The Call-On-Doc Guide to Panic Disorder
Published on Feb 22, 2024 | 4:02 PM
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Whereas it's not unusual for adults to have panic attacks, with every one in ten Americans experiencing them annually, one of the defining characteristics of panic disorder is the consistency that they occur among other symptoms. (2) Affecting around 5% of all American adults, panic disorder is an anxiety disorder that is well-known to psychiatrists and healthcare providers alike. (1) Ranging in severity, the condition can affect multiple aspects of a person’s life if left untreated.
What are panic disorder symptoms?
Despite being a mental condition, panic disorder symptoms can result in intense physical and mental sensations that can leave a person impaired. As per the Fifth Edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), those diagnosed with panic disorder will experience regular panic attacks, where one or more episodes are followed by either a persistent fear of having another attack within a month or displaying significant abnormal behavior linked to the attacks. (3)
While the severity of the condition and panic attacks can vary, panic disorder is recognized as a condition that can produce intense mental and physical symptoms, such as:
Physical Symptoms: Panic attacks involve a range of physical sensations, such as:
- Changes in behavior with the intention of preventing panic attacks, including avoiding people, situations, places, and more.
- May experience ongoing physical symptoms even when not having a panic attack, including headaches, digestive issues, fatigue, or difficulty sleeping.
- Palpitations or a pounding heart.
- Sweating.
- Trembling or shaking.
- Shortness of breath or feeling like you're suffocating.
- Feelings of choking.
- Chest pain or discomfort.
- Nausea or abdominal distress.
- Dizziness, lightheadedness, or feeling faint.
- Chills or heat sensations.
- Numbness or tingling sensations.
Mental and Emotional Symptoms: Alongside physical symptoms, panic attacks often involve intense mental and emotional experiences, including:
- Feelings of derealization (feeling detached from reality) or depersonalization (feeling detached from oneself).
- Constant worry and anxiety about having another panic attack or the consequences of panic attacks.
- Sudden episodes of intense fear and dread.
- Sudden and intense fear
- Fear of losing control or going crazy.
- Fear of dying.
- A sense of impending doom.
- Intrusive thoughts or ruminations.
It should be noted that a symptom of panic disorder does include thoughts of suicide. Medical providers stress that if you are having such thoughts, and especially if you are remotely considering them, you should use the Suicide & Crisis Lifeline and dial 988. With personnel who can speak English and Spanish, those working the National Suicide Prevention Hotline are available 24 hours a day, seven days a week, in all 50 states and five territories.
Can panic attacks cause high blood pressure?
Anything that initiates your fight or flight response, like a panic attack, will cause a temporary spike in your blood pressure, but will not directly cause chronically high blood pressure. However, in the case of prolonged stress or anxiety, which can occur when panic disorder is left untreated, the possibility of a person developing hypertension grows while their stress remains. (4)
Can panic attacks cause chest pain?
Chest pain is a well-known symptom of panic attacks and panic disorder in general. While not a symptom for all panic attacks, over 70% of all incidences can exhibit the feeling. Additionally, up to 25% of all patients who report feeling chest pain when utilizing emergency services have been diagnosed with or exhibit signs of panic disorder. (5)
Despite where the pain is, chest pain during a panic attack does not necessarily mean a heart attack or life-threatening condition. However, it's important to keep in mind that those with panic disorder are at a slightly increased risk for heart disease and at an even greater risk for conditions like hypertension. It's thereby important to seek out panic disorder treatment and manage the condition when you suspect you may have it.
Can panic attacks make you faint?
Fainting from a panic attack is considered rare, with it seldom occurring as a result, and far less so on a regular basis without an underlying condition. Those who hyperventilate during a panic attack may lose consciousness due to the process creating an imbalance of too much oxygen in the body and removing too much carbon dioxide at too fast of a rate. (6)
A common panic disorder symptom, that extends to panic attacks, is the feeling of lightheadedness, dizziness, or that the person feels as though they are floating. In such events where a person regularly loses consciousness or faints, they should seek out medical attention immediately as it could indicate a serious underlying condition.
How to stop a panic attack?
Focus on your Breathing: Sit or lay down, putting one hand on your chest and the other on your belly. Breathe in through your nose and out through your mouth for several minutes until you calm down.
Distract Yourself: Keep a list of things that help you relax, like:
- Going for a walk
- Painting
- Cooking
- Calling a good friend
Can panic attacks kill you?
Panic attacks are considered nonfatal, in that they won’t kill you, but can exacerbate conditions that affect your heart or other critical parts of the body. Left untreated, regular panic attacks from a panic disorder can add to conditions that deteriorate your health over time.
Patients with conditions that affect their breathing, like asthma, can worsen the frequency or severity of an asthma attack when associated with panic disorder. It’s thus important to encourage patients who have asthma with anxiety related to seek treatment immediately so as to best manage their health.
What is panic disorder frequently linked with?
A number of studies point to other mental health disorders as the most common conditions that accompany panic disorder. (8) The most common examples include:
- Depression: A majority of patients with panic disorder will experience depression at some point in their lifetime. (9) Patients who receive or seek out panic disorder treatment early are found to have a significant chance of avoiding depression, especially when taking active measures to manage their symptoms.
