Panic disorder

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Panic disorder is an anxiety disorder where a person experiences repeated, unexpected panic attacks — sudden surges of intense fear or discomfort that peak within minutes.

These attacks can occur without warning and often make people fear losing control, having a heart attack, or dying.

It can become disabling if untreated, but effective treatments can help most people regain control and live normal lives.

⚕️ What Is a Panic Attack?

A panic attack is a sudden, intense episode of fear accompanied by strong physical symptoms — even when there’s no real danger.
These can happen once or repeatedly and often come “out of the blue.”

⚠️ Symptoms of a Panic Attack

(Peak within 10 minutes and usually subside within 20–30 minutes)

  • Rapid heartbeat or palpitations

  • Chest pain or tightness

  • Shortness of breath / choking feeling

  • Dizziness, lightheadedness, or fainting

  • Trembling or shaking

  • Sweating or chills

  • Nausea or abdominal distress

  • Numbness or tingling (especially in hands or face)

  • Feeling detached from reality (derealization)

  • Fear of losing control, going crazy, or dying

🧠 Causes & Risk Factors

Panic disorder results from a mix of biological, psychological, and environmental factors:

  • Genetics: Family history of anxiety or panic disorders

  • Neurochemical imbalance: Abnormal levels of serotonin, norepinephrine, and GABA

  • Stressful life events: Death, divorce, trauma, major life changes

  • Medical conditions: Thyroid problems, heart rhythm disturbances

  • Personality traits: More common in people who are sensitive to stress or prone to worry

  • Substance use: Caffeine, stimulants, or withdrawal from alcohol/drugs can trigger attacks

🩺 Diagnosis

A doctor or mental health professional will:

  • Rule out medical conditions that mimic panic (e.g., heart, thyroid, or lung issues).

  • Assess frequency and pattern of attacks.

  • Diagnose panic disorder if at least two unexpected attacks are followed by worry about more attacks or behavioral changes (like avoiding certain places).

💊 Treatment Options

Panic disorder is highly treatable with therapy, medication, or a combination of both.

1. Psychotherapy (First-line treatment)

  • Cognitive Behavioral Therapy (CBT):
    Teaches how to identify and challenge panic-triggering thoughts, control breathing, and confront feared situations safely.
    ✅ Most effective long-term treatment.

  • Exposure Therapy:
    Gradual exposure to sensations that trigger panic (like rapid heartbeat) helps desensitize the fear response.

  • Relaxation & Mindfulness Techniques:
    Deep breathing, grounding, meditation, and yoga help calm the nervous system.

2. Medications

Used to reduce frequency and severity of attacks.

CategoryExamplesPurpose
SSRIs (Selective Serotonin Reuptake Inhibitors)Sertraline (Zoloft), Paroxetine (Paxil), Fluoxetine (Prozac)First-line treatment; balance brain chemicals
SNRIs (Serotonin-Norepinephrine Reuptake Inhibitors)Venlafaxine (Effexor XR)For persistent anxiety and panic
BenzodiazepinesClonazepam (Klonopin), Alprazolam (Xanax)Fast relief; short-term use only (risk of dependence)
Tricyclic antidepressants (TCAs)Imipramine, ClomipramineAlternative if SSRIs not tolerated
Beta-blockersPropranololReduce physical symptoms like heart palpitations

3. Lifestyle and Self-Help

  • Avoid stimulants (caffeine, nicotine, energy drinks).

  • Get regular sleep and maintain routine.

  • Exercise regularly — lowers anxiety hormones.

  • Balanced diet to stabilize blood sugar and energy.

  • Breathing exercises: Practice slow, steady breaths during stress.

  • Support groups: Help reduce isolation and fear.

❤️ Prognosis

  • With proper treatment, 70–90% of people improve significantly.

  • Early therapy and medication use can prevent full-blown attacks and restore normal functioning.

  • Continued coping strategies and therapy help prevent relapse.

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