Panic Attacks and Panic Disorder – Diagnosis and Treatment
Diagnosis
When a healthcare provider suspects panic disorder, they use a step-by-step process to make sure the diagnosis fits.
- Physical Health Evaluation: First, they do a physical exam. They might run blood tests to check hormone levels, like the thyroid, and order heart tests such as an electrocardiogram (ECG/EKG). These help rule out other medical problems that could look like panic attacks.
- Assessment of Symptoms: The provider asks about specific symptoms that happen during panic attacks. You might mention chest pain, shortness of breath, a pounding heart, or that overwhelming sense of fear.
- Psychological Review: Mental health professionals talk with you about your worries, stress, and any big life changes or trauma. Sometimes they use questionnaires or interviews to figure out patterns in your thoughts and behaviors.
- Review of Substance Use: They’ll ask about alcohol or drug use, since some substances can trigger symptoms that feel like panic attacks.
Diagnostic Criteria Table
| Diagnostic Requirement | Description |
|---|---|
| Recurrent, unexpected panic attacks | The person has frequent panic attacks not linked to a clear trigger. |
| Persistent concern or behavior change | There is at least one month of ongoing worry about attacks or changes in habits. |
| Not linked to other causes | Symptoms aren’t due to drugs, another illness, or a different mental disorder. |
You only get a panic disorder diagnosis if you meet all DSM-5 criteria. If you have panic attacks but don’t check every box, you still might need help to keep things from getting worse.
A good diagnosis makes it easier to tell panic disorder apart from other anxiety issues or medical problems. Getting it right means you can actually get the treatment that fits.
Treatment
Talking Therapy
Talking therapy, also called counseling or psychotherapy, is a pretty common way to manage panic symptoms. It helps people understand their panic disorder and pick up skills to handle anxiety.
Cognitive-behavioral therapy (CBT) is the one most folks have heard of. In CBT, you work with a therapist. Together, you spot beliefs and thoughts that might make panic attacks worse.
CBT usually involves exercises where you face the feelings and situations tied to panic, but in a safe space. By practicing, you learn that symptoms like a racing heart aren’t actually dangerous.
Over time, these symptoms lose their power, and panic attacks might not happen as often.
Therapy might be weekly or every other week. After a while, lots of people notice their panic attacks aren’t as strong or frequent. Some therapists set up follow-up sessions to keep you moving forward and help with any flare-ups.
Benefits of Talking Therapy:
- Offers tools for coping with daily stress.
- Makes places or things linked to panic less scary.
- Helps you find new ways to handle anxiety.
Medication Options
Doctors often use medicines to help reduce panic disorder symptoms. Some meds are for daily use, others are for sudden attacks. Here are the main groups used for panic:
| Type of Medicine | Main Uses | Notes |
|---|---|---|
| Selective Serotonin Reuptake Inhibitors (Antidepressants) | Lower panic symptoms; often first choice | May take weeks to work |
| Serotonin-Norepinephrine Reuptake Inhibitors (Antidepressants) | Helps with panic and sadness | Monitor for side effects |
| Benzodiazepines (Sedatives) | Fast relief of panic feelings | Short-term use; risk of habit |
SSRIs: Doctors usually reach for SSRIs first. They’re generally safe, but you might get side effects like stomach upset or trouble sleeping. Sometimes, it takes a couple tries to find the right one.
SNRIs: These work similarly to SSRIs and can help with both anxiety and depression. Venlafaxine is a common choice.
Benzodiazepines: These act fast to calm panic symptoms. Doctors might use them for really severe or frequent attacks. But they’re careful—people can get used to them, and they’re not great for anyone with a history of substance problems.
You might need to try more than one medicine or a mix before you feel better. It can take a few weeks to notice less panic.
Important Points About Medicine:
- Always talk to your healthcare provider about side effects and risks.
- Some meds aren’t safe for everyone, like pregnant women.
- Don’t stop taking your medicine suddenly—check with your doctor first.
