Panic Disorder Symptoms: When to Seek Help

Symptoms of Panic Disorder

Hello, doctor.
I am currently a sophomore in college.
I have been experiencing symptoms suggestive of panic disorder since middle school, but the frequency of these episodes has been low, occurring about 1 to 2 times a year.
However, since starting college, the frequency has slightly increased, with episodes occurring approximately every six months to a year.
I found some information online and realized that while I do not have suicidal thoughts, I do experience some physiological symptoms associated with panic attacks.
Additionally, the locations where these attacks occur are repetitive, such as while waiting for the bus or on the bus and subway.
Since the episodes are infrequent, I have not sought medical attention.
I would like to know if I should see a doctor.
Also, I have been experiencing circular hair loss on my scalp for the past year.
I initially thought it would improve after my major exams, but the symptoms have not improved.
I would like to know if this is related to my panic symptoms.
Thank you.

Ms. Huang, 10~19 year old female. Ask Date: 2016/09/22

Dr. Zhong Mingxun reply Psychiatry

You are experiencing symptoms of panic disorder, but the frequency of episodes is not high.
However, I recommend that you seek help from a mental health specialist, as this can greatly improve your quality of life and alleviate concerns about the recurrence of panic attacks.
Additionally, the appearance of circular hair loss on your scalp is likely related to stress.
While major exams certainly bring stress, there are many underlying pressures hidden in interpersonal interactions and attitudes toward tasks.
On the surface, these may seem unrelated to panic, but I suspect that a deeper exploration would reveal a significant connection.

Reply Date: 2016/09/22

More Info

Panic disorder is a type of anxiety disorder characterized by recurrent and unexpected panic attacks, which are sudden periods of intense fear or discomfort that peak within minutes. Symptoms can include palpitations, sweating, trembling, shortness of breath, feelings of choking, chest pain, nausea, dizziness, chills, or hot flashes, numbness, and feelings of unreality or detachment. Given your description of experiencing panic-like symptoms since middle school, with an increase in frequency since starting college, it is important to consider seeking professional help.

While you mentioned that your panic attacks occur infrequently—about once or twice a year—this does not diminish the impact they can have on your life. The fact that these attacks have a specific context, such as waiting for a bus or being on public transportation, suggests that you may be developing a situational avoidance behavior, which is common in panic disorder. This can lead to a cycle where you start to avoid situations where you fear a panic attack might occur, potentially limiting your activities and social interactions.

It is crucial to understand that even if your symptoms are not severe enough to cause suicidal thoughts, they can still significantly affect your quality of life. The anxiety and fear associated with the possibility of having a panic attack can lead to increased stress and avoidance behaviors, which can exacerbate your overall anxiety levels. Therefore, seeking help from a mental health professional can provide you with coping strategies, therapeutic interventions, and possibly medication if deemed necessary.

Regarding your concern about the circular hair loss (alopecia areata) that you have been experiencing, there is a recognized connection between stress and hair loss. Stressful events or chronic anxiety can trigger or worsen conditions like alopecia areata. The physiological response to stress can lead to changes in the immune system, which may contribute to hair loss. Therefore, addressing your anxiety symptoms may not only help with your panic attacks but could also potentially improve your hair condition.

In summary, I strongly encourage you to seek help from a mental health professional. They can provide a comprehensive evaluation of your symptoms and help you develop an effective treatment plan. Treatment options may include cognitive-behavioral therapy (CBT), which is particularly effective for panic disorder, and relaxation techniques to manage anxiety. Additionally, discussing your alopecia with a dermatologist or healthcare provider can help you explore treatment options for that condition as well.

Remember, seeking help is a sign of strength, and taking proactive steps to address your mental health can lead to significant improvements in your overall well-being. Don't hesitate to reach out for support; it can make a world of difference in managing your symptoms and improving your quality of life.

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