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Panic Disorder – How to get the right help to cut down on panic attacks

Panic Disorder – How to get the right help to cut down on panic attacks

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Continue ReadingPanic Disorder – How to get the right help to cut down on panic attacks

What, Why, and How?

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Intervention outcome statistics

Percentage of respondents in the U.S. who reported symptoms of depressive disorder in the last seven days from April 2020 to April 2022 7:32 PM


Source

Overview

Panic Disorder is a typical anxiety disorder marked by sudden and recurring episodes of extreme terror and physical symptoms such as chest pains, irregular heartbeat, shortness of breath, dizziness, or stomach pain. These episodes might happen without any initial concern or stress factor.

Individuals who have panic disorder may experience recurrent, unexpected panic attacks. When you experience sudden, overpowering anxiety or dread for no apparent reason, you might be experiencing a panic attack. Physical symptoms such as a speeding heart, breathing difficulty, and sweating are possible.

The majority of people have panic attacks once or twice in their lifetimes. Others get panic attacks more frequently, sometimes for no apparent reason. Panic disorder is a continuous fear of panic attacks repeating for at least one month.

Panic disorder signs can be overpowering and terrifying, but they can be controlled and reduced with treatment. The most crucial step in lowering symptoms and increasing your well-being is to get help.

Symptoms

As per the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5), a panic episode is defined as – “an abrupt surge of intense fear or intense discomfort that reaches a peak within minutes.”

Panic attacks are episodes of acute dread that strike without notice. A panic episode may usually last between 5 and 20 minutes, and symptoms can last up to an hour in severe circumstances. Everyone’s experience is unique, and signs often fluctuate.

A panic episode can create the following symptoms:

  • The feeling of derealization and depersonalization
  • Tingling or numbness in your body
  • Shortness of breath or a suffocating sensation
  • The anxiety of losing control or going insane
  • Palpitations or a racing heart
  • A feeling of impending danger
  • Feeling like you’re about to choke
  • Nausea or stomach discomfort
  • Stiffness or pain in the chest
  • Tingling or numbness
  • Feeling weak or dizzy
  • Trembling or shaking
  • Cramps in stomach
  • Hot flashes or chills
  • Vertigo
  • Lightheadedness
  • Sweating or shivering
  • Throat constriction
  • Fear of death
  • Unbearable headache

A specific occurrence or external stimuli can sometimes set off a panic episode. Other times, panic disorder symptoms appear for no apparent reason. The signs are usually proportional to the threat intensity in your surroundings.

Panic episodes can substantially impact your daily life due to their unpredictability. Some people have panic attacks at the workplace, with companions in public, or even at home.

You might have the panic disorder if you’ve experienced four or more panic episodes or are afraid of having another one soon. It would be best if you had unanticipated panic attacks to be considered a panic disorder patient.

Many people living with panic disorder refer to having an attack in certain places at a particular time. They may believe the attack was sparked by the restaurant, elevator, or classroom and will avoid these specific locations. This can progress to agoraphobia or the fear of being in certain public places.

Causes

Specialists aren’t sure what triggers panic disorder, but one theory is that individuals with it have susceptible brains regarding fear. Panic attacks and phobias have been linked, and people facing hypersensitivity to carbon dioxide might signal their brains that they’re suffocating. It may also contribute to panic disorder.

The following events may trigger panic disorder:

  • An accident or a severe sickness
  • The demise of a close friend
  • Family estrangement
  • After baby birth

Some people feel that panic episodes are linked to:

  • Depression
  • Anxiety
  • Alcohol consumption
  • Smoking
  • Substance abuse
  • Suicidal tendency
  • Seasonal affective disorder (SAD)
  • High-stress levels
  • Having negative emotions

The findings on whether a person’s genes are responsible for developing panic disorder are unclear.

According to a 2020 study, panic disorder might possess a genetic connection. Researchers have discovered 40 distinct genes related to panic disorder, most of which were tied to our body’s neurotransmitter network (which controls communications between the nerve cells). They claimed that biomarker testing could help detect panic disorder.

According to a 2018 study, information on panic disorder and genetics is contradictory, and further research is required before any conclusions can be made. According to the researchers, life stress, trauma, and anxiety tolerance are all essential psychological and social elements that contribute to the disease.

Variations in the “COMT” gene indicate the most substantial evidence for being linked to panic disorder in both the 2020 and 2018 investigations. This gene produces an essential enzyme (protein) that impacts our cognitive capacities and behavioral regulation.

In addition, a 2019 study found a “strong genetic link” between panic disorder and other illnesses like major depressive disorder and neuroticism.

Diagnosis

There is no specialized lab testing for panic disorder. Because signs resemble typical cardiac arrest, your doctor will likely begin by evaluating you and checking out other health problems.

You may have the following to aid in diagnosis:

  • A thorough physical examination
  • Thyroid tests and tests for other probable disorders, as well as cardiac tests like an electrocardiogram (ECG or EKG)
  • A psychological assessment to discuss your symptoms, anxieties, stressful situations, relationship issues, scenarios you fear the most, and family history.
  • A psychological self-assessment or questionnaires can be conducted.
  • You may also be questioned about your usage of alcohol or other drugs.

