Dr. MJ Bazos MD,
Panic Disorder: Panic
Attacks and Agoraphobia
What is panic disorder?
Panic disorder is a common condition in which a
person has episodes of intense fear or anxiety that occur suddenly (often
without warning). These episodes--called panic attacks--can last from minutes to
hours. They may occur only once in a while, or they may occur quite frequently.
The cause, or "trigger," for these attacks may not be obvious.
What happens during a panic attack?
Panic attacks are associated with physical
symptoms that include the following:
- Feeling that your heart is pounding or racing
- Chest pain
- Shortness of breath
- Feeling that you are choking
- Out-of-body feeling
- Tingling or numb feeling in
- Chills or hot
A person may also have
an extreme fear of losing control, going crazy or dying during a panic attack.
It is very rare for a person to have all of these symptoms at once. However, the
presence of at least 4 symptoms strongly suggests that a person
has panic disorder.
Many of the symptoms that occur during a panic
attack are the same as the symptoms of diseases of the heart, lungs, intestines
or nervous system. The similarities between panic disorder and other
diseases may add to the person's fear and anxiety during and after a panic
Just the fear of having a panic attack is often
enough to trigger the symptoms. This is the basis for a condition called
agoraphobia. A person who has agoraphobia finds it difficult to leave home
(or another safe area) because he or she is afraid of having a panic
attack in public or not having an easy way to escape if the symptoms
Should I see my doctor if I'm having
Many people who have panic attacks don't seek
medical care because of embarrassment or the fear of taking medicine. If you
have panic attacks, it is very important to seek medical care and discuss your
problem with your doctor. After you have been evaluated thoroughly, your doctor
will be able to tell you if your panic attacks are related to panic disorder or
are caused by another problem. Simple treatments are available to help control
Can medicines help people who
have panic disorder?
Several medicines can make panic attacks less
severe or stop them altogether.
Paroxetine (brand name: Paxil) and sertraline
(brand name: Zoloft) are antidepressant medicines that have been approved by the
U.S. Food and Drug Administration (FDA) to treat panic disorder. Antidepressants
are very effective in preventing anxiety and panic attacks. Often they
completely stop the attacks. You don't have to be depressed for them to help.
Side effects are usually mild. Antidepressants will not make you lose control or
change your personality. These medicines can be used for as long as necessary,
even for years.
Alprazolam (brand name: Xanax) and clonazepam
(brand name: Klonopin) are also medicines approved by the FDA to
treat panic disorder. These medicines give relief from fear and anxiety.
They should be used only for a short period of time (a few weeks to a few
months), unless you absolutely can't function without them. Never suddenly stop
taking one of these medicines. If you need to stop, these medicines should
be slowly tapered off over several weeks under your doctor's supervision.
Can counseling help people who have
Several kinds of counseling are very effective
for treating panic disorder. You can ask your doctor about the different
kinds of counseling that are available. Counseling does not work as fast as
medicine, but it can be just as effective. The combination of both counseling
and medicine seems to be an effective treatment for panic disorder.
How long does treatment last?
How long treatment continues depends on you.
Stopping panic attacks completely is a reasonable goal. Your doctor will
design a treatment plan just for you. A treatment period lasting at least 6 to 9
months is usually recommended. Some people taking medicine for panic disorder
are able to stop after only a short time. Other people need to continue
treatments over a long period of time, or even for their lifetime.