Panic Attacks and Panic Disorder: What They Feel Like and What Helps

Finn: The National Institute of Mental Health estimates that about 3 in every 100 adults in the U.S. had panic disorder in the past year.

Claire: Thanks for joining us. You're listening to Between Visits, sponsored by Hope Health Network, a network of medical practices serving South Carolina. We dig into the medical and mental health topics that matter most to patients and the public.

Claire: I'm Claire, and this is episode 1. I'm going to quickly play our disclaimers, and then we'll get started!

Recorded disclaimer: This show is for entertainment, education and general information only. It's not medical advice, and listening doesn't make you a patient. Our hosts and guests are not real people, medical doctors or healthcare providers. We do our best, but we can be wrong, and our content can have errors and omissions. Talk with a licensed medical provider in your state before you make any decisions about your health or medical care.

Claire: Joining me today is Finn, from our digital entertainment team. Today's topic is an important one: Panic Attacks and Panic Disorder: What They Feel Like and What Helps.

Claire: This can be a heavy subject. If it ever starts to feel like too much, at any point today, it's okay to step away. And help is always just a call away, any time, day or night. In an emergency, call 911. In a crisis, call or text 988.

Claire: Okay, Finn. Thanks for being here today.

Finn: Thanks, Claire. I'm glad we're talking about this.

Claire: Me too, Finn. Let's get started.

Claire: Today we're talking about panic attacks. And I want to start with what it actually feels like, because if you've had one, you know it can be really scary.

Finn: It can. It often comes out of nowhere. Your heart is pounding. You might be sweating, or shaking, or having trouble catching your breath.

Claire: And your mind is racing too, right?

Finn: Right. A lot of people feel out of control. Some people feel like something terrible is about to happen. Some even fear they're going to die.

Claire: That sounds awful. So if that's happened to someone listening, what do you want them to know first?

Finn: Two things. You are not alone. And help is out there. This is common, and it can be treated.

Claire: Okay. I like starting there. How common are we talking?

Finn: The National Institute of Mental Health estimates that about 3 in every 100 adults in the U.S. had panic disorder in the past year.

Claire: Three in a hundred. So in a full movie theater, that's a few people.

Finn: Yes. And it's more common in women than in men. It often starts in the late teens or early adult years, and sometimes it runs in families.

Claire: Now, you just said panic disorder. Is that the same thing as a panic attack? Because I think people use those like they're the same.

Finn: Good catch. They're not the same. A panic attack is the episode itself, a wave of intense fear with those body symptoms. It might happen once, or now and then.

Claire: And panic disorder?

Finn: That's when the attacks keep coming, without warning, and you spend a lot of time worrying about the next one. Many people start changing their lives to avoid another attack.

Claire: So I could have one panic attack and not have panic disorder.

Finn: Exactly. Not everyone who has a panic attack will develop panic disorder.

Claire: That's good to know. How long does one of these last? It must feel like forever.

Finn: It really can. An attack can last a few minutes, up to about an hour, and sometimes longer. They can happen any time, even while you're asleep.

Claire: While you're asleep? Wow. So you could wake up in the middle of the night with a panic attack.

Finn: You could. They can come several times a day, or only a few times a year. It's different for different people.

Claire: Okay, here's the one I really wanted to ask. Chest pain. Your heart's pounding, your chest hurts. How do you know it isn't a heart attack?

Finn: That's the big one. A panic attack can feel a lot like a heart attack. Panic attacks themselves are not life threatening. But here's the most important thing I'll say today. Don't guess.

Claire: Don't guess.

Finn: Right. Chest pain can have other causes. So if you have chest pain and you're not sure why, call 911, or go to the nearest emergency room.

Claire: So nobody should sit at home trying to figure it out by themselves.

Finn: Exactly. Let someone check you out. And that fear can feed on itself, too. Your heart pounds, you get scared, and then you get more scared. It can turn into a cycle.

Claire: That sounds really scary to go through. Now, I want to be clear, we're moving away from emergencies here. Let's say other medical causes have already been ruled out, and the attacks keep coming. So someone makes a regular appointment. What happens at that visit? People get nervous about that.

