Panic Disorder: When Fear Overwhelms—Part 2
Do you sometimes have sudden attacks of fear that last for several minutes? Do these attacks occur at unpredictable times? If so, you may have a type of anxiety disorder called panic disorder.
What causes panic disorder?
Panic disorder sometimes runs in families, but no one knows for sure why some people have it, while others don't. Several parts of the brain are involved in fear and anxiety, and by learning more about fear and anxiety in the brain, scientists may be able to create better treatments. Researchers are also looking for ways in which stress and environmental factors may play a role.
How is panic disorder treated?
First, talk to your doctor about your symptoms. Your doctor should do an exam to make sure that another physical problem isn't causing the symptoms. The doctor may refer you to a mental health specialist. Panic disorder is generally treated with psychotherapy, medication, or both.
Psychotherapy—A type of psychotherapy called cognitive behavior therapy is especially useful for treating panic disorder. It teaches a person different ways of thinking, behaving, and reacting to situations that help him or her feel less anxious and fearful.
Medication—Doctors also may prescribe medication to help treat panic disorder. The most commonly prescribed medications for panic disorder are antianxiety medications and antidepressants. Antianxiety medications are powerful, and there are different types. Many types begin working right away, but they generally should not be taken for long periods.
Antidepressants are used to treat depression, but they also are helpful for panic disorder. They may take several weeks to start working. Some of these medications may cause side effects such as headache, nausea, or difficulty sleeping. These side effects are usually not a problem for most people, especially if the dose starts off low and is increased slowly over time. Talk to your doctor about any side effects you may have.
It's important to know that although antidepressants can be safe and effective for many people, they may be risky for some, especially children, teens, and young adults. A black box warning (the most serious type of warning that a prescription drug can have) has been added to the labels of antidepressant medications. These labels warn people that antidepressants may cause some people to have suicidal thoughts or make suicide attempts. Anyone taking antidepressants should be monitored closely, especially when beginning treatment with medications.
Another type of medication called beta blockers can help control some of the physical symptoms of panic disorder, such as excessive sweating, a pounding heart, or dizziness. Although beta blockers are not commonly prescribed, they may be helpful in certain situations that bring on a panic attack.
Some people do better with cognitive behavior therapy, while others do better with medication. Still others do best with a combination of the two. Talk with your doctor about the best treatment for you.
What is it like to have panic disorder?
One day, without any warning or reason, I felt terrified. I was so afraid, I thought I was going to die. My heart was pounding and my head was spinning. I would get these feelings every couple of weeks. I thought I was losing my mind. The more attacks I had, the more afraid I got. I was always living in fear. I didn't know when I might have another attack. I became so afraid that I didn't want to leave my house. My friend saw how afraid I was and told me to call my doctor for help. My doctor told me I was physically healthy but that I have panic disorder. My doctor gave me medicine that helps me feel less afraid. I've also been working with a counselor learning ways to cope with my fear. I had to work hard, but after a few months of medicine and therapy, I'm starting to feel like myself again.
U.S. National Institutes of Health, National Institute of Mental Health. (Reviewed 2013, January 4). Panic disorder: When fear overwhelms (NIH Publication No. TR 10-4679). Retrieved June 11, 2013, from http://www.nimh.nih.gov