Panic Disorder vs. Anxiety: Symptoms and Treatment Options

Anxiety Disorder and Panic Disorder

Hello Doctor: Recently, I have been experiencing frequent chest tightness and pain, difficulty breathing, and even hyperventilation.
I often feel nauseous for no apparent reason, and sometimes I have a sensation of a foreign body in my throat.
On two occasions, I became extremely anxious due to chest tightness and pain, feeling a sudden fear of dying, which led me to the emergency room.
However, after undergoing an electrocardiogram and blood tests, the results were normal, and the emergency treatment consisted of sedatives and related medications.
Consequently, I later consulted a psychiatrist who diagnosed me with panic disorder and prescribed You-jet (a medication).
However, I found that the definition of panic disorder online states that it occurs suddenly and without reason.
In my case, my symptoms usually arise from chest pain or nausea, which leads to significant anxiety and a series of uncomfortable symptoms, ultimately resulting in a feeling of impending death and difficulty breathing, prompting me to seek emergency care.
Is this situation indicative of panic disorder or simply anxiety disorder? Additionally, if it is purely anxiety disorder, is You-jet an appropriate medication? I am concerned that You-jet is specifically for panic disorder and not for anxiety disorder.
Thank you, Doctor, for clarifying this.

Xiao U, 30~39 year old female. Ask Date: 2017/05/25

Dr. Guo Jialun reply Psychiatry

Anxiety disorders, in a broad sense, encompass various anxiety-related diagnoses, such as panic disorder and generalized anxiety disorder.
Many patients exhibit multiple symptoms simultaneously.
In terms of treatment, the primary medication options are selective serotonin/norepinephrine reuptake inhibitors (SSRIs/SNRIs), thus the use of You-jet (a medication) can also be effective for anxiety disorders.
However, individual responses to medication types and effective dosages may vary, and there are also non-pharmacological treatments available, such as cognitive behavioral therapy.
It is advisable to discuss these options with your physician.

Reply Date: 2017/05/25

More Info

Understanding the distinction between panic disorder and anxiety is crucial for effective treatment and management of symptoms. Based on your description, it appears that you are experiencing symptoms consistent with panic disorder, which can often be accompanied by anxiety.
Panic disorder is characterized by recurrent, unexpected panic attacks—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, and a fear of losing control or dying. In your case, the episodes of chest pain, difficulty breathing, and overwhelming fear of dying align with this diagnosis.
On the other hand, generalized anxiety disorder (GAD) involves persistent and excessive worry about various aspects of life, which can lead to physical symptoms such as muscle tension, restlessness, fatigue, and difficulty concentrating. While panic attacks can occur in GAD, they are not as sudden or intense as those seen in panic disorder.

Your experience of panic attacks triggered by physical sensations like chest pain or nausea is not uncommon. Many individuals with panic disorder report that their attacks are often precipitated by physical symptoms, which then lead to heightened anxiety and further physical distress. This cycle can create a feedback loop where the fear of experiencing another panic attack leads to increased anxiety and more physical symptoms.

Regarding the medication you mentioned, You-jet (which contains the active ingredient fluoxetine, a selective serotonin reuptake inhibitor or SSRI) is commonly prescribed for both panic disorder and generalized anxiety disorder. SSRIs are effective in treating anxiety disorders by increasing serotonin levels in the brain, which can help improve mood and reduce anxiety. Therefore, it is appropriate for both conditions, and your concerns about it being only for panic disorder are unfounded.
In terms of treatment, a combination of medication and psychotherapy is often the most effective approach. Cognitive-behavioral therapy (CBT) is particularly beneficial for both panic disorder and anxiety, as it helps individuals understand and change their thought patterns and behaviors that contribute to their symptoms. Techniques such as exposure therapy, relaxation training, and breathing exercises can also be helpful in managing panic attacks.

It's important to follow your healthcare provider's recommendations regarding medication. If you are experiencing side effects or if your symptoms are not improving, it is essential to communicate this with your doctor. They may adjust your dosage or consider alternative treatments.
In summary, while your symptoms are indicative of panic disorder, they can also coexist with generalized anxiety. The medication you are taking is suitable for both conditions, and combining it with therapy can enhance your treatment outcomes. If you have further concerns or if your symptoms persist, do not hesitate to seek additional support from your healthcare provider.

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