Panic Disorder: Overcoming Anxiety and Depression Challenges

Doctor... may I ask about panic disorder?

Dear Doctor: I have been diagnosed with panic disorder for over a year.
Initially, I managed quite well for the first six months and felt almost fully recovered.
Because of this, I have been taking lighter medication for the past two months, only occasionally.
However, during the Lunar New Year, I began to feel increasingly depressed.
I wasn't surprised by the depression during this time, as my mother has faced many grievances from relatives on my father's side for years.
Since childhood, I have always experienced a low mood during the New Year.
Additionally, my mother often feels unwell due to menopause, which worries me.
As a result, I spent the entire New Year in a state of severe depression.
I also caught a cold during this period, which made me feel even more sorrowful.
On Valentine's Day night, while shopping with my girlfriend, I unexpectedly experienced a resurgence of panic symptoms from a year ago: palpitations, weakness, helplessness, cold sweats, and dizziness...
It felt as if I was about to die.
However, with my previous experience, I reassured myself that I would be okay.
I gradually calmed my emotions by resting on a motorcycle seat, which helped me feel better.
Yet, in the days following the episode, I have been experiencing persistent dizziness.
Whenever I go outside, I feel dizzy and weak, although I feel somewhat better in my room.
I am worried that my dizziness might be caused by other neurological issues, which makes me feel inadequate.
Thinking about my future makes me very sad.
I am currently a senior in college, and I am certain that I will not graduate smoothly this year.
I worry about how I will survive in society if I continue to feel this way.
I cannot live independently, and I don't know what to do.
Doctor, is panic disorder considered a serious mental illness, and is the chance of relapse quite high? Is there a possibility that I will fully recover one day? My family has a history of depression, so could it be that I have a genetic predisposition to depression? Will I always be like this? Thank you for your response.

A B, 20~29 year old female. Ask Date: 2003/02/18

Dr. Wang Zhenyang reply Psychiatry

Hello A-B,
From your letter, I can sense that you are not feeling well right now and that some of your thoughts are leaning towards a pessimistic and negative outlook.
This is a common thought pattern among individuals suffering from panic disorder or depression.
Catastrophic thinking can exacerbate your condition, leading to a state of constant anxiety.
Therefore, it is crucial to seek medical attention promptly, take medication, and arrange for psychological therapy to further explore the reasons behind your emotional distress.
Finding ways to adjust and cope can make it easier for your condition to improve or even fully recover.
Panic disorder can often become chronic; however, studies have shown that in long-term follow-ups, 30% to 40% of cases experience complete symptom relief, while 50% have only mild symptoms that do not interfere with daily life.
Approximately 10% to 20% of cases continue to experience persistent symptoms.
Thus, there is potential for improvement in your condition, and the fact that you have experienced better days recently is a positive sign.
Combining medication with psychological therapy can lead to greater progress.
Panic disorder is also frequently comorbid with depression, so a dual approach to treatment is necessary.
Wishing you a speedy recovery.
Dr.
Wang Zhenyang

Reply Date: 2003/02/18

More Info

Panic disorder can be a challenging condition to navigate, especially when it intertwines with feelings of anxiety and depression. Your experience reflects a common struggle among individuals dealing with panic disorder, particularly when external stressors, such as family dynamics and personal health issues, exacerbate your mental state. It’s important to recognize that you are not alone in this journey, and there are ways to manage and potentially overcome these challenges.

Firstly, it’s crucial to understand that panic disorder is characterized by recurrent and unexpected panic attacks, which can lead to persistent worry about future attacks or changes in behavior to avoid situations where attacks have occurred. The symptoms you described—heart palpitations, dizziness, and feelings of helplessness—are typical of panic attacks. It’s commendable that you were able to apply coping strategies from your previous experiences, such as reassuring yourself that you would be okay and taking time to rest. This self-awareness is a vital tool in managing panic disorder.

Your mention of feeling a resurgence of depression during the holiday season is also significant. Seasonal changes and family stressors can trigger depressive episodes, especially if you have a history of depression in your family. The emotional toll of witnessing your mother’s struggles and the familial pressures during holidays can create a perfect storm for both anxiety and depression to flourish. It’s essential to acknowledge these feelings rather than suppress them, as doing so can lead to a cycle of worsening mental health.

Regarding your concerns about the future and your ability to graduate, it’s understandable to feel apprehensive. Many individuals with panic disorder and depression worry about their capacity to function in daily life and meet societal expectations. However, it’s important to remember that recovery is possible. While panic disorder can be persistent, many individuals find relief through a combination of therapy, medication, and lifestyle changes. Cognitive-behavioral therapy (CBT) is particularly effective for panic disorder, as it helps individuals identify and challenge negative thought patterns and behaviors associated with panic attacks.

You also expressed concerns about the genetic predisposition to depression due to your family history. While genetics can play a role in mental health conditions, it does not determine your fate. Many individuals with a family history of mental illness lead fulfilling lives and manage their conditions effectively. It’s essential to focus on what you can control—your treatment plan, coping strategies, and support systems.

Here are some steps you can take to help manage your panic disorder and associated depression:
1. Seek Professional Help: If you haven’t already, consider reaching out to a mental health professional. They can provide a comprehensive assessment and tailor a treatment plan that may include therapy and medication.

2. Practice Mindfulness and Relaxation Techniques: Techniques such as deep breathing, meditation, and progressive muscle relaxation can help reduce anxiety and improve your overall emotional well-being.

3. Establish a Support Network: Surround yourself with supportive friends and family who understand your struggles. Sharing your feelings can alleviate some of the burdens you carry.

4. Stay Active: Regular physical activity can significantly improve mood and reduce anxiety. Even simple activities like walking can make a difference.

5. Educate Yourself: Understanding panic disorder and its effects can empower you. Knowledge can help demystify your experiences and reduce fear.

6. Set Realistic Goals: Focus on small, achievable goals rather than overwhelming yourself with the pressure to graduate or succeed immediately. Celebrate your progress, no matter how small.

7. Limit Stressors: Identify and minimize sources of stress in your life. This might involve setting boundaries with family members or taking breaks when needed.

In conclusion, while panic disorder and depression can feel overwhelming, they are manageable conditions. With the right support and strategies, you can work towards a future where you feel more in control of your life and emotions. Remember, recovery is a journey, and it’s okay to seek help along the way. You are not defined by your struggles, and there is hope for a brighter future.

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