- If one medicine doesn’t help, another or a combo might work.
Working closely with your care team to find the safest, most helpful plan. You can use therapy, medicine, or both. It really depends on what works for you.
Everyday Tips and Self-Care
Managing panic attacks often means tweaking your daily routine. Try deep breathing, gentle yoga, or progressive muscle relaxation to lower stress. These activities help your body relax and can make panic symptoms less intense.
Getting regular exercise—walking, jogging, swimming—can boost your mood and help you handle anxiety better.
Certain things make anxiety worse. It’s smart to avoid caffeine, alcohol, smoking, and recreational drugs as much as possible. These can make panic attacks come more often or feel worse.
Joining a support group lets you share stories and pick up tips from people going through the same thing. A steady sleep schedule matters, too. Aim for enough rest so you can stay sharp during the day.
| Helpful Activities | Why They Matter |
|---|---|
| Deep breathing | Reduces physical tension |
| Light exercise | Lifts mood, eases anxiety |
| Avoiding stimulants | Lowers risk of panic triggers |
Different Ways to Ease Symptoms
Lots of people check out alternative options to help with panic. Mindfulness and meditation can calm your mind and keep you in the present. Simple relaxation tricks—like deep breathing or gentle yoga—might also lower stress.
Some individuals try hypnosis to relax or manage panic. Others go for herbal products or dietary supplements. Just know these aren’t regulated by the FDA, so talk to your doctor before trying them.
Getting Ready for Your Visit
Steps to Take Before You Go
Getting ready can make your doctor visit smoother. Write down all your symptoms, even the ones that seem minor or unrelated. Note when they started and how often they show up.
List any major stress, trauma, or important events that happened before your first panic attack.
Bring a complete medical history, including any physical or mental health issues you’ve had. Write down all medicines, vitamins, herbal remedies, and supplements you take, with exact dosages.
Think about asking a friend or family member to come with you. They can support you and help remember what the doctor says. Jot down any questions you want to ask, so you don’t forget anything important.
| What to Bring | Details |
|---|---|
| List of symptoms | When symptoms started, how often, severity |
| Important personal history | Any major stress, trauma, or significant events |
| Complete medical history | Other illnesses, both physical and mental |
| Medications & supplements | Names and dosages |
| List of questions | For both primary care and specialists |
| Support person (optional) | Someone to help with remembering details |
Questions You Might Want to Ask at Your First Visit
When you see your main doctor, having your questions ready helps. You might want to ask things like:
- What could be causing my symptoms?
- Could something else be behind these symptoms?
- Will I need any tests?
- Should I see a mental health specialist?
- Is there anything I can do now to help myself?
Having a written list means you won’t forget your concerns.
Questions for the Specialist If You Are Referred
If you’re sent to a mental health specialist, ask questions to understand your care plan, such as:
- Do I have panic disorder or just panic attacks?
- What treatment do you recommend?
- If I need therapy, how often and for how long?
- Would group therapy help me?
- What side effects could the medicines have?
- How long will I need to take medicine?
- How will you track my progress?
- What can I do right now to lower my chance of future attacks?
- Are there things I can try at home?
- Do you have any written materials I can take?
Ask anything else on your mind. It’s important to get all the info you need to feel comfortable with your care.
What Your Doctor May Ask or Do
Your doctor or specialist will probably ask a bunch of questions to really understand your health and what’s going on with your panic attacks.
They might start with things like:
- What symptoms have you noticed, and when did they start?
- How often do your panic attacks happen, and how long do they usually last?
- Are there any triggers you’ve picked up on?
- Do you find yourself worrying about having another attack?
- Have you started avoiding certain places or changed your activities because of your symptoms?
- How do these symptoms show up at school, work, or in your relationships?
They’ll likely ask about your personal or family history with mental health conditions, any past trauma, and habits around caffeine, alcohol, drugs, or exercise.
Your doctor wants to understand every part of your life that panic attacks might touch. If you can be open and honest, they can give you the best advice and support for what you’re dealing with.
