I feel on edge….A LOT! How do I know if I have panic disorder?
Good question! About 2% of the population will have symptoms of panic disorder in any given year. Panic disorder usually starts during teenage years or in early adulthood.
If you think you have it, ask yourself a couple of questions:
❓Do I often have waves or spells of anxiety or panic with or without body symptoms that last for minutes (even up to an hour) and then pass?
❓Do these spells seem to come out of nowhere?
❓Do I have body sensations like heart racing, sweating, clammy palms, feeling like my throat is closing, and/or tunnel vision?
❓Do I feel like I am losing control during these spells?
❓Do I worry about having these spells and avoid activities because of them?
✅ If you answer yes to any of these questions, you may be experiencing panic attacks. BUT, it is important to talk to your primary care clinician to figure out if any of these symptoms could be due to a medical issue before you assume it is a panic attack.
🤔 Tell me more.
We don’t know a lot about why some people get panic attacks and some people don’t. We do know that they tend to run in families. They are do to a combination of factors (including genetic) but also seem to be due to an over reactive fight or flight response as well as behavioral response. The body reacts to many things as if they are scary triggers, even when they are neutral or even pleasant. And it has been pointed out that some people also freeze in this state, which can look a little different than a typical panic attack. Over time, when someone has this type of reaction repeatedly, they learn to avoid situations that might induce panic.
😨 Once a person has a panic attack, there are both external triggers and internal factors at play. External triggers are the situations where a person may have had a panic attack previously. The internal factors can be things like mild elevation in heart rate, increased rate of breathing, or sweating. Once a person has experienced a panic attack, these small physiological changes can trigger a panic attack because they can be similar to the panic attack itself. And once a panic attack occurs, there is a spiral of body symptoms, then thoughts, then more body symptoms that occur. Over time, these symptoms are associated with the external trigger, which leads to avoidance and even limiting of life activities to avoid the unpleasant panic attacks. To stop panic attacks, someone has to learn to tolerate the body symptoms, external situations, and control the thoughts around the panic attacks. Trust us, this is not easy work!
✔️ To be diagnosed with panic disorder, a person should meet the following criteria:
-Have recurring and out of the blue panic attacks
-Have had at least one panic attack with one the following symptoms in the following month: Concern about the panic attacks and their consequences and/or avoidance or behavior change because of the panic attacks. The panic attacks should also not be caused by a medical issue, use of a substance, or withdrawal from a substance.
😔 And what are the symptoms of a panic attack?
-Waves/spells of fear and anxiety that come out of the blue
-Feeling like you are out of control or like you are dying during a panic attack
-Worry about a panic attack happening again
-Fear and avoidance of triggers for panic attacks
-Physical symptoms including: Racing heart, sweating, chills, numbness/tingling in hands and feet, difficulty breathing, weakness/dizziness, tunnel vision, chest tightness or pain, and/or stomach upset
These symptoms are not all the ones people experience but are the most common ones reported.
🤷 So what should if I think I have panic disorder?
📢 Talk to your primary care clinician first. Like we said, it is REALLY important to make sure that you don’t have a medical issue or are not on a medication that may be causing this. If there is no other cause, then you can consider therapy and/or medication. Both therapy and medication are effective for treating panic disorder and often times people benefit from a combination of both. Medications for panic disorder include antidepressants, which also work for anxiety (like Selective Serotonin Reuptake Reinhibitors (SSRIs), beta blockers (that help lower physiological symptoms around the time of a panic attack, like propranolol) and/or benzodiazepines (which can help to lower anxiety before or during a panic attack, like Lorazepam). Keep in mind that Benzodiazepines are only recommended for short term use as people can build a tolerance to these medications and they can put someone at risk for misuse or abuse. Therapy also is critical in the treatment of panic disorder. One that works for Panic Disorder is Cognitive Behavioral Therapy (CBT), which can include mindfulness, breathing activities, but also gradual exposure to help the person increase their tolerance of activities where they may have previously had panic symptoms or panic attacks.
🏠 Other things you can do at home while you are waiting for professional support include: incorporating exercise into daily activity, including relaxation and breathing activities into daily activities, decreasing caffeine and use of any other stimulants, 💤 getting adequate rest 💤, ensuring good nutrition and hydration, and avoiding smoking or other substances.
But I have had these for a long time. Can I really get better?
Yes! Many times people with panic disorder have made a lot of changes in their lives to avoid panic. But over time, this becomes very limiting. So it is really important to take the first step in talking about what you are experiencing. By talking to an experienced clinician and telling them your symptoms, seeking treatment, and committing to changes, people with panic disorder do get better. It isn’t always a linear process and sometimes panic attacks do recur, but once you have the tools and support to work with them, you will have a greater ability to not get stuck in the cycle of panic!
Stay safe. Stay well.
Those Nerdy Girls
Please note: If you need additional resources, Mental Health America (MHA) offers a great way to search for resources. And if you are in need of immediate assistance, please contact the National Suicide Prevention Lifeline at 1-800-273-8255 (Español: 1-888-628-9454; Hearing Support: 1-800-799-4889) or the Crisis Text Line by texting HOME to 741741.
NIMH Definition of Panic Disorder