What is Panic Disorder?

Panic Disorder is an anxiety disorder which causes repeat and out-of-the-blue panic attacks–attacks of unbridled and intense fear. The attacks usually last for minutes, but can last for hours. People often don’t know what they are anxious about.

To be diagnosed with a Panic Disorder, one must experience at least four of the following symptoms, all of which come on within a ten minute period. These symptoms are: a racing or pounding heart, chest pain or discomfort (which sometimes makes people think they are having a heart attack,) dizziness, shortness of breath, numbness or tingling, trembling, nausea, sweats or chills, a sensation of choking, fear of losing control, fear of dying and feelings of detachment or unreality.

Also, after having a panic attack, those with this disorder usually have at least a month where the fear of having another panic attack is overwhelming. Terrified that they will be beset again, people often do not want to be alone or far from their doctor or hospital. Panic Disorder is more common in women than in men. Panic Disorder or panic attacks often occur along with another anxiety disorder. 

What Can You Do About Panic?

You’ve had two panic attacks and you never want another. You thought you were going to die with the first one and you knew you were going to die with the second. What’s a person to do?

Medications and Cognitive Behavioral Therapy help panic. Let’s start with medications.

Benzodiazepines such as Ativan and Klonopin are a quick fix (often working in minutes,) but there are risks. They are addictive. Taken as prescribed or once-in-a-while is o.k., but taken too often is dangerous. People who say they will never get to ‘too often,’ sometimes get there too quickly.

SSRIs (Selective Serotonin Reuptake Inhibitors)are a safer bet, but they can take time (weeks)to work. Well-known SSRIs that work for Panic Disorder are: Prozac, Paxil, Luvox, Celexa and Lexapro, but there are others too.

Only take these medications if they are prescribed by a doctor, preferably a psychiatrist. Often a doctor will prescribe a benzodiazepine for the short term, until other medication kicks in. For some people, small doses of benzodiazepines are given in conjunction with an SSRI.

Cognitive behavioral techniques also work well. If you know you are panicking about the possibility of having a heart attack, a cognitive behavioral therapist will help you look at the reality of these thoughts. How likely is it that you will have a heart attack? What indicators do you have? If the answer to the first is ‘I don’t know. I guess not particularly,’ and the answer to the second is ‘None that I know of,’ she will point out that focusing your mind on positive thoughts does a lot more to keep you healthy than worrying unnecessarily.

If fear of something is a constant companion, exposure can be a terrific tool. But I will say it outright. Exposure takes work. In exposure, people imagine or are shown pictures or are taken to the places they fear. They learn to sit with their anxiety, rating its intensity, while ‘doing a relaxatin technique to reduce their panic.

Relaxation techniques work. When it comes to panic, your mind is single minded–it cannot relax and panic at the same time. Learning to deep breathe or do deep muscle relaxation helps calms things down. Visualization also works. Think of the place where you’ve felt the best, the safest, the most secure. Then, go there in your mind. My place is Turtle Beach in St. Kitts. My runner up is my bed, on top of flannel sheets and underneath my soft, down comforter.