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Panic Disorder


Facts to Know:

  • People with panic disorder experience “panic attacks” which are episodes characterized by the sudden onset of distressing bodily sensations, which are interpreted as threatening or dangerous.
  • Panic attacks are often associated with worry about having future unanticipated panic attacks, which can lead to the avoidance of certain places and activities.
  • Panic disorder is very treatable with therapy and/or medication.

What is panic disorder?

The exact cause of panic disorder is unknown. However, we know that panic disorder has biological and environmental underpinnings. Factors such as a neurochemical imbalance, a family history of anxiety disorders, and significant life stressors may contribute to the onset of panic disorder.

Panic attacks often occur at unpredictable moments, and without a direct connection to a known trigger. They typically last around 20-30 minutes (but can contribute to several hours of fatigue), and often peak in intensity within ten minutes. Psychological factors maintain panic disorder, since individuals learn to anticipate and dread feared bodily sensations, and consequently make attempts to avoid or escape scenarios that may trigger anxiety. Therefore, individuals often fail to learn that the physical symptoms they are experiencing during a panic attack are in fact non-threatening and will decline if cognitively and emotionally processed in a helpful way. Panic attacks can occur in any setting, such as while engaged in a leisure activity, at work, in class, or upon waking in the morning.

Panic disorder is closely related to and highly co-occurring with the condition of Agoraphobia, in which individuals are excessively afraid to be in public places, such as crowded or open areas, for fear that they may experience severe anxiety and/or that it will too difficult for them to leave a situation if necessary. Agoraphobia can interfere with basic daily tasks such as leaving the home or commuting to work.

Panic disorder can overlap with other mental health conditions, and can often lead to problems in daily living, as well as to social and occupational interference. It occurs in about 2-3% of adults and teenagers, and is twice as common in women as in men.  

Physical Symptoms

  • Difficulty breathing (e.g. shallow breathing)
  • Racing heart/heart palpitations
  • Sweating
  • Shaking/trembling
  • Chills/hot flushes
  • Tingling in extremities
  • Stomach distress
  • Chest pain
  • Dizziness or feelings of faintness
  • Feeling detached from oneself
  • Feelings of choking/suffocating
  • Nausea

Cognitive Symptoms:

  • Racing thoughts and difficulty concentrating
  • Fear of losing control
  • Fear that one is dying or fear of imminent doom
  • Fear of “going crazy”
  • Fear of having a heart attack
  • Fear of repeated, unpredictable attacks
  • Fear of visiting certain places (e.g. crowded spaces) or participating in certain activities (e.g. exercise) for fear of having another panic attack

Diagnosis

A mental health professional is best equipped to make a diagnosis of panic disorder. In order to meet criteria for panic disorder, an individual would typically experience distressing physical symptoms, coupled with associated cognitive symptoms (such as fear of losing control). Individuals may also experience urges to avoid and escape from certain situations.

Treatment

At ColumbiaDoctors, we provide a complete host of treatments for panic disorder. Search our providers for a therapist or psychiatrist who might be a good fit.

Psychotherapy

Psychotherapy is an evidence-based treatment for panic disorder. Our therapists and psychiatrists are trained in the latest therapy modalities, such as Cognitive Behavioral Therapy (CBT), the first-line treatment for panic disorder. In many cases, panic disorder can be successfully treated with psychotherapy alone, as individuals learn to think and respond to feelings of anxiety in more effective ways, which can often lead to a significant reduction in symptoms and improvement in quality of life.

Psychopharmacology (Medication Management)

In cases of moderate to severe panic disorder, medications may be an important component of treatment.  Medications for panic disorder typically include selective serotonin reuptake inhibitors, beta-blockers, and/or benzodiazepines. At ColumbiaDoctors, our psychiatrists combine a thorough evaluation with the latest research to design a customized treatment plan for each individual. 

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