Panic Disorder: Symptoms, Treatment, and Concerns

Is it typical panic disorder?

Hello Doctor, I suddenly felt short of breath in the middle of the night at the beginning of August while trying to sleep.
I woke up startled four to five times, and then when I sat up, my heart rate suddenly increased, and I felt a tightness in my chest and difficulty breathing, needing to take deep breaths.
I felt like I was about to faint.
I called an ambulance, and by the time I reached the hospital (about a ten-minute ride), my condition had eased, and I was able to walk into the emergency room.
The emergency staff diagnosed it as a panic attack.
A few days later, I visited a psychiatrist, who said it couldn't be classified as a panic disorder yet and prescribed medication, but I didn't take it.
At first, I still experienced slight shortness of breath before falling asleep, but after about a week, the symptoms subsided, and I didn't pay much attention to it.
Last Sunday, I started experiencing sudden awakenings again while trying to sleep, which occurred repeatedly.
Even though I was very sleepy, I couldn't fall asleep.
Every day since then, I have been experiencing recurring symptoms of chest tightness, shortness of breath, and dizziness, which would ease for about 20 minutes before recurring.
Eventually, I couldn't stand it anymore and took one dose of Xanax prescribed in the emergency room, but it didn't seem to help; I still felt dizzy and had chest tightness afterward.
(I was diagnosed with COVID-19 in early September and am worried that it may have affected my heart or lung function or caused lingering effects.) I would like to ask the doctor: 1) Is this a typical panic disorder? Can symptoms occur this frequently in a day? 2) Are medications for treating panic disorder addictive? I am really afraid that once I start taking them, I will have to rely on them for life, and that the dosage will keep increasing.
3) I can reasonably conclude that my academic workload is a source of stress; are there other ways to treat panic disorder? Thank you for your help!

Ccc, 20~29 year old female. Ask Date: 2022/10/01

Dr. Qiu Junda reply Psychiatry

Hello.
1) The described symptoms indeed suggest the possibility of panic disorder, and these symptoms may occur frequently.
2) Medications such as Xanax do carry a risk of addiction.
Therefore, it is advisable to discuss medication options with a psychiatrist, including your concerns about addiction.
3) If academic pressures are a source of stress for you, you may want to search for articles on stress management.
Learning some techniques from these resources can be considered a non-pharmacological treatment approach.

Reply Date: 2022/10/01

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 described, such as shortness of breath, rapid heartbeat, chest tightness, and feelings of impending doom, are indeed typical of panic attacks. It’s important to understand that panic disorder can manifest in various ways, and the frequency and intensity of attacks can vary from person to person.
1. Is this typical of panic disorder?
Yes, the symptoms you are experiencing align with panic disorder. Panic attacks can occur unexpectedly, even during sleep, as you described. It is not uncommon for individuals with panic disorder to experience daily symptoms, especially when under stress. The fact that you have had episodes of waking up gasping for air and feeling unable to breathe indicates that your body is reacting to anxiety, which can exacerbate feelings of panic.
2. Concerns about medication and addiction:
Regarding your concerns about medication, it’s essential to differentiate between the types of medications used to treat panic disorder. Benzodiazepines, such as Xanax (alprazolam), are often prescribed for short-term relief of acute anxiety symptoms. While effective, they can lead to dependence if used long-term. However, there are other classes of medications, such as selective serotonin reuptake inhibitors (SSRIs) like Prozac (fluoxetine), which are commonly used for long-term management of panic disorder. SSRIs are generally not considered addictive and can help reduce the frequency and intensity of panic attacks over time. It’s crucial to have an open discussion with your healthcare provider about your concerns regarding medication, as they can help tailor a treatment plan that minimizes risks while effectively managing your symptoms.

3. Addressing the source of stress:
You mentioned that academic pressure is a significant stressor for you. Identifying and addressing the root causes of anxiety is an integral part of treatment. Cognitive-behavioral therapy (CBT) is a highly effective therapeutic approach for panic disorder. CBT helps individuals understand the relationship between their thoughts, feelings, and behaviors, and teaches coping strategies to manage anxiety. Additionally, relaxation techniques, mindfulness practices, and lifestyle changes such as regular exercise, adequate sleep, and a balanced diet can also contribute to reducing anxiety levels.

4. Alternative treatments:
Besides medication and therapy, there are several alternative approaches you can consider. Engaging in regular physical activity can help reduce anxiety and improve overall mental health. Mindfulness meditation and deep-breathing exercises can also be beneficial in managing panic symptoms. Support groups, whether in-person or online, can provide a sense of community and understanding, which can be incredibly helpful when dealing with anxiety disorders.

In summary, your symptoms are consistent with panic disorder, and while medication can be a part of the treatment plan, it is essential to work closely with your healthcare provider to find the right balance that addresses your concerns about dependence. Therapy, particularly CBT, along with lifestyle modifications, can significantly enhance your ability to cope with panic disorder and reduce the frequency of attacks. Remember, you are not alone in this, and seeking help is a vital step towards recovery.

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