Written By Mili Dhru, Contributing Writer
Every year, approximately 11% of Americans experience panic attacks. These sudden episodes of fleeting but frightening feelings are typically triggered by non-threatening and harmless situations but can cause a series of strong physiological and psychological reactions (Cleveland Clinic, 2020). People who experience panic attacks that occur frequently and unexpectedly are most commonly diagnosed with panic disorder. This condition is a specific type of anxiety disorder that is characterized by a “persistent fear of having another panic attack after [having] experienced at least one month (or more) of persistent concern or worry about additional panic attacks (or their consequences) recurring” (Burke, 2018).
Panic disorder affects about 2-3% of Americans annually, and it is twice as common in women than men; onset of the disorder is usually around the teen – early adult years, but people of all ages can experience individual instances of panic attacks. Although the exact cause of panic disorder is unknown, risk factors such as “family history, major life stress, traumatic events, major life changes, smoking and excessive caffeine intake” can significantly exacerbate the condition (Mayo Clinic, 2018). Panic disorder can greatly impact daily life – impairing driving, causing people to miss work and frequently visit their doctors, and compelling those affected by the condition to avoid situations likely to induce a panic attack (ADAA, 2020).
The situations that prompt attacks usually make people feel as though they are in danger, activating the sympathetic nervous system’s fight-or-flight response; oftentimes, these symptoms can manifest in a way that resembles a heart attack. Those who visit the emergency department for their symptoms are commonly tested to determine whether or not the cause of their symptoms is actually related to a heart condition, and blood tests may also be conducted to eliminate the possibility of other conditions that may present the same symptoms (Burke, 2018).
But what exactly are the symptoms of a panic attack? Most people report experiencing shortness of breath/hyperventilation, fear of losing control, sweating, hot/cold flashes, and choking, amongst other symptoms. Panic attacks can also develop into a complication called agoraphobia, a type of anxiety disorder that causes people to “avoid places or situations that might cause them to panic and make them feel trapped, helpless or embarrassed” (Mayo Clinic, 2017); agoraphobia can develop at any time, but it has most commonly been observed to “appear within a year of [the] first recurrent panic attacks” (ADAA, 2020).
Fortunately, there are several treatment options available to reduce the severity and frequency of panic attacks and improve overall day-to-day function. The two most successful treatments are psychotherapy and medication, and depending on the individual’s history, preference, and severity of panic attacks, they may be recommended one over the other (Mayo Clinic, 2018). Psychotherapy, also known as talk therapy, is an effective preliminary treatment option because it allows people to “understand panic disorder and panic attacks and how to cope with them” (Mayo clinic, 2018). Therapists also commonly use a form of psychotherapy called cognitive behavioral therapy to help patients learn to overcome the symptoms of panic disorder they find dangerous or frightening by talking through their own experiences. Medications are also available to help manage and lessen the symptoms associated with panic disorder and may be able to treat certain comorbidities such as depression and social phobia.
The most frequently prescribed medications are selective serotonin reuptake inhibitors (SSRIs), serotonin and norepinephrine reuptake inhibitors (SNRI’s) and benzodiazepines. SSRIs are a class of antidepressants that are generally prescribed in the initial stages of the disorder because of their low risk and minimal side effects; popular SSRIs include “fluoxetine (Prozac), paroxetine (Paxil, Pexeva) and sertraline (Zoloft)” (Mayo Clinic, 2018). SNRIs are also antidepressants that help regulate the neurotransmitters serotonin and norepinephrine–causing a person’s mood to stabilize and reducing feelings of anxiety. Benzodiazepines act as central nervous system depressants and are amongst the most severe prescription medications for panic disorder. This class of medications is usually only recommended for temporary use due to its high dependence potential and dangerous side effects when administered with other drugs (Mayo Clinic, 2018).
Although panic disorder can be a long-term condition that may be challenging to treat, certain measures can be taken to reduce the risk of experiencing frequent panic attacks. Enforcing effective stress management and relaxation techniques as part of a daily regimen; avoiding smoking, alcohol, caffeine, and recreational drugs; and remaining physically active and maintaining a quality sleep schedule may help lower stress and anxiety at an earlier stage. Many people who are diagnosed with panic disorder refrain from sharing their experiences with loved ones and seeking support or they do not realize that their condition is legitimate and that they could potentially respond well to treatment. If you are experiencing recurrent panic episodes, speaking with a primary care provider to determine the best treatment plan may be a helpful first step in managing the symptoms of panic disorder.
Burke, D. (2018, August 29). Panic Disorder: Causes, Symptoms, and Treatment. Retrieved December 27, 2020, from https://www.healthline.com/health/panic-disorder
Panic attacks and panic disorder. (2018, May 04). Retrieved December 27, 2020, fromhttps://www.mayoclinic.org/diseases-conditions/panic-attacks/symptoms-causes/syc-20376021
Panic Attacks: Panic Disorder, Anxiety Disorder, Symptoms, Causes. (2020, August 12). Retrieved December 27, 2020, from https://my.clevelandclinic.org/health/diseases/4451-panic-disorder
Panic Disorder. (2020). Retrieved December 27, 2020, from https://adaa.org/understanding-anxiety/panic-disorder