Panic Disorder
Understanding Panic Disorder
You may have experienced moments where your heart suddenly pounds, your chest feels tight, or you feel dizzy and like you can’t breathe. Maybe it comes out of nowhere—and leaves just as suddenly, but not without lingering fear. If you’re living in fear of these episodes or avoiding certain situations because of them, you might be dealing with panic disorder.
This condition isn’t about being “dramatic” or “overreacting.” Panic disorder is a real and treatable medical condition. It’s marked by unexpected panic attacks—intense surges of fear or discomfort—and ongoing worry about when the next one might strike. It can make everyday life feel unpredictable and exhausting, but you don’t have to face it alone.
Symptoms You Might Experience
Panic disorder centers around repeated, unexpected panic attacks. These attacks are more than just feeling anxious—they’re sudden, powerful waves of fear or physical discomfort that reach a peak within minutes. Common symptoms include:
Racing or pounding heartbeat
Chest pain or discomfort
Shortness of breath or feeling like you can’t breathe
Dizziness, lightheadedness, or feeling faint
Sweating or chills
Trembling or shaking
Nausea or stomach upset
Numbness or tingling sensations
A sense of detachment or unreality (derealization)
Feeling like you’re losing control, going crazy, or dying
Panic disorder isn’t just about the attacks themselves—it’s also about what happens in between. You may find yourself constantly worried about having another attack, or avoiding places and situations where one might happen, which can significantly interfere with your daily life.
What Makes Panic Disorder Different
While many people have one or two panic attacks in their lifetime—often during extreme stress—panic disorder involves recurring attacks and persistent fear of future episodes. You might begin to structure your life around avoiding anything that could “trigger” an attack, including driving, crowds, exercise, or even leaving home.
This avoidance can sometimes lead to agoraphobia, where the fear of panic attacks becomes so strong that you avoid public or unfamiliar spaces altogether.
Causes and Risk Factors
Panic disorder, like many mental health conditions, is the result of a combination of factors. You may be more likely to develop it if you:
Have a family history of panic attacks or anxiety disorders
Experienced major stress, trauma, or life changes (such as loss, illness, or job changes)
Have a more sensitive nervous system or heightened stress response
Use stimulants (like caffeine or certain medications) that can trigger symptoms
Have co-occurring mental health conditions like depression, PTSD, or social anxiety
Your brain’s fight-or-flight system plays a key role. In panic disorder, this system is often activated inappropriately—responding as if you’re in danger even when you’re safe.
Diagnosis and Evaluation
At Valiant Mental Health, we approach panic disorder with curiosity and care—not judgment. If you’ve experienced sudden episodes of intense fear, we’ll explore the nature of your symptoms, when they started, how often they occur, and how they’ve affected your daily life.
We’ll also rule out medical causes that can mimic panic attacks, such as thyroid disorders, heart issues, or side effects from medications. Many people feel confused or embarrassed by their symptoms—especially when medical tests come back “normal.” That’s why we take time to explain what’s happening and ensure your treatment is guided by both science and compassion.
Evidence-Based Treatment Options
Panic disorder is highly treatable, and many people find relief through a combination of medication and therapy. You don’t have to “push through it” or avoid your triggers forever.
Medications:
Several medication classes can be helpful in reducing the frequency and intensity of panic attacks:
Selective serotonin reuptake inhibitors (SSRIs) – Often the first choice, SSRIs like sertraline (Zoloft) or paroxetine (Paxil) help regulate the brain’s response to fear and stress over time.
Serotonin-norepinephrine reuptake inhibitors (SNRIs) – Medications like venlafaxine (Effexor XR) are sometimes used if SSRIs aren’t effective or well-tolerated.
Benzodiazepines – Fast-acting medications such as lorazepam (Ativan) or clonazepam (Klonopin) can provide short-term relief, but are used cautiously due to risks of dependence.
Beta-blockers – May help reduce physical symptoms like rapid heart rate during predictable situations (e.g., public speaking).
Buspirone – A non-sedating option that can help with underlying anxiety, though not typically first-line for acute panic.
Medication works best when it’s tailored to your symptoms, health history, and goals. We’ll talk through the pros and cons so you can make an informed choice.
Therapy:
Cognitive Behavioral Therapy (CBT) is the gold standard for panic disorder. It focuses on helping you:
Identify and reframe thoughts that trigger panic
Learn breathing and grounding techniques
Reduce avoidance behaviors
Gradually expose yourself to feared situations in a safe and structured way
CBT has a strong track record of helping people regain control, rebuild confidence, and significantly reduce or eliminate panic attacks over time.
Other approaches may include:
Interoceptive exposure (exposing you to feared physical sensations in a safe way)
Acceptance and Commitment Therapy (ACT)
Relaxation training and mindfulness practices
Education about the fear response and how your body reacts to stress
What to Expect from Medication Management
Choosing medication doesn’t mean you’ll feel “dull” or disconnected. The goal is to turn down the volume on your body’s false alarms—so that you’re not constantly living in fear of fear itself. At Valiant, we’ll walk with you through the process, adjusting as needed, and ensuring you feel informed and supported along the way.
We’ll also help you understand how long medications typically take to work, what side effects to watch for, and what success looks like at each step of treatment.
How Valiant Mental Health Supports You
Living with panic disorder can feel isolating, but you’re not alone. At Valiant Mental Health, we understand how frightening and frustrating panic attacks can be—and how deeply they can affect your relationships, your work, and your sense of freedom.
Our providers create a safe, judgment-free space where you can talk openly, ask questions, and develop a treatment plan that fits your life. Whether you’re ready to try medication, start therapy, or simply want to understand your options, we’ll meet you where you are and help you move forward—one step at a time.
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