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Silverman HM. The Pill Book. For many people, the first panic attack may occur a stressful time. It may happen during a life-threatening illness or accident, the loss of a relationship, or separation from family.
A woman may have her first panic attack after she gives birth. It is also possible for a first panic attack to be caused by a drug reaction or a reaction to nicotine or caffeine. But after the situation that caused the first panic attack is resolved, attacks may continue.
Recurrent panic attacks can be mild to severe. They may continue for years, especially if you also have agoraphobia avoiding places where you fear another attack will occur. You may have long periods of time without panic attacks. And you may have other periods of time when attacks occur often. You may need longer or different treatment if you have both panic disorder and agoraphobia. You may also have other conditions linked with panic disorder and panic attacks, such as drug or alcohol problems, depression, or other mental health disorders.
You will need treatment for these conditions. Panic disorder may last a lifetime, but its symptoms can be controlled with treatment. Most people who have panic disorder get better with treatment. They are able to get back to a normal lifestyle.
But relapse can occur, especially if treatment is stopped too soon. It can be hard to tell the difference between the symptoms of a panic attack such as shortness of breath and chest pain and the symptoms of a heart attack or another serious medical problem. If you have symptoms of a panic attack, be sure to get medical care right away so that other medical conditions can be ruled out. The following health professionals can diagnose panic attacks.
They may work together with other health professionals to treat panic attacks and panic disorder:. Many community mental health centers, hospital outpatient clinics, and family service agencies have treatment programs for people with panic disorder. You may be diagnosed with panic disorder if you have at least two unexpected panic attacks along with fear or worry about having another panic attack and avoiding situations that may trigger it. The doctor will ask you questions about your symptoms.
He or she will listen to your heart and check your blood pressure. You may get blood tests. The doctor may need to rule out other physical conditions that have symptoms similar to panic disorder, such as a heart attack or hyperthyroidism. Successful treatment reduces how many panic attacks you have and how often you have them. It lowers the anxiety you feel because of the fear of future attacks. And it improves the quality of your life. Treatment may include:.
Unfortunately, many people don't seek treatment for anxiety disorders. You may not seek treatment because you think the symptoms aren't bad enough. Or maybe you think that you can work things out on your own. But getting treatment is important. If you need help deciding whether to see your doctor, see some reasons why people don't get help and how to overcome them. If your panic attacks were caused by a specific trigger, such as a medicine reaction, you may not need treatment after the trigger has been removed.
In this case, that would mean stopping the medicine with the help of your doctor. But sometimes panic attacks caused by outside factors can continue after the trigger has been removed. They may turn into panic disorder. You may have mild to severe panic attacks off and on for years, especially if you also have agoraphobia avoiding places where you fear another attack will occur.
Even after treatment is stopped because the attacks appear to be under control, attacks can suddenly return. Learn your early warning signs and triggers so you can seek treatment early. If your panic attacks get too severe or happen too often, you may need to be hospitalized until they are under control. You also may need a brief hospital stay if you have panic attacks along with another health condition, such as agoraphobia or depression.
Panic attacks combined with these conditions can be harder to treat. An important part of ongoing treatment is making sure that you are taking your medicine as prescribed. Often people who feel better after using medicine for a period of time may believe they are "cured" and no longer need treatment. But when medicine is stopped, symptoms usually return. So it's important to continue the treatment plan. You will be continually checked to see if you have other conditions linked with panic disorder, such as depression or problems with drugs or alcohol.
These conditions will also need treatment. But you may be able to prevent or reduce the number of panic attacks with home treatment. For example, you can try relaxation exercises or limiting alcohol and caffeine. Here are steps you can take to decrease the number of panic attacks you have. These steps can also reduce the severity of your symptoms when an attack does occur:. If someone in your family has panic attacks, you may feel frustrated, overworked because you have to take over his or her responsibilities , or socially isolated because the person restricts family activities.
These feelings are common. Family therapy , a type of counseling that involves the entire family, may help. Medicines for panic disorder are used to control the symptoms of panic attacks, reduce their number and severity, and reduce the anxiety and fear linked with having another attack. Your symptoms of panic disorder should start to improve within a few weeks after you start taking medicines. If improvement is not seen within 6 to 8 weeks, a higher dose or another medicine may be needed.
Some medicines used to treat panic attacks need to be continued for a year or longer and then may be decreased gradually over several weeks.
If you have panic attacks again while medicines are being stopped, the medicines may be continued for at least a few months more. Some people may need to stay on medicines for a long time to keep symptoms under control.
Taking medicines for panic disorder during pregnancy may increase the risk of birth defects. If you are pregnant or thinking of becoming pregnant, talk to your doctor. You may need to keep taking medicines if your panic disorder is severe. Your doctor can help weigh the risks of treatment against the risk of harm to your pregnancy.
