woman smilingA threat to your safety can trigger a series of responses that enable you to escape the situation or to fight back. Your heart races, pumping blood through your body at a faster rate. Your breathing quickens, accelerating the delivery of oxygen to your tissues. You may also experience trembling, tightness in your chest, sweating, and dizziness as you react to danger. You might even feel chest pain as you’re overwhelmed by fear.

But what if you experienced these sensations without any justifiable cause? People with panic disorder suffer from episodes of intense, overwhelming anxiety, in which they experience the physical and psychological symptoms of fear for no apparent reason. These attacks are so terrifying that they often lead to social isolation, depression, and substance abuse.

Help is available for people who struggle with the debilitating effects of panic disorder. Through intensive psychotherapy, controlled exposure to fear, and anti-anxiety medication, individuals with this condition can reduce their symptoms and lead well-rounded, fulfilling lives. A rehab program for co-occurring disorders may also be required for people who suffer from drug or alcohol addiction as well as panic disorder.

Panic disorder — classified as an anxiety disorder — affects approximately 6 million American adults, or roughly 3 percent of the population, according to the Anxiety and Depression Association of America. This serious psychiatric condition, which usually begins to manifest itself in adolescence or early adulthood, affects twice as many females as males. A large percentage of the people who meet the criteria for panic disorder also have major depression.A typical panic attack lasts for only five to 10 minutes, but for the person experiencing one of these episodes, it can seem like a lifetime. While the attack is going on, she may fear that she is going to die or go insane. In fact, the symptoms are so severe that the fear of another panic attack can actually trigger another episode.

The causes of panic disorder are still being explored, but researchers believe that the condition may be attributed to multiple sources, including genetics, imbalances in brain chemistry, and vulnerability to fear or anxiety. There are several factors that can increase the risk of having repeated panic attacks:
  • Having a close relative with an anxiety disorder
  • Having a history of past trauma or abuse
  • Having one or more co-occurring psychiatric disorders
  • Going through a major life change, such as a divorce or death in the family
  • Being exposed to severe stress
  • Having a history of substance abuse
Alcohol and drug abuse are common among people living with panic disorder. A review of studies published in the Journal of Clinical Psychiatry estimates that around 20 percent of individuals with this condition have abused drugs or alcohol at some point in their lives. Although substance abuse does not cause panic disorder, alcohol and drugs can intensify the symptoms and increase the risk of a panic attack. A study published in Addictive Behaviors found that in a group of 97 people who suffered from anxiety attacks, over 90 percent had abused at least one chemical substance. However, most of the individuals who abused alcohol and drugs (63 percent and 59 percent, respectively) began their substance abuse before they developed panic disorder.
There are very few documented cases in which a panic attack caused serious physical harm or death. However, when one of these events occurs, the individual may sincerely believe that he or she is going to die or go crazy. There are several techniques to manage the symptoms of an anxiety attack while it’s happening. The more you practice these techniques in your daily life, the more confident you’ll feel that you can deal successfully with future episodes:
  • Practice calm breathing, inhaling through your nostrils and exhaling slowly through your mouth at an even, regular pace.
  • Reassure yourself that you have survived panic attacks in the past, and that you will live through this one, too.
  • Remind yourself that panic attacks may be scary, but they are not life-threatening.
  • Teach yourself to relax your muscle groups in order to relieve mental as well as physical tension.
  • Build a toolkit of self-soothing objects and practices, such as listening to music or squeezing a rubber ball, that you can use to distract yourself during an attack.
The more you learn about panic disorder and its causes, the easier it will be to talk yourself out of an anxiety attack. If you know that your disorder is not caused by a serious illness, a heart attack, or a stroke, you may be less fearful of the outcome. If self-soothing techniques and calming practices don’t solve the problem, your doctor or psychiatrist may prescribe anti-anxiety medications or antidepressants to help you manage your symptoms.
How can you tell if you or someone you care about has panic disorder? The condition is characterized not just by disabling anxiety attacks, but also by a persistent fear of future attacks that results in the avoidance of normal activities. The signs and symptoms of panic disorder include:
  • Repeated episodes of intense anxiety (panic attacks) that aren’t triggered by a rational source of fear
  • Constant worrying about having another panic attack and feeling out of control or terrified in public
  • Social or occupational impairment as a result of panic attacks and the fear of attacks
  • Frightening physical symptoms with each attack, such as chest pain, a choking sensation, dizziness, numbness, rapid heart rate, and a sense of being out of control or detached from one’s body
  • In order to qualify as panic disorder, these episodes must not be caused by another psychological condition, such as social phobia, post-traumatic stress disorder, or obsessive-compulsive disorder.
Before being diagnosed with panic disorder, many of these individuals seek help from primary care doctors, emergency rooms, or specialists to find the cause of these episodes, notes the Merck Manual. These patients are often dismissed as hypochondriacs or prescribed anti-anxiety drugs without adequate psychotherapy or behavioral modification training. The co-occurrence of alcohol abuse, drug addiction, depression, or other serious disorders may be overlooked. People who suffer from panic disorder are usually aware that their attacks have no basis in reality. Yet this awareness doesn’t necessarily make it any easier to deal with an attack when it occurs. Self-soothing techniques and calming behaviors, which can be learned in therapy, can help prevent attacks or reduce their severity. However, it takes time and patience to learn the right skills for managing an anxiety attack.

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Treatment for panic disorder

Family in a meadow There is good news for people whose lives have been restricted by panic disorder: the condition responds very well to treatment. According to American Family Physician, a combination of cognitive behavioral therapy and prescription medication is most effective at reducing the symptoms. Antidepressants in the family of SSRIs (selective serotonin reuptake inhibitors), such as Prozac (fluoxetine), Zoloft (sertraline), and paroxetine (Paxil) have proven to be more effective than tranquilizers like Xanax (alprazolam), which have a higher potential for abuse and addiction.

Cognitive behavioral therapy, or CBT, focuses on changing the destructive thought patterns that characterize anxiety. People with panic disorder struggle with repetitive worries and concerns about their anxiety attacks, such as:

Through therapy, these persistent thoughts can be replaced with more positive beliefs about oneself and the world: “I’m strong enough to survive this,” “I’ve got a lot of good things going on in my life,” or “I’m building a better future every day.”

Exposure therapy, which desensitizes the patient to the source of panic, has also been used successfully to treat panic disorder. In a safe, controlled environment, the patient is exposed to frightening situations in slow increments, so that he or she can gradually overcome the fear. Exposure therapy is usually used in combination with medication therapy, CBT, and other modalities to provide the best results.

Help for panic disorder and substance abuse

People with panic disorder and substance abuse issues have unique needs when it comes to treatment. In order to recover fully from both disorders, the conditions must be treated at the same time, within the same program. This requires a treatment plan that integrates psychotherapy and medication management with recovery services. Treatment should be performed at the same facility by cross-trained staff members, to provide continuity of care. To ensure the best outcomes for the patient, the length of stay should be determined by the individual’s needs. Patients with co-occurring conditions often need longer periods of treatment to fully address their symptoms.

The multidisciplinary team at The Recovery Village specializes in the treatment of patients with co-occurring disorders, or a psychiatric disorder combined with substance abuse. We are fully equipped to treat complex conditions like panic disorder, as well as alcoholism, drug dependencies, and eating disorders. Call our compassionate intake specialists today to learn more about our unique, specialized rehab plans.

Panic Disorder
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