Panic Disorder: Signs, Symptoms, and Treatment Options

My friend?

My friend told me that recently he sometimes feels like he can't breathe, his heart races, and he can sometimes clearly feel his heartbeat.
At times, he feels like something is pressing on his throat, which is very uncomfortable.
He often feels like he is about to leave this world, gets easily irritable, and feels like others are talking badly about him.
Sometimes he feels nauseous, even though he hasn't eaten much, he can't eat anything, and he experiences dizziness, headaches, and neck pain.
Recently, I saw "panic disorder" in a textbook, and it seems very similar to my friend's symptoms.
Does my friend really have panic disorder? I'm very worried about his condition.
If he does have panic disorder, which specialist should he see? How can it be treated?

houzi, 10~19 year old female. Ask Date: 2008/09/25

Dr. Su Zongwei reply Psychiatry

It could possibly be panic disorder, but it is essential to first undergo a differential diagnosis through a consultation with a physician, either in psychiatry or psychosomatic medicine.
Thank you.

Reply Date: 2008/09/25

More Info

Panic disorder is a type of anxiety disorder characterized by recurrent and unexpected panic attacks. These attacks are sudden periods of intense fear or discomfort that peak within minutes and can include a variety of physical and psychological symptoms. Based on your friend's description, it does sound like he may be experiencing symptoms consistent with panic disorder.

Signs and Symptoms of Panic Disorder
1. Physical Symptoms: Your friend reports feeling short of breath, rapid heartbeat, a sensation of choking, nausea, dizziness, and muscle tension. These symptoms are common during panic attacks and can mimic those of a heart attack or other serious medical conditions, which often leads individuals to seek emergency medical care.

2. Psychological Symptoms: He also experiences feelings of unreality or detachment from himself, which is known as depersonalization. This can make him feel as though he is about to leave this world, a common fear during panic attacks. Additionally, irritability and heightened sensitivity to perceived negative judgments from others can also be indicative of anxiety.

3. Behavioral Changes: The avoidance of situations that may trigger these attacks is common. If your friend begins to avoid places or situations where he fears an attack might occur, this can further exacerbate the disorder.

Diagnosis and Treatment Options
If your friend is indeed experiencing panic disorder, it is crucial for him to seek help from a healthcare professional. The appropriate specialists to consult would be a psychiatrist or a psychologist. They can provide a comprehensive evaluation and determine the best course of treatment.

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Treatment Options:
1. Psychotherapy: Cognitive Behavioral Therapy (CBT) is particularly effective for panic disorder. It helps individuals understand the thoughts and behaviors that contribute to their panic attacks and teaches coping strategies to manage anxiety.

2. Medication: Antidepressants, particularly selective serotonin reuptake inhibitors (SSRIs) like Prozac (fluoxetine), and benzodiazepines like Xanax (alprazolam) can be prescribed to help manage symptoms. It's important that any medication is taken under the supervision of a healthcare provider, as they can help monitor for side effects and adjust dosages as necessary.

3. Lifestyle Modifications: Encouraging your friend to engage in regular physical activity, practice relaxation techniques (such as deep breathing or mindfulness meditation), and maintain a healthy diet can also be beneficial. Reducing caffeine and alcohol intake may help decrease anxiety levels.

4. Support Groups: Joining a support group where individuals share their experiences with panic disorder can provide emotional support and practical advice.

Conclusion
It is understandable that you are concerned about your friend's well-being. Panic disorder can significantly impact one's quality of life, but with appropriate treatment, many individuals can manage their symptoms effectively. Encourage your friend to seek professional help as soon as possible. Early intervention can lead to better outcomes and help him regain control over his life. If he is hesitant, offering to accompany him to his first appointment may provide the support he needs to take that important step.

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