner. So, its worth educating yourself about effective treatment before meeting with your PCP.
Ideally, a PCP would recommend a therapist or psychiatrist. A cognitive behavioral therapist who has experience with anxiety disorders is an ideal choice.
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Causes Of Panic Disorder
The causes of panic disorder are not clearly understood.
Panic disorder is also associated with significant life changes. Leaving for college, getting married, or having your first child are all major life transitions that may create stress and lead to the development of panic disorder.
Fear of a panic attack or recalling a panic attack can result in another attack.
Learn About Panic Attacks And Anxiety
Knowledge is power. With more information about panic attacks, you can be aware of your symptoms, feel more in control, and shorten your attacks.
While many people experience a panic attack just once or a few times, others experience them as part of an existing anxiety disorder. Learning about anxiety can help you better manage it.
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When Should I Call The Doctor
Some panic attacks have signs that can be confused with a physical problem like a heart attack. If you have chest pain or trouble breathing or lose consciousness, seek emergency medical care.
You should call your healthcare provider if you have panic attacks and experience:
- Chronic anxiety that interferes with daily life.
- Difficulty concentrating.
The Worst Type Of Panic Attack
All panic attack types are incredibly stressful and can make it much harder to go about your daily life. These attacks may cause physical and mental symptoms that are so distressing they can cause people to fear to leave their own home.
But arguably nighttime panic attacks are the worst type of panic attacks because they cause significant distress that not even daytime panic attacks may cause:
- They often hit you by surprise with no warning.
- They may wake you up from sleep when your thoughts aren’t entirely formed.
- They often prevent you from going back to sleep and cause sleep deprivation.
- They may create significant health fears.
- They may cause you to fear sleep in the future.
Furthermore, you might find that your nocturnal panic attacks are also disturbing your partners sleep. This can put a strain on your relationship.
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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?
- Im afraid to leave my house. What should I do?
- Is there a possibility that my panic attacks will come back after treatment?
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.
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The Difference Between An Anxiety Attack And A Panic Attack
Once again, anxiety attack is not a clinical term. It’s a term used to describe periods of more intense anxiety that go beyond traditional anxiety experiences.
That differs from the term panic attack. Panic attacks are severe anxiety attacks like what is described above – attacks that are often so disabling that many people struggle to cope with them and develop panic disorder, health anxiety, and possibly agoraphobia.
Traditionally, the term “anxiety attack” is used to discuss weaker versions of panic attacks. If you have multiple panic attacks, you have panic disorder. Anxiety attacks can affect anyone – even those without panic disorder or an anxiety disorder – and so the term is used to encompass all of these types of attacks.
For the purposes of this article, we’ll discuss these types of anxiety attacks as the weaker version of a panic attack. But in life, people do use the two terms somewhat interchangeably, and both are related to the same feelings of doom, along with relevant symptoms.
Key Points About Panic Disorder
- Panic disorder is an overreaction of fear and anxiety to daily life stressors.
- The reaction causes a hyperphysical response, followed by intense worry that another attack will happen soon. This can upset the ability to function normally.
- It is a common disorder and can often lead to depression.
- Panic disorders can be disabling because you become so afraid of when the next panic attack may happen that you can’t cope with regular tasks.
- Treatment involves use of anti-anxiety medicines and antidepressants along with cognitive behavioral therapy.
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