Criteria for diagnosis

Panic disorder does not affect everybody who gets panic episodes. The Diagnostic and Statistical Manual of Mental Disorders (DSM-5), issued by the American Psychiatric Association, provides the following criteria for a diagnosis of panic disorder:

  • You get panic episodes regularly.
  • At least one of the panic episodes was followed by a continuous fear of getting another attack.
  • You are facing the fear of the outcome of an attack, like losing control, having a cardiac arrest, or going insane.
  • Significant behavioral changes, like avoiding situations that might trigger a panic attack.
  • Your panic episodes aren’t the result of drug or alcohol abuse, a physical ailment, or a mental health issue like specific phobias or obsessive-compulsive disorder.

You might still benefit from treatment if you experience panic attacks, but no identified panic disorder so far. If frequent panic episodes are not addressed, they might progress to panic disorder or phobias.

Treatment and Prevention

The goal of panic disorder treatment is to reduce or eliminate the symptoms. This can be accomplished by therapy, lifestyle modifications, and, in some situations, medication, similar to anxiety treatments.

Cognitive-behavioral therapy (CBT) is commonly used in treatment. CBT trains you to adjust your thinking and behaviors to understand and manage severe panic attacks.

Your doctor may recommend that you see a psychotherapist. They might suggest:

  • Psychotherapy, also known as talk therapy (for example, cognitive-behavioral therapy)
  • Selective serotonin reuptake inhibitors (SSRIs) or serotonin and norepinephrine reuptake inhibitors (SNRIs) are antidepressants (SNRIs)
  • Anti-anxiety drugs like benzodiazepines are sedatives that influence the central nervous system (generally used for short periods)

To prevent panic disorders, it is suggested to:

  • Keep a consistent routine
  • Perform regular physical activity
  • Exercise deep breathing
  • Get adequate rest
  • Limit alcohol consumption
  • Avoid consumption of Caffeine

Related Conditions

Panic disorder can be effectively treated. Many people, however, put off getting treatment because they are humiliated. Panic attacks or panic disorder that goes untreated can make it challenging to live a happy life. You might develop:

  • Anticipatory anxiety
  • Depression
  • Phobias
  • Suicidal ideation

Panic Disorder Case Study

David Brenner, a 50-year-old man who had visited the ER complaining of respiratory problems, was recommended by his regular care doctor. David was perplexed, anxious, and irritated since his doctor could not identify a medical cause for his symptoms. David has had numerous times in the past six months where he felt a strong sense of panic that would quickly peak. During these times, David also started sweating, having heart palpitations, chest pain and discomfort, and breathlessness. David occasionally feared that he would pass away.

David always worries about suffering another attack as a result. In addition, he has started to stay away from strange persons and surroundings where it could be challenging to receive assistance in the occurrence of another panic attack. David’s life is greatly affected by fear and related avoidance since David has been declining social invitations, finding reasons to remain in whenever possible, and depending on his wife to take their kids to numerous activities. David’s wife has grown dissatisfied with what she sees as his unreasonable dread of panic attacks, although initially, she was sympathetic.

Symptoms

  • Agoraphobia
  • Anger
  • Anxiety
  • Panic
  • Suicidal thoughts
  • Worry

Diagnoses and Related Treatments

The following treatments have empirical support for individuals with Panic Disorder:

  • Fear Stimuli Identification Therapy (FSIT)
  • Applied Relaxation for Panic Disorder
  • Cognitive Behavioral Therapy for Panic Disorder
  • Psychoanalytic Treatment for Panic Disorder

Semi-structured assessments with David, his wife, and his family were done throughout the first three sessions. In light of these conversations, a diagnosis was made on the disorder’s severity, and its causes were investigated.

To determine the nature or classification of the Disorder, DSM-V was reviewed. In the subsequent seventeen sessions, David was required to write about a particular subject, and Cross-questioning about the concepts discussed in the texts was done.

Following a diagnosis of panic attacks, therapy based on the FSIT approach was initiated. There were five sessions every week, for a total of fourteen sessions. During treatment, his spouse saw positive behavioral changes in various areas of his life. Clinical observations made throughout treatment also pointed to a subtly improving personality change in her. The distinction between pre and post-assessments supported the accuracy of the hypotheses and the effectiveness of the FSIT. Over three months, feedback from David’s family concerning any potential return of Panic Attack symptoms was sought every week. It was later determined that the disorder’s symptoms had stopped occurring.

Discussion

David had already seen several psychiatrists and psychologists and was mainly treated with antidepressants and CBT before entering the clinic. The client’s disease was unaffected by this in any noticeable way.

To comprehend the primary reasons for David’s condition, it is vital to briefly describe a patient’s social and familial environment before writing about intervention or therapy.

Treatment program

According to prior experience, FSIT therapy is one of the most effective treatments for deeply ingrained diseases, and the client was diagnosed with panic attacks. After the course of therapy, all oral medications were discontinued entirely. For the client’s treatment, 40 sessions were held in total.

Recommendations

  • It is advised that research be conducted on the fear response.
  • FSIT should be employed for treatment when a patient’s issue triggers their fear response.

For treatment, the therapist should concentrate on the causes of the issue.

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