When Constant Panic Attacks Impair Daily Life

Panic disorder can be a very debilitating condition, to the point where staying in the safety and comfort of one’s home seems like the best solution. But isolating oneself in order to avoid the potential panic attacks only leads to more impairment, negatively impacting career and relationships, as well as possibly leading to depression in addition to the anxiety disorder.

A panic attack can be a highly distressing experience. In fact, those who experience panic attacks describe them as feeling like they are having a heart attack. Because of the severity of the symptoms, many will seek emergency medical care.

It is understandable why, when experiencing constant panic attacks, it seems like the best thing to do is just stay away from anything that might inadvertently trigger a new one. But the difficulty with that strategy is the nature of panic disorder itself. Typically, the attacks are not predictable and may not follow any usual trajectory. This means that a trigger could be just about any thing, any person, or any situation.

With this in mind, should an individual be attempting to avoid the constant panic attacks that render them hostage to the disorder, getting professional treatment is the appropriate path to take. Mental health providers can offer solutions in either an outpatient or residential setting, with the decision as to which is best resting on the severity of the panic disorder.

About Panic Disorder

Panic disorder is one of the mental health disorders within the anxiety disorder spectrum, and affects 2.7% of the adult population in a given year, and 4.7% over the course of a lifetime.  Panic disorder features unpredictable and intense physical symptoms and is more prevalent in women, with double the number of women experiencing this debilitating disorder than men.

Untreated panic disorder can be highly disruptive to daily functioning, with the constant fear or dread of the next potential panic attack. This is because it is very hard to predict when a panic attack might be forthcoming, which causes those who suffer from panic disorder to remain in a place where they feel safe and in control. About 50% of those with panic disorder have symptoms of agoraphobia. This can have devastating impact on the individual’s quality of life, placing significant limitations on normal functioning.

Signs and symptoms of panic disorder may stem from past traumatic events, a family history of anxiety disorders, a major life event, such as divorce or sudden loss of a loved one, and major life stressors. However, in many cases there is no known cause or trigger for the onset of the attacks.

Symptoms of a panic attack might include:

• Chest tightening, chest pains
• Racing heart
• Heart palpitations
• Dizziness
• Hot flashes
• Feeling out of control
• Nausea
• Abdominal cramping
• Diarrhea
• Feeling very weak or faint
• Shortness of breath
• A strong feeling of terror or doom
• Tingling or numbness in the hands and fingers
• Headache
• Chills
• Feelings of detachment
• Fear of death

To meet the DSM-5 diagnostic criteria for panic disorder the individual would experience the persistent worry about impending panic attacks for at least one month, would experience significant impairment in functioning, and cannot be related to a substance use disorder or a medical condition.

What Causes Panic Disorder?

At present, the exact cause of panic disorder is still unknown. According to the Mental Health America website, research has identified a connection between panic attacks and a “suffocation alarm mechanism” in the brain, which causes the individual to feel their life is in peril. There are, however, some identified factors that could contribute to the disorder. These include:

• Biology. Panic disorder may run in families, primarily when there are family members who have been diagnosed with an anxiety disorder
• Environmental factors. This can include stressful life events, loss of a loved one, exposure to trauma, history of abuse
• Personality traits. Some people possess certain personality traits that may contribute to an exaggerated reaction to a stimuli.
• Stress regulation malfunction. This is a chemical issue in which the individual’s production of cortisol and adrenaline are easily triggered and difficult to manage once triggered.

Treatment for Panic Disorder

Treatment for panic disorder will range from outpatient care through a private mental health provider to inpatient or residential care in a mental health treatment center. The level of care is dependent on various factors, such as the severity of the symptoms, the degree of daily impairment in functioning, the length of time with the disorder, and whether there are co-occurring mental health disorders present.

Outpatient. Outpatient treatment is available in several formats, including a private psychiatric practitioner, an outpatient treatment center, or a partial hospitalization program, often referred to as a day program.

Residential. A residential program will involve an extended stay at a mental health treatment center. These may be a private care facility that is in a home setting with a small number of patients, or a larger mental health treatment facility. The residential setting allows for a more intensive, customized treatment protocol based on the specific features of an individual’s panic disorder diagnosis. Also, in a residential setting there is more flexibility in trialing different combinations of treatment elements and therapies.

