Panic Disorder: Symptoms and Coping Strategies

Am I suffering from panic disorder?

Hello, doctor.
I have a few concerns I'd like to ask about:
1.
I have always experienced nasal congestion during seasonal changes, particularly when the weather gets cold or during winter.
When nasal congestion occurs, I feel like I can't breathe and am short of breath, even when breathing through my mouth.
This makes me feel uncomfortable all over, restless, and it often happens at night when I lie down, making me feel like I'm about to suffocate.
I feel mentally exhausted but can't seem to fall asleep.

2.
Recently, this situation seems to have worsened.
Even when I'm not congested, I feel tightness in my chest and have difficulty getting enough air, even when taking deep breaths.
I also feel off all over, constantly wanting to crack my knuckles or toes, and I can't calm down.
I feel irritable, like I want to hit something or punch a wall.
This often occurs while sitting, in the car, or in the bathroom, and walking around seems to help alleviate the discomfort a bit.
3.
I feel fine before bed, but as soon as I lie down, I feel like I can't breathe and feel unwell all over.
Even when my girlfriend tries to hug or hold me, I feel trapped, as if I'm going to die.
This induces a sense of fear.
After finally falling asleep, I often wake up suddenly with a jolt, making it difficult to sleep well at night.
Recently, I've experienced these episodes frequently while riding my motorcycle, eating, during meetings, and even while trying to sleep.
It feels like I'm unable to breathe and that I'm close to death, and the frequency of these occurrences has increased, affecting my daily life.

XH, 20~29 year old female. Ask Date: 2018/12/22

Dr. Huang Xiaoxian reply Psychiatry

Dear XH, thank you for your question.
The symptoms you described are indeed similar to those of typical panic disorder.
Generally speaking, panic disorder is highly related to one's constitution and stress levels.
Given the severity and the clear impact on your life that you mentioned, I recommend seeking a comprehensive evaluation at a medical facility to facilitate appropriate treatment.
I hope this response is helpful to you.

Reply Date: 2018/12/22

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. The symptoms you describe align closely with those of panic disorder, and it is essential to understand both the symptoms and effective coping strategies to manage this condition.

Symptoms of Panic Disorder
1. Physical Symptoms: Panic attacks often manifest with physical symptoms such as heart palpitations, shortness of breath, chest pain, dizziness, trembling, sweating, and feelings of choking. You mentioned experiencing a sensation of not being able to breathe, which can be particularly distressing and may lead to feelings of impending doom.

2. Cognitive Symptoms: Alongside physical symptoms, panic disorder can also involve cognitive symptoms, including intense fear of losing control, fear of dying, or fear of going crazy. Your feelings of being overwhelmed and the sensation of needing to escape or move around to alleviate discomfort are common during panic attacks.

3. Behavioral Changes: Individuals with panic disorder may begin to avoid situations where they previously experienced panic attacks, leading to a cycle of avoidance that can significantly impact daily life. This avoidance can lead to agoraphobia, where individuals fear being in situations where escape might be difficult.

Coping Strategies
1. Breathing Techniques: Since you experience difficulty breathing during panic attacks, practicing controlled breathing techniques can be beneficial. Try inhaling deeply through your nose for a count of four, holding for a count of four, and exhaling slowly through your mouth for a count of four. This can help regulate your breathing and reduce feelings of panic.

2. Cognitive Behavioral Therapy (CBT): CBT is a highly effective treatment for panic disorder. It involves identifying and challenging negative thought patterns and beliefs that contribute to anxiety. Working with a therapist can help you develop coping strategies and gradually expose yourself to feared situations in a controlled manner.

3. Medication: In some cases, medication may be prescribed to help manage symptoms. Selective serotonin reuptake inhibitors (SSRIs) like Prozac, or benzodiazepines like Xanax, can be effective in reducing anxiety and panic symptoms. It is crucial to follow your healthcare provider's instructions regarding medication use and to discuss any concerns you may have.

4. Lifestyle Modifications: Regular physical activity, a balanced diet, and adequate sleep can significantly impact your overall mental health. Engaging in relaxation techniques such as yoga, meditation, or mindfulness can also help reduce anxiety levels.

5. Support Systems: Connecting with friends, family, or support groups can provide emotional support and reduce feelings of isolation. Sharing your experiences with others who understand can be incredibly validating and comforting.

Conclusion
It is essential to seek professional help if you are experiencing symptoms of panic disorder that interfere with your daily life. A mental health professional can provide a comprehensive evaluation and develop a tailored treatment plan that may include therapy, medication, and coping strategies. Remember, you are not alone in this, and with the right support and treatment, it is possible to manage and reduce the impact of panic disorder on your life.

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