Panic Disorder Relapses: Symptoms and Management Strategies

Panic disorder relapse issues?

Hello Doctor, about two years ago, I experienced rapid heartbeat and difficulty breathing.
After a check-up that showed everything was normal, I was referred to a psychiatrist and diagnosed with panic disorder.
To be honest, I still don't fully understand the cause.
However, after six months of medication treatment, I did see improvement.
About a year ago, one night, I suddenly had the same symptoms again, but they lasted for about an hour and then got better, so I didn't see a doctor.
Occasionally, I felt minor discomfort, but it was brief, so I didn't pay much attention to it.
Then, in December of last year, one night, I suddenly started shaking and felt completely weak.
That night, I couldn't sleep at all.
A month later, again at night, I suddenly felt weak all over, had gastrointestinal discomfort, and experienced diarrhea.
After returning home and taking a shower, I was still shaking and felt uncomfortable sleeping.
Although I felt better the next day, I still had occasional minor discomfort.
Should I go back for a follow-up? Are there any preventive methods besides medication? Thank you.

Ni, 20~29 year old female. Ask Date: 2018/02/13

Dr. Qiu Junda reply Psychiatry

Hello.
The situation mentioned in the text mostly pertains to symptoms of panic and anxiety.
Since you have already consulted a psychiatrist and have shown improvement, it is recommended that you continue your follow-up appointments.
If you wish to discontinue treatment, please discuss it with your physician to avoid any negative impact on your condition.
As for non-pharmacological methods, you may consider reading educational articles on stress management, anxiety relief, and relaxation techniques.
Learning some of these methods may be beneficial.
Thank you.

Reply Date: 2018/02/13

More Info

Panic disorder is a complex condition characterized by recurrent and unexpected panic attacks, which can lead to significant distress and impairment in daily functioning. Your experience of panic attacks, particularly the symptoms of rapid heartbeat, difficulty breathing, and feelings of weakness, is consistent with the disorder. It’s important to recognize that panic disorder can have a cyclical nature, where periods of remission can be followed by relapses triggered by stress, anxiety, or even seemingly benign situations.

Given your history, it seems that you have experienced a resurgence of symptoms after a period of relative stability. This is not uncommon in individuals with panic disorder. The symptoms you describe, such as body shaking, weakness, gastrointestinal discomfort, and sleep disturbances, can be indicative of heightened anxiety or panic attacks. The fact that these symptoms have recurred, particularly during nighttime, suggests that they may be linked to anxiety about your health or other stressors in your life.

Should You Return to the Doctor?
Yes, it would be advisable to return to your healthcare provider, especially since your symptoms have intensified and are affecting your quality of life. A thorough evaluation can help determine whether your current treatment plan needs adjustment or if additional interventions are necessary. It’s also important to rule out any other medical conditions that could be contributing to your symptoms, especially since you mentioned gastrointestinal issues and physical weakness.

Non-Pharmacological Management Strategies
In addition to medication, there are several non-pharmacological strategies that can help manage panic disorder and reduce the frequency and intensity of panic attacks:
1. Cognitive Behavioral Therapy (CBT): This is one of the most effective forms of therapy for panic disorder. CBT helps you identify and challenge negative thought patterns and beliefs that contribute to anxiety and panic. It also teaches coping strategies to manage panic symptoms when they arise.

2. Mindfulness and Relaxation Techniques: Practices such as mindfulness meditation, deep breathing exercises, and progressive muscle relaxation can help reduce overall anxiety levels and improve your ability to cope with panic symptoms when they occur.

3. Regular Physical Activity: Engaging in regular exercise can help reduce anxiety and improve mood. Activities such as walking, jogging, yoga, or swimming can be beneficial.

4. Healthy Lifestyle Choices: Maintaining a balanced diet, getting adequate sleep, and avoiding stimulants (like caffeine and nicotine) can help reduce anxiety levels. Alcohol should also be consumed in moderation, as it can exacerbate anxiety symptoms.

5. Support Groups: Connecting with others who have similar experiences can provide emotional support and practical advice for managing panic disorder.

6. Journaling: Keeping a journal of your thoughts and feelings can help you identify triggers for your panic attacks and develop strategies to cope with them.

7. Gradual Exposure: If certain situations trigger your panic attacks, gradual exposure to these situations in a controlled manner can help desensitize you to the triggers over time.

Conclusion
Panic disorder can be challenging, but with the right combination of medical treatment and self-management strategies, many individuals find relief from their symptoms. It’s essential to maintain open communication with your healthcare provider about your symptoms and treatment preferences. By addressing both the psychological and physiological aspects of panic disorder, you can work towards a more stable and fulfilling life. Remember, seeking help is a sign of strength, and taking proactive steps towards managing your health is crucial.

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