Medicines to treat panic disorder often may prevent another panic attack. But they may not take away the fear of having another attack. Counseling can help you handle this fear. The fear of having an attack may actually bring on another attack. Cognitive-behavioral therapy focuses on changing certain thinking and behavior patterns.
It has been proved effective for treating panic disorder. Support groups are often good places to share information, problem-solving tips, and emotions related to panic disorder.
Self-help materials can help you learn to cope with panic disorder or anxiety. These include instructional videos, books, and audio materials. Body-centered relaxation exercises can be useful for reducing anxiety and treating symptoms of stress. They include:. Mindfulness activities are techniques that help relax the mind. They are often combined with body-centered relaxation exercises.
These techniques include:. Current as of: September 23, Maldonado PhD - Behavioral Health. Author: Healthwise Staff. Medical Review: Anne C. This information does not replace the advice of a doctor. Healthwise, Incorporated, disclaims any warranty or liability for your use of this information.
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Updated visitor guidelines. Top of the page. Panic Attacks and Panic Disorder. Topic Overview What are panic attacks and panic disorder? More women than men get panic attacks. What causes panic attacks and panic disorder? Benzodiazepines , such as alprazolam Xanax , can help treat the symptoms of panic when they occur.
For this reason, doctors only recommend them for short-term use during a crisis. Which drugs can treat anxiety disorder? While hyperventilating is a symptom of panic attacks that can increase fear, deep breathing can reduce symptoms of panic during an attack. In one study , published in , 40 people joined either a therapy group that involved deep or diaphragmatic breathing or a control group. After 20 intensive training sessions, those who practiced deep breathing saw improvements in their attention levels and emotional well-being.
Blood tests also showed lower cortisol levels in this group, suggesting lower levels of stress. The participants did not have panic disorder, but the strategies could help people who have panic attacks. Another group of scientists found that slow breathing could have similar effects. They suggested it could also improve feelings of relaxation, comfort, and alertness and reduce symptoms of arousal anxiety, depression, anger, and confusion.
Focus on taking deep breaths in and out through your mouth, feeling the air slowly fill your chest and belly and then slowly leave them again. Breathe in for a count of four, hold for a second, and then breathe out for a count of four:. What is diaphragmatic breathing and how do you do it? Take away the fear that you may be dying or that impending doom is looming, both symptoms of panic attacks. This can allow you to focus on other techniques to reduce your symptoms.
It is not always possible to avoid triggers for a panic attack, but if you know what triggers it, this can help you understand that it is a panic attack and not something else. Some panic attacks come from triggers that overwhelm you. To reduce the stimuli, close your eyes during your panic attack. This can block out any extra stimuli and make it easier to focus on your breathing. Focus on the physical sensations you are familiar with, like digging your feet into the ground or feeling the texture of your jeans on your hands.
These specific sensations ground you firmly in reality and give you something objective to focus on. American Family Physician recommended mindfulness as a strategy for dealing with panic and anxiety in , saying it can be as helpful for reducing stress as CBT and other behavioral therapies.
Some people find it helpful to find something to focus all their attention on during a panic attack. Pick one object in clear sight and consciously note everything about it possible.
Describe the patterns, color, shapes, and size of the object to yourself. Focus all your energy on this object, and your panic symptoms may subside. Muscle tension is a symptom of anxiety, and muscle relaxation techniques can help reduce tension and promote relaxation during an attack. Progressive muscle relaxation aims to release tension in one group of muscles at a time to relax the whole body. If you attend muscle relaxation therapy, your therapist might take you through the following steps :.
To start relaxing your muscles at home, consciously relax one muscle at a time, starting with something simple like the fingers in your hand, and move your way up through your body. Guided imagery techniques can help reduce stress and anxiety.
Research suggests that both spending time in nature and visualizing nature can help treat and manage anxiety. A sunny beach with gently rolling waves? A cabin in the mountains? Picture yourself there and try to focus on the details as much as possible. Imagine digging your toes into the warm sand, or smelling the sharp scent of pine trees. This place should be quiet, calm, and relaxing — no streets of New York or Hong Kong, no matter how much you love the cities in real life.
Here, learn about five visualization techniques that can help you meditate. Research shows that regular exercise can not only keep the body healthy but boost mental well-being, too. Experts have found that exercising at 60 to 90 percent of your maximum heart rate for 20 minutes three times per week can help reduce anxiety. If you are not used to exercising, talk with your doctor before starting. There is some evidence that starting aerobic exercise anew can trigger additional anxiety in people with an anxiety disorder.
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