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Treatment for Panic Disorders

An obscure Los Angeles Timesreport provides a window into the debilitating nature of the panic disorder.

According to the report, a 43-year-old woman with this condition dialed 911 more than 400 times between 2011 and 2013, “honestly believing she will die,” stated her attorney.

The woman would sometimes call 911 up to six times a day. In 2013, between Jan. 1 and Sept. 13, she called the paramedics 220 times. Each time, responders came to her aid, but they reportedly found no medical issues with her. 

Ultimately, the woman was sentenced to 180 days in jail, three years of probation, and mandatory psychological counseling.

“This verdict, and especially the sentence, were a grave injustice,” her attorney said.  

The woman’s case illustrates this unassailable fact about panic disorders: They can make you believe the world is closing in on you. 

What’s more, panic disorder (PD) can affect every area of your life.

Sound familiar?

If you believe you have a panic disorder, the National Institute of Mental Health (NIMH) poses some questions to consider: 

“Do you sometimes have sudden attacks of anxiety and overwhelming fear that last for several minutes? Maybe your heart pounds, you sweat, and you feel like you can’t breathe or think. Do these attacks occur at unpredictable times with no obvious trigger, causing you to worry about the possibility of having another one at any time?”

If panic attacks are frequent for you, read on to learn about the best treatment options to address this disorder. 

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What Is Panic Disorder?

Panic disorder is a type of anxiety disorder that produces panic attacks. It is a prevalent condition. PD affects 6 million people or about 2.7 percent of the U.S. population, states the Anxiety and Depression Association of America.

The Mayo Clinic defines a panic attack as a sudden episode of intense fear that sets off severe physical reactions when there appears to be no real danger or apparent cause. 

According to MedlinePlus.gov, the physical symptoms of a panic attack include: 

  • Weakness or dizziness
  • Sweating
  • Difficulty breathing
  • Rapid heartbeat
  • Numb or tingly hands
  • Chest or stomach pain
  • Feeling hot or a cold chill

Panic attacks can happen anytime, anywhere, and without warning. The symptoms of a panic attack can peak within minutes. When it subsides, the recipient feels worn out. 

The Mayo Clinic details the psychological symptoms that can accompany a panic attack:

  • A sense of impending doom or danger
  • Fear of loss of control or death
  • The feeling of unreality or detachment

With a panic disorder, you live in fear that you will have another one. The fear can be so overwhelming that you may avoid certain situations attacks occur, says the Mayo Clinic

What Causes Panic Disorders?

There is no known cause for panic disorders and attacks. The following factors may play a role, according to the Mayo Clinic:

  • Genetics
  • Certain changes in the way parts of your brain function
  • A temperament that is more sensitive to stress or prone to negative emotions
  • Major stress

Panic attacks can appear suddenly and without warning. Over time, they can be triggered by particular situations. Research links panic attacks to the “fight-or-flight” response that occurs from a predator attack, reports Psychology Today

The sweating, rapid heartbeat, and heavy breathing that mark a panic attack are also representative of the symptoms people experience in a fight-or-flight situation. 

“When attacked by a predator, a prey animal either runs away or evades detection by staying put. The fight-or-flight response revs up metabolism and tones muscles in preparation for vigorous activity, and it is shared by most, or all mammals, according to Psychology Today

Woman looking out her window

Risk Factors

According to the Mayo Clinic, these factors can make it more likely that someone will experience a panic disorder or attacks: 

  • Family history of panic attacks or panic disorder
  • History of childhood trauma, like physical or sexual abuse
  • A traumatic event, such as sexual assault or a serious accident
  • A major life stressor, like the death or serious illness of a loved one
  • A major life change, like a divorce or the birth of a child
  • Smoking or drinking caffeine excessively

Complications

Panic disorder and the attacks that come with this condition can have you living in a constant state of fear, sapping you of joy and vitality.

The Mayo Clinic details the following complications from panic attacks:

  • Avoiding social situations
  • Experiencing problems at work or school
  • Depression, anxiety disorders, and other psychiatric disorders
  • Resorting to alcohol or other substance misuse
  • Having financial trouble
  • Developing certain phobias, such as a fear of driving or leaving home
  • Frequent medical care for health concerns and other medical conditions
  • Increased risk of suicide or suicidal thoughts

A panic disorder may include agoraphobia, an anxiety disorder in which people are afraid to leave their homes. 

