Overview

Panic attacks are sudden onset, spontaneous or triggered, periods of intense fear, reach their peak within minutes and last for several minutes. People with panic disorder have recurrent unexpected panic attacks, often worry about having more panic attacks, make extreme efforts to prevent future attacks by avoiding places, situations, or behaviors they associate with panic attacks.

During a panic attack, you may experience:

  • Heart palpitations, a pounding heartbeat, or an accelerated heartrate
  • Sweating
  • Trembling or shaking
  • Sensations of shortness of breath, smothering, or choking
  • Feelings of impending doom
  • Feelings of being out of control

Risk Factors

 

  • Genetic factors- family history of anxiety or other mental illnesses in biological family
  • Environmental factors – Exposure to stressful and negative life
  • Physical health conditions, such as thyroid problems or heart arrhythmias,
  • Use of excessive caffeine or other substances/medications

Treatments and Therapies

Panic disorders are generally treated with psychotherapy, medication, or both.

Medication

Medication does not cure panic disorders but can help relieve symptoms. The most common classes of medications used to combat panic disorders are anti-anxiety drugs (such as benzodiazepines), antidepressants, and beta-blockers.

Antidepressants usually take higher dose and longer duration (8-12 weeks) to work compared to the treatment of depression. Once you start feeling better, usually after a course of 6 to 12 months, you may be able to gradually taper off the antidepressants. Stopping them abruptly can cause withdrawal symptoms.

Please Note: In some cases, children, teenagers, and young adults under 25 may experience an increase in suicidal thoughts or behavior when taking antidepressants, especially in the first few weeks after starting or when the dose is changed. This warning from the U.S. Food and Drug Administration (FDA) also says that patients of all ages taking antidepressants should be watched closely, especially during the first few weeks of treatment.

If you are considering taking an antidepressant and you are pregnant, planning to become pregnant, or breastfeeding please let us know prior to starting the medicines.

Benzodiazepines are highly effective in relieving symptoms however one can develop a tolerance to them if these medicines are taken regularly for long period of time. Risk of developing tolerance is more in people who have substance use problems (current or past) or who are combining benzodiazepines with other addictive medicines like opioids. These medicines are associated with intense withdrawal symptoms also, so they must be tapered off gradually. This is the reason these medicines are used as needed only.

Beta blockers

Beta-blockers are medicines that can help block some of the physical symptoms of anxiety and panic attack, such as an increased heart rate, sweating, or tremors. Beta-blockers are commonly the medications of choice for the “performance anxiety” type of social anxiety.

Psychotherapy

Psychotherapy or “talk therapy” can help people with anxiety disorders. To be effective, psychotherapy must be directed at the person’s specific anxieties and tailored to his or her needs.

Cognitive Behavioral Therapy

Cognitive Behavioral Therapy (CBT) is an example of one type of psychotherapy that can help people with panic disorders. It teaches people different ways of thinking, behaving, and reacting to anxiety-producing and fearful objects and situations. CBT can also help people learn and practice social skills, which is vital for treating social anxiety disorder.

Cognitive therapy and exposure therapy are two CBT methods that are often used, together or by themselves, to treat panic disorder.

Holistic approach

  • Getting regular exercise such as brisk walk, swimming, jogging etc. helps with anxiety and depression and promote sleep in addition to the physical benefits of work out
  • Yoga and anaerobic exercise have also shown beneficial effects on mental health
  • Keep a mood log
  • Be mindful of your triggers and warning signs
  • Eat healthy and nutritious diet
  • Maintain regular follow ups with your care providers
  • Take all medicines as prescribed, consult your doctor before making any medicine changes
  • Avoid misuse of alcohol or other drugs
  • Adopt good sleep habits
  • Mindful breathing