August 17th, 2010
11:28 AM ET

Why is panic disorder a psychiatric condition?

Every weekday, a CNNHealth expert doctor answers a viewer question. On Tuesdays, it's Dr. Charles Raison, an associate professor of psychiatry and behavioral sciences at Emory University, and an expert in the mind-body connection for health.

Question asked by Chad of Richmond, Virginia

Why is panic disorder classified as just a psychiatric condition when there are so many physical symptoms (some painful) that arise during the attack? They would occur whether in good/bad mood, or even asleep.
Expert answer:

This is a great question that cuts right to the heart of mind-body medicine. Panic attacks are a great example of how our false dichotomies between emotional and physical issues really don't stand up to the way the world really is. Panic attacks are so physical, in fact, that they are often first diagnosed when a person goes to the emergency room absolutely convinced that he or she is having a heart attack.

Let me ask you some questions in return. Why do people with major depression tend to have increased heart rate and blood pressure, and why do they have increased inflammation, just like people who are sick? Why does stress early in life greatly increase a person's risk for developing heart disease, diabetes and dementia later in life? Why do the bodies of people with schizophrenia seem to have a metabolism that puts them at risk for diabetes? Why - back in the old days before modern medications - did nearly 5 percent of all people admitted to psychiatric hospitals drop dead from their psychiatric diseases, usually after developing fevers as high as 110° F and becoming stiff as boards?

You get my point. Because the mind and body cannot be separated (except perhaps by the guillotine!), mental processes affect the functioning of the body. And bodily processes affect the functioning of the brain. These days, this is one of the hottest areas of scientific research in medicine.

So that is one answer to your question. The other answer is that historically, illnesses are psychiatric until a clear cause for them is found, and then they tend to migrate over to other medical disciplines. The classic example of this is the insanity that often accompanies syphilis in its advanced stages. A century ago, syphilitic patients filled psychiatric wards. Then, antibiotics were discovered and the responsibility for preventing syphilis-related insanity became the province of infectious disease doctors.

As a psychiatrist, it is kind of discouraging that if we researchers do our job right, there may be no "psychiatric" illnesses left in 100 years. They may all be understood, and as a result will have been farmed out to every other medical discipline, as appropriate.

soundoff (103 Responses)
  1. Kelly

    Dr. Charles Raison, please continue your education, as you are mistaken in your opinion.

    August 17, 2010 at 11:37 | Report abuse | Reply
    • E. Saab

      Kelly: Exactly how is he wrong? I lived with my wonderful wife for almost 20 years. She suffered terribly from panic attacks, and knew deep down that it had