Panic Disorder: Signs, Symptoms, and When to Seek Help - Psychiatry

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Anxiety Panic Disorder


Hello, doctor.
I am a third-year junior high school student, and I am feeling quite stressed as I prepare for the upcoming entrance exams.
In the past, I occasionally experienced sudden feelings of unease, often accompanied by a sense of foreboding that made me feel scared, even though I didn't know what I was afraid of.
At the same time, I felt sharp pain and discomfort in my chest.
I tried to share this with my classmates, but they couldn't relate, and since it would pass quickly, I didn't pay much attention to it.
However, yesterday while I was on the bus, I suddenly felt extremely anxious and scared, even more than before.
I experienced shortness of breath, as if something was pressing on my chest, and I felt dazed, as if I was losing control.
Later, while having hot pot with my family, I was afraid it would happen again.
That night, I suddenly woke up with shortness of breath, which made me very tired in class today.
I didn't want to talk and felt unable to respond honestly to my classmates' greetings.
Is this situation normal, or could I be experiencing panic disorder and need to see a doctor?

Wang, 10~19 year old female. Ask Date: 2020/11/23

Dr. Lin Mianzhang reply Psychiatry


Hello Wang: Preparing for exams can be tough! Your situation is very similar to panic attacks, which may be related to the stress of exam preparation.
However, there are other factors that can cause symptoms similar to panic attacks that need to be carefully differentiated, such as excessive caffeine intake, hyperthyroidism, and arrhythmias.
Therefore, I recommend that you first undergo a preliminary physiological assessment with an internist or family physician.
If the assessment shows no obvious physiological diseases, you can then seek assistance from a psychiatrist.
Visiting a doctor does not necessarily mean you will need medication, and given your young age, doctors will be more cautious about prescribing.
If your symptoms are mild, you can start with psychotherapy; if the symptoms persist and worsen, then consider the possibility of medication.
Generally speaking, panic disorders can show significant improvement or even complete recovery with treatment.
Wishing you success in your exams and a speedy recovery!

Reply Date: 2020/11/23

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, such as shortness of breath, chest pain, feelings of unreality, and overwhelming fear, are indeed indicative of a panic attack. It’s important to understand that these attacks can occur without any clear trigger, which can make them particularly distressing.

From your account, it seems that you have been experiencing anxiety symptoms for some time, especially with the added pressure of upcoming exams. The feelings of unease and the physical symptoms you experienced while on the bus, as well as the subsequent fear of having another attack, are common in individuals who may be developing panic disorder. The fact that you felt a sense of impending doom and had difficulty breathing indicates that your body was responding to a perceived threat, even if there was no immediate danger.

Panic attacks can be quite debilitating, leading to avoidance behaviors where individuals start to avoid situations where they fear an attack might occur. This can significantly impact daily life, including school performance and social interactions. Your experience of waking up in a panic and feeling fatigued the next day further suggests that these episodes are affecting your overall well-being.

It’s crucial to seek help if you find that these symptoms are interfering with your daily life. A mental health professional, such as a psychologist or psychiatrist, can provide a thorough assessment and help determine whether you have panic disorder or another anxiety-related condition. They can also offer treatment options, which may include cognitive-behavioral therapy (CBT), medication, or a combination of both. CBT is particularly effective for panic disorder as it helps individuals understand and change the thought patterns that contribute to their anxiety.

In addition to professional help, there are self-care strategies you can implement to manage anxiety. These include practicing relaxation techniques such as deep breathing exercises, mindfulness meditation, and regular physical activity. Establishing a routine that includes adequate sleep, healthy eating, and social support can also be beneficial.

It’s understandable to feel hesitant about discussing these feelings with others, especially if you feel they may not understand. However, reaching out to a trusted adult, such as a parent or teacher, can provide you with additional support. They may be able to help you find the resources you need to address your anxiety.

In summary, while your symptoms may be indicative of panic disorder, only a qualified mental health professional can provide a definitive diagnosis. Given the impact these feelings are having on your life, I encourage you to seek help sooner rather than later. Addressing these issues early can lead to better outcomes and help you manage your anxiety effectively, allowing you to focus on your studies and enjoy your time with friends. Remember, you are not alone in this, and there are people and resources available to help you through it.

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