Treatment for Panic Disorders

The good news is that panic disorders and agoraphobia are treatable. According to Verywell Mind, people diagnosed with panic disorder can be treated with medicine, psychotherapy, or a combination of both. 

Treatment Medications

One of two medications is prescribed to treat panic disorder: antidepressants or anti-anxiety drugs. They help lessen the severity of panic attacks and reduce anxiety, says Verywell Mind

Antidepressant medications: Selective Serotonin Reuptake Inhibitors (SSRIs) are often prescribed for panic disorders because they work to balance serotonin levels, resulting in decreased anxiety, mood regulation, and improved sleep. SSRIs have a demonstrated record of long-term effectiveness and limited side effects, Verywell Mind states. 

Popularly prescribed SSRIs include: 

  • Prozac (fluoxetine)
  • Paxil (paroxetine)
  • Zoloft (sertraline)
  • Celexa (citalopram)

Anti-anxiety medications: Benzodiazepine medications are recommended because they are fast-acting and sedating. Considered central nervous system (CNS) depressants, benzos have a demonstrated ability to induce calm and relaxation. These effects can reduce panic disorder symptoms.

Commonly prescribed benzodiazepines include:

  • Xanax (alprazolam)
  • Valium (diazepam)
  • Ativan (lorazepam)
  • Klonopin (clonazepam)

Benzodiazepines can be habit-forming and have a high potential for abuse. If you take benzos, it is critical that you follow the doctor’s orders. When taken as recommended, however, benzodiazepines are a safe and effective means of treating panic disorder symptoms.

Psychotherapy

The goal of psychotherapy is to help you heal and learn constructive approaches to issues.

In the context of panic disorders, a therapist can help you work through unresolved issues and feelings while helping you cultivate healthier ways of thinking and behaving in response to panic symptoms. 

The common forms of psychotherapy (or talk therapy) utilized to treat panic disorder are: 

Cognitive behavioral therapy (CBT): This type of therapy has been demonstrated to effectively treat panic disorder. With CBT, you learn coping skills by transforming your negative thinking patterns and unhealthy behaviors, according to Verywell Mind.Panic-Focused Psychodynamic Psychotherapy (PFPP): The goal of PFPP is to help you uncover past experiences and emotional issues that led to the bloom of a panic disorder.

Sources

Anxiety and Depression Association of America. (n.d.). Facts & Statistics. Retrieved from https://adaa.org/about-adaa/press-room/facts-statistics

Bloomekatz, A. (2013, December 24). Attorney says client who got jail for abusing 911 has panic disorder. Retrieved from https://www.latimes.com/local/lanow/la-me-ln-woman-called-911-panic-disorder-attorney-says-20131224-story.html

Cleveland Clinic. (n.d.). Agoraphobia Symptoms & Treatments. Retrieved from https://my.clevelandclinic.org/health/diseases/15769-agoraphobia

Grohol, J. M. (2019, May 26). Psychotherapy. Retrieved from https://psychcentral.com/psychotherapy/

Mayo Clinic. (2018, May 04). Panic attacks and panic disorder. Retrieved from https://www.mayoclinic.org/diseases-conditions/panic-attacks/symptoms-causes/syc-20376021

MedlinePlus.gov. (2019, February 07). Panic Disorder. Retrieved from https://medlineplus.gov/panicdisorder.html

National Institute of Mental Health. (n.d.). Panic Disorder: When Fear Overwhelms. Retrieved from https://www.nimh.nih.gov/health/publications/panic-disorder-when-fear-overwhelms/index.shtml

Psychology Today. (n.d.). Panic as Fight-or-Flight. Retrieved from https://www.psychologytoday.com/us/blog/the-human-beast/201604/panic-fight-or-flight

Star, K. (2019, June 15). The Top Treatment Options for Panic Disorder. Retrieved from https://www.verywellmind.com/treatment-for-panic-disorder-2584322

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