Treatment elements for panic disorder include:

• Psychotherapy. Using evidence-based psychotherapies such as cognitive behavioral therapy (using the panic control treatment protocol), virtual-reality CBT, prolonged exposure therapy, and panic-focused psychodynamic psychotherapy (PFPP)
• Eye movement desensitization reprocessing (EMDR)
• Group therapy, including skills-training group and support groups
• Medication, including tricyclic antidepressants, MOAIs, SNRIs, and benzodiazepines
• Relaxation techniques using holistic therapies

Holistic Methods for Managing Anxiety

When someone is besieged with constant panic attacks—some up to several attacks per day—it is wise to access holistic therapies to help manage the anxiety. These practices can significantly reduce chronic anxiety symptoms that may underlie the panic disorder. Incorporating at least a few of these into a weekly routine will go a long way toward regulating anxiety in general:

Yoga. Yoga uses movement and breathing focus to bring about deep relaxation, as it helps release muscle tension.

Mindfulness. Mindfulness helps us to reduce stress by focusing our thoughts to the present moment instead of becoming distracted by worries or past events.

Massage therapy. Massage can help release toxins from the body, resulting in muscle relaxation and a calm mind.

Aromatherapy. Several essential oils used in aromatherapy induce relaxations, such as lavender oil, bergamot, rose, ylang ylang, and German chamomile.

Exercise. Regular physical movement, especially cardio activities, can help promote a happier state of being while also reducing stress and aiding in better sleep quality.

Nutrition. In addition to maintaining a healthy diet, there are certain foods that help anxiety in particular, including Brazil nuts, eggs, fatty fish, pumpkin seeds, dark chocolate, yogurt, green tea, and chamomile tea.

How to Manage a Panic Attack

When a panic attack strikes it is very helpful to have some proven coping skills at the ready. It is wise to get familiar with these strategies by practicing them in advance.

Tips for managing a panic attack include:

• It will pass. Remind yourself that it is temporary, not life threatening, and try to stabilize your self at the very outset of the event. A grounding technique involves observing your surroundings and finding five items you can see, four things you can touch, three things you can hear, two things you can smell and one item you can taste. This pattern helps to distract from the feelings of fear being experienced.
• Deep Breathing. Concentrate on slow, deep breathing. Deep breathing technique should be practiced on a regular basis so it becomes second nature when needed during an attack. Deep breathing involves breathing in through the nose slowly for 4 or 5 seconds, filling both the lower lungs and upper lungs, allowing the chest to expand. Hold the breath for 4 seconds, and then slowly exhale through the mouth for 5 seconds, pushing the air out entirely. Repeat this pattern several times until you feel your body begin to relax.
• Go with it. Try not to fight the panic attack, but instead accept you are having one and reassure yourself it will soon pass. Use positive self-talk, such as telling yourself, “I have survived these before,” or “This too shall pass,” or “I am going to be fine, everything will be okay.” These affirming thoughts can override the sense of fear while helping you feel you are in control.
• Get help if needed. Don’t be afraid to ask for help, even if it is just to have someone accompany you so you can get outside in the fresh air. Sometimes, just taking a short walk, alone or with a friend, can help you get through the panic attack. If you fear the panic attack is out of control, ask someone to get you to the hospital for an evaluation.

Elevation Behavioral Health Provides Residential and Outpatient Treatment for Panic Disorder

Elevation Behavioral Health is a private mental health provider located in a luxury home setting in Los Angeles, California. The intimate setting nestled in a beautiful hillside location offers the healing environment so helpful to individuals suffering from constant panic attacks. At Elevation, a compassionate and knowledgeable staff will nurture the individual while teaching new techniques and coping skills that will help them manage panic disorder going forward.

The program is integrative, meaning that treatment involves a blend of evidence-based psychotherapies, adjunctive therapies, medication, and holistic therapies. The goal is to help each individual reclaim a sense of control over their world and to enjoy a better quality of life. For more information about the program, please reach out to our team at (888) 561-0868.