- Eating Disorders: Studies have shown that two-thirds of patients with eating disorders suffer from an anxiety disorder. (10) As an anxiety disorder, panic disorder is one of the most commonly found and often develops when eating disorders are not managed.
- Generalized Anxiety Disorder: On top of commonly occurring with other mental conditions, generalized anxiety disorder and panic disorder can occur in the same patient. (11) Such instances of the two occurring together are especially the case after the patient has experienced a tragedy, disaster, or an extended time of noteworthy stress. (12)
- Substance Abuse: Alongside there being a strong association between those with substance abuse issues and panic attacks, patients with panic disorders frequently report high rates of substance abuse, especially concerning alcohol, tobacco products, marijuana, and others.
- Insomnia: Panic disorder and insomnia commonly occur together in patients, compounding on each other due to the effects lack of sleep plays into the exacerbation of panic disorder symptoms. (13)
What causes panic disorder?
Panic disorders do not have one singular source for us to point to and direct blame, but they do have multiple factors that contribute to the condition's development. Like other mental disorders, the factors can be a combination of:
- Genetic: Genetics may play a role, as individuals with a family history of anxiety disorders, including panic disorder, may be at a higher risk.
- Biological: Biological factors, such as imbalances in neurotransmitters like serotonin and norepinephrine, could contribute to the development of panic disorder.
- Environmental: Environmental stressors, traumatic life events, or major life changes may trigger the onset of panic disorder in susceptible individuals.
- Psychological: Learned behavior or cognitive factors, such as catastrophic thinking or misinterpreting bodily sensations, can perpetuate and exacerbate symptoms.
How is panic disorder diagnosed?
The DSM-5 entails several key points that disqualify normal panic attacks and other conditions. These include experiencing frequent and unexpected panic attacks. Additionally, for a diagnosis of panic disorder, at least one panic attack must be followed by one month or more of ongoing concern about having another attack, persistent fear of the consequences of an attack (such as losing control or having a heart attack), or significant behavioral changes such as avoiding triggering situations. It's also crucial that the panic attacks are not attributed to substance use, medical conditions, or other mental health disorders like social phobia or obsessive-compulsive disorder.
What is the best treatment for panic disorder?
After assessing your history, a provider may conduct a physical exam to rule out other conditions and may refer you to a mental health professional for a diagnosis. Treatment typically involves psychotherapy, like cognitive behavioral therapy (CBT), which teaches coping mechanisms and ways to manage panic attacks through exposure therapy, alongside medication options such as SSRIs, SNRIs, beta-blockers, or benzodiazepines. Medications may have side effects, and finding the right one may take time, but a healthcare provider can help tailor the treatment plan to your needs. (14)
Can panic disorder be cured?
Panic disorder can be treated and managed for long-term relief with a combination of prescriptions and lifestyle changes. (15)
What can you do to help panic disorder?
Like depression and other anxiety disorders, there are active steps that can be taken to help reduce the severity of panic disorder and allow a patient to more easily live a normal life. The following can be applied alongside treatment and are not meant to replace treatment. Patients with panic disorder can also develop healthy lifestyle habits such as:
- Practice Relaxation Techniques: Incorporate relaxation techniques such as deep breathing exercises, progressive muscle relaxation, or meditation into your daily routine to help reduce stress and anxiety.
- Stay Active: Engage in regular physical activity such as walking, jogging, yoga, or swimming, as exercise can help alleviate symptoms of anxiety and improve overall well-being.
- Maintain a Healthy Lifestyle: Eat a balanced diet, limit caffeine and alcohol intake, and ensure you get enough sleep each night, as these factors can influence anxiety levels.
- Identify Triggers: Pay attention to situations, thoughts, or activities that tend to trigger your panic attacks and work on developing strategies to cope with or avoid these triggers when possible.
- Challenge Negative Thoughts: Practice challenging and reframing negative thought patterns associated with panic attacks through cognitive-behavioral techniques, such as cognitive restructuring.
- Build a Support Network: Surround yourself with supportive friends, family members, or support groups who can offer encouragement, understanding, and practical assistance when needed.
- Maintain Consistency: Stick to your treatment plan and attend therapy sessions regularly, even when you start feeling better, to maintain progress and prevent relapses.
- Educate Yourself: Learn more about panic disorder, its symptoms, and effective coping strategies through self-help resources, books, or reputable websites to empower yourself in managing the condition.
When it comes to getting everything you need to manage panic disorder, Call-On-Doc can help by offering an easy process for your prescription refill and a resource for many of the surrounding health services that you need to stay healthy, so you can put all of your focus on getting healthy. We’re here to help, educate, and be the best telemedicine provider for everyone in the United States!
Wayne C. Hahne,
English graduate and Call-On-Doc’s medical resource guide, Wayne C. Hahne is an experienced and passionate medical education content expert. Through diligent research, provider interviews and utilizing the industry's leading resources for wellness information, it is Mr. Hahne’s personal mission to educate the general public on medical conditions with in-depth and easy-to-understand written guides.
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