Panic Disorder

What is panic disorder?

Panic disorder occurs when you have a surge of intense fear that strikes suddenly and repeatedly without warning. These overwhelming feelings of anxiety and stress are often referred to as panic attacks.
Panic disorder symptoms are mostly centered around panic attacks. Symptoms of a panic attack often include a pounding or racing heart, sweatiness, and dizziness. Your hands may tingle or feel numb, causing you to genuinely believe you’re having a heart attack or stroke.
A panic attack isn’t dangerous, but it can be frightening. It can make you feel like you’re “out of control.”

Symptoms of Panic Disorder

While most panic attacks average only a couple of minutes, they can feel much longer when you’re having one. Sometimes these attacks can go on for up to 10 minutes. In rare cases, they may last an hour or more.
If you have panic disorder, you’ll most likely only have symptoms when you’re having a panic attack. Your symptoms can be both physical and psychological (or emotional).

Physical symptoms

Common physical symptoms of a panic attack can include:

• pounding heart (or palpitations)
• chest pain or discomfort
• trembling or shaking
• sweating
• chills or hot flashes
• shortness of breath
• dizziness or lightheadedness
• faintness
• nausea or abdominal distress
• feelings of choking
• numbness or tingling sensations

Psychological symptoms

• a sense of unreality (derealization) or of being detached from oneself (depersonalization)
• a fear of dying or that something bad is going to happen
• a feeling of smothering
• a fear of losing control or “going crazy”

Treatment of Panic Disorders

Treatment can help reduce the intensity and frequency of your panic attacks and improve your function in daily life. The main treatment options are psychotherapy and medications. One or both types of treatment may be recommended, depending on your preference, your history, the severity of your panic disorder and whether you have access to therapists who have special training in treating panic disorders.

• Psychotherapy: Psychotherapy, also called talk therapy, is considered an effective first choice treatment for panic attacks and panic disorder. Psychotherapy can help you understand panic attacks and panic disorder and learn how to cope with them.
  A form of psychotherapy called cognitive behavioral therapy can help you learn, through your own experience, that panic symptoms are not dangerous. Your therapist will help you gradually re-create the symptoms of a panic attack in a safe, repetitive manner. Once the physical sensations of panic no longer feel threatening, the attacks begin to resolve. Successful treatment can also help you overcome fears of situations that you've avoided because of panic attacks.
• Medications: Medications can help reduce symptoms associated with panic attacks as well as depression if that's an issue for you. Several types of medication have been shown to be effective in managing symptoms of panic attacks, including:
  • Selective serotonin reuptake inhibitors (SSRIs). Generally safe with a low risk of serious side effects, SSRI antidepressants are typically recommended as the first choice of medications to treat panic attacks. SSRIs approved by the Food and Drug Administration (FDA) for the treatment of panic disorder include fluoxetine (Prozac), paroxetine (Paxil, Pexeva) and sertraline (Zoloft).
  • Serotonin and norepinephrine reuptake inhibitors (SNRIs). These medications are another class of antidepressants. The SNRI venlafaxine (Effexor XR) is FDA approved for the treatment of panic disorder.
  • Benzodiazepines. These sedatives are central nervous system depressants. Benzodiazepines approved by the FDA for the treatment of panic disorder include alprazolam (Xanax) and clonazepam (Klonopin). Benzodiazepines are generally used only on a short-term basis because they can be habit-forming, causing mental or physical dependence. These medications are not a good choice if you've had problems with alcohol or drug use. They can also interact with other drugs, causing dangerous side effects.