Sudden Fear: Is It Panic Disorder?

Feeling inexplicably fearful may be a symptom of panic disorder?

Hello Doctor, I have been in a state of prolonged stress and feeling down.
Recently, I've been trying not to dwell on it, which has helped a bit.
However, yesterday when I went out with friends, even though the atmosphere was pleasant and there was no pressure, I suddenly felt an intense fear accompanied by nausea and a feeling of wanting to vomit.
It felt like nothing I did was right at that moment.
Although I was able to move, I felt very uncomfortable and didn't know what to do.
This feeling of fear lasted for a few minutes before it disappeared, but the nausea and urge to vomit have persisted until now.
The last time I experienced something similar was in early May, also in the afternoon, during a pleasant situation.
At that time, in addition to fear and nausea, I also felt my hands and feet slightly weak and had difficulty breathing, with slight trembling in my hands.
This too lasted for a few minutes, and any other discomfort completely resolved by bedtime.
I have researched panic symptoms online, and while some are somewhat similar, they don't seem to be that severe.
I am very afraid of experiencing this feeling again, so I would like to ask you, Doctor, what is this situation? Thank you, Doctor.

Yun, 10~19 year old female. Ask Date: 2021/08/22

Dr. Zhang Gengjia reply Psychiatry

Dear Sir/Madam,
From your letter, it is clear that you are experiencing discomfort and distress due to sudden onset stress.
I would like to share my experiences regarding life management and coping with stress.
Living in this world inevitably brings about feelings of inadequacy and pressure to overcome oneself.
Deep within my soul, there is always a resonating voice that says, "Not enough, not enough; what you are doing is still insufficient." I hope this voice can guide everyone to overcome their own weaknesses and downfalls, empowering them to respond more robustly and live healthier lives.
If the sudden stress becomes overwhelming, I recommend seeking an evaluation at our outpatient clinic.
We have consultations available from Monday to Friday, both in the morning and afternoon.
I encourage you to consider visiting our clinic for a personal assessment of your symptoms, so we can collaboratively discuss the best course of action for you.
Wishing you mental and physical well-being.
Sincerely,
Dr.
Chang Geng-Jia
Department of Psychiatry

Reply Date: 2021/08/22

More Info

It sounds like you are experiencing episodes of intense fear and discomfort that can be quite distressing. Based on your description, it is possible that you are dealing with symptoms consistent with panic disorder, which is characterized by sudden and unexpected panic attacks. These attacks can occur even in seemingly safe and pleasant situations, leading to feelings of intense fear, physical symptoms like nausea, shortness of breath, and a sense of impending doom.

Panic disorder is a type of anxiety disorder that can significantly impact your daily life. The episodes you described, where you felt overwhelming fear and physical symptoms like nausea and trembling, align with the hallmark features of panic attacks. These attacks can occur without any clear trigger, which can make them particularly frightening. The fact that you experienced these symptoms in enjoyable situations, such as being out with friends, can be confusing and may lead to a fear of future attacks.

It's important to note that panic attacks can be accompanied by a range of physical symptoms, including heart palpitations, sweating, chills, hot flashes, chest pain, dizziness, and feelings of unreality or detachment. The fear of having another attack can lead to avoidance behaviors, where you might start to avoid situations or places where you previously experienced panic, which can further limit your activities and enjoyment of life.

Given that you mentioned feeling low and under stress for an extended period, it is possible that these factors are contributing to your anxiety and panic symptoms. Chronic stress can exacerbate anxiety disorders and make individuals more susceptible to panic attacks. It's also worth noting that the fear of having a panic attack can create a cycle of anxiety, where the anticipation of an attack can trigger further anxiety and potentially lead to more attacks.

To address these concerns, I recommend seeking professional help from a mental health provider. Cognitive-behavioral therapy (CBT) is one of the most effective treatments for panic disorder. CBT helps individuals understand and change their thought patterns and behaviors related to panic attacks. Additionally, exposure therapy, which involves gradually facing the situations that trigger anxiety, can also be beneficial.

In some cases, medication may be prescribed to help manage symptoms. Selective serotonin reuptake inhibitors (SSRIs) and benzodiazepines are commonly used to treat panic disorder. However, medication should be discussed with a healthcare provider to determine the best course of action for your specific situation.

It's essential to remember that you are not alone in this experience, and many people successfully manage panic disorder with the right support and treatment. Taking the first step to seek help can be daunting, but it is a crucial part of regaining control over your life and reducing the impact of panic attacks on your daily activities.

In summary, the symptoms you are experiencing could be indicative of panic disorder, and I encourage you to consult with a mental health professional who can provide a thorough assessment and develop a tailored treatment plan. With the right support, you can learn to manage your symptoms and improve your overall well-being.

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