Navigating Panic Disorder: Signs and Symptoms

It was my first summer camp in beautiful Kentucky. I was in my cabin, relaxing when all of a sudden, I heard a blaring alarm. Where I lived in Florida, we didn’t have this system but as I looked around, people knew what to do. Suddenly, a staff member runs in saying we had a tornado warning and everybody needed to get in his van to move towards a safer shelter.

But I didn’t process anything past “tornado warning” and my body decided not to respond to his instructions. Instead, I began losing control; I dashed out of the cabin, completely overlooked our transportation, and headed down a steep hill towards the cafeteria. 

An overwhelming amount of hail began striking my body, it was difficult to see past the rain, and I kept losing my footing and footwear. Once I finally reached my destination, it only took a couple of steps before I slipped on the wet cafeteria tile flooring. I layed there, staring at the ceiling, my heart racing, and my face filled with tears. I tried to keep it together, now filled with the embarrassment of people seeing me slip and fall, as my body trembled.

It wasn’t very long after that, when the alarms began blaring again, and I couldn’t hold myself anymore. I began to sob; my thoughts were racing, my hands shaking, and my body coiling. I happened to see another person also experiencing the same feelings and mine grew. The only comfort I received was in the fetal position on the ground while being held by a family friend who happened to be a staff member.

This was a panic attack, and it wasn’t the only one I would experience in my life. Being my first one, it has stayed in my memory throughout the years. This is a similar experience for people who I see in therapy; their first panic attack is often their worst and most memorable.

If this is your experience, you're not alone. In this blog, I hope to uncover more about panic attacks and how panic disorder works.

Common symptoms of panic attacks

According to a manual used by mental health professionals to help clients (Diagnostic and Statistical Manual of Mental Health Disorders, Fifth Edition, Revised 2022), panic attacks:

• Come out of nowhere - they are unexpected, and you did nothing to cause them

• Intense emotions - of fear or discomfort 

• Short-term - they reach a peak within minutes but seem longer

• Varying experience of at least four of the following:

  • Palpitations, pounding heart, or accelerated heart rate

  • Sweating

  • Trembling or shaking

  • Sensations of shortness of breath or smothering

  • Feelings of choking

  • Chest pain or discomfort

  • Nausea or abdominal distress

  • Feeling dizzy, unsteady, light-headed, or faint

  • Chills or heat sensations

  • Paresthesias (numbness or tingling sensations)

  • Derealization (feelings of unreality) or depersonalization (being detached from oneself).

  • Fear of losing control or “going crazy

  • Fear of dying

TIP: To understand anxiety and stress, check out a comprehensive guide I created for adults here.

Developing Panic Disorder

It's interesting that we can be calm and have a panic attack (remember, they come out of nowhere) or we can be anxious and have a panic attack (to be expected but not always the case). A panic attack is an event/experience while panic disorder is a condition or on-going.

A key trait of panic disorders is having another panic attack within a month or more and one or both of the following:

1. Dread of having another panic attack or their consequences - losing control, difficulty breathing, feeling of having a heart attack

2. Behavioral changes due to panic attacks - avoiding activities or places, escaping ambiguity, trying to exercise control over discomfort or unfamiliar areas

Again, panic disorders, much like having panic attacks, are nothing you caused but rather our brains trying to keep up safe, but trying too hard. There are some genetic components that make some families more susceptible to anxiety and panic attacks but more research is needed.

Effective treatments for panic disorder

I've had the opportunity to work with individuals with panic disorder and have found great results using various therapy skills informed by Cognitive Behavioral Therapy (CBT) and Acceptance and Commitment Therapy. Coping skills such as: focusing on deep breathing, sitting in a comfortable place, muscle relaxation, and learning to manage the discomfort are but a few of research-based strategies.

Research in the medical and mental health field has found the combination between CBT and medications such as selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs) to be helpful. Please consult your medical doctor about your options for medication management.

Concluding Words

It's helpful to find a therapist who understands you and the panic attacks you are experiencing. Together, you can build a plan to increase your awareness of your mental and physical experiences, to build up your strengths and confidence, and create a plan to manage panic disorders.

Learn more about panic disorders here.

When I experienced a second panic attack many years later at a dentist office, I was better prepared to manage my experience with the coping skills I learned in the mental health field. I still had an uncomfortable experience but I felt proud of how I handled it afterwards. Guidance is available and I invite you to reach out to us and schedule a complimentary 15-minute consultation to discuss your situation.

Credits

1. American Psychiatric Association. (2022). Anxiety disorders. In Diagnostic and statistical manual of mental disorders (5th ed., text rev.). https://dsm.psychiatryonline.org/doi/full/10.1176/appi.books.9780890425787.x05_Anxiety_Disorders

2. Video on What is Panic Disorder: What is Panic Disorder?

3. Photo by Aliaksei Lepik