Finn: It's mostly a conversation. A health care provider will ask about your symptoms. That could be your primary care provider, a psychiatrist, a psychologist or a clinical social worker.

Claire: So your regular provider can be a good place to start?

Finn: Yes. They may also do a physical exam, to make sure some other health problem isn't causing it. Sometimes a short questionnaire at a checkup is the first step.

Claire: That doesn't sound so bad. Just talking it through.

Finn: Right. To call it panic disorder, a provider looks for repeated attacks that come without warning, plus at least a month of worrying about having more, or changing how you live because of them.

Claire: Okay. Then the question everyone wants answered. What helps?

Finn: The good news is there are real options. Treatment can include medication, counseling, or both. It can take some trial and error to find what works for you, and it can take a little time.

Claire: So don't give up if the first thing isn't perfect.

Finn: Yes. With the right treatment and support, people can manage their symptoms and feel better day to day.

Claire: Let's start with counseling. What does that look like?

Finn: The National Institute of Mental Health calls cognitive behavioral therapy the gold standard talk therapy for panic disorder. You'll hear people call it C B T.

Claire: And in regular words, what is it?

Finn: It helps you face the fears and beliefs behind the panic. One part of it gently brings on some of those body feelings, like a racing heart, in a safe setting. Over time, they feel less scary.

Claire: Oh, interesting. So your body learns it's okay.

Finn: That's a nice way to put it. They feel less frightening over time. A provider can talk with you about whether it's a good fit.

Claire: And what about medicine?

Finn: There are a few kinds. Some antidepressants can help treat panic disorder. They may take several weeks to start working, so you do have to give them time.

Claire: Are there side effects?

Finn: Some of the common ones are headaches, nausea or trouble sleeping. Those usually aren't severe, especially when the dose starts low and goes up slowly. The provider who prescribes it and your pharmacist should go over this with you before you start any medicine. So ask them any questions you have.

Claire: What else is there?

Finn: Benzodiazepines can ease symptoms quickly. But some people build up a tolerance or become dependent on them, so they're usually prescribed only for short periods. And beta blockers can help with things like a racing heart, though they aren't commonly prescribed for panic disorder.

Claire: And if someone's already on something and wants to stop?

Finn: Please talk with your provider first. Don't stop a medicine on your own.

Claire: What about everyday stuff? Sleep, exercise, that kind of thing.

Finn: Those can help. Good sleep, exercise, healthy food and people you trust. They just don't replace treatment.

Claire: So they help, but they're not the whole answer.

Finn: Right.

Claire: If someone's listening and they're not sure what to say to their provider, what could they ask?

Finn: Here's a simple one. Could my sudden attacks of fear be panic attacks? And would therapy, medicine or both be right for me?

Claire: I like that. You could write that down and take it with you.

Finn: You could. And one more thing, because it matters. If you or someone you know is struggling, or having thoughts of suicide, call or text 988, any time. It's free and it's confidential.

Claire: Thank you for saying that. Okay, before we wrap up. If people only remember a few things from today, what should they be?

Finn: First, you're not alone, and this can be treated.

Claire: Okay. What else?

Finn: Second, one panic attack doesn't mean you have panic disorder. But if they keep happening, tell your provider.

Claire: And one more?

Finn: If you have chest pain and you don't know why, don't guess. Call 911.

Claire: That's really helpful. Thank you for walking us through this.

Finn: Thanks for having me, Claire. I hope it helps someone.

Claire: This episode is sponsored by Hope Health Network. Its member practices all have providers experienced in managing panic disorder, or can refer you to a network provider who is. Hope Health Network medical practices provide evidence-based medical care and include Hope Integrative Medicine, Hope Medical Associates, Hope Behavioral Medicine and Hope Addiction Medicine. To learn more, go to Hope Health Network dot com. That website, along with appointment links for all four practices, is in the description of this episode.

Claire: One last reminder. In an emergency, call 911. In a crisis, call or text 988.

Claire: This podcast is a production of Hope Health Network Media.

Claire: You've been listening to episode 1 of Between Visits, Panic Attacks and Panic Disorder: What They Feel Like and What Helps. Thanks for hanging out with us. See you next time!