Panic disorder develops when the fear of the next attack starts to shape your life: avoiding the highway, the grocery store, the crowded restaurant. It responds very well to treatment, and you don't have to keep organizing your days around it.
Common panic attack symptoms
- Pounding or racing heart
- Shortness of breath or a smothering feeling
- Chest tightness or discomfort
- Dizziness, lightheadedness or feeling faint
- Trembling, sweating, chills or hot flushes
- Tingling or numbness
- Feeling detached or unreal
- Fear of losing control or dying
The panic cycle
Panic feeds on itself. A normal body sensation, like a skipped beat or a rush of heat, gets read as danger. That fear releases adrenaline, which creates more sensations, which confirms the fear. Before long, you start avoiding places and situations where an attack might happen.
Treatment interrupts that loop at several points at once: understanding what your body is doing, changing how you respond to sensations, and calming the overactive alarm system underneath.
How panic disorder is treated
Cognitive Behavioral Therapy
The most effective therapy for panic. You learn to read sensations accurately and gradually return to the places you've been avoiding.
Medication
SSRIs and SNRIs are the standard of care and reduce both the frequency and intensity of attacks over time.
Body-based skills
Slow breathing, grounding and muscle relaxation to ride out the wave rather than fight it.
Ruling out medical causes
Thyroid problems, heart rhythm issues, caffeine and some medications can mimic panic, so we make sure the picture is complete.
Panic and hormonal change
Many women experience their first panic attacks in perimenopause. Shifting estrogen can heighten anxiety and trigger hot flashes and palpitations that feel a lot like panic. If that sounds familiar, my perimenopause and menopause page explains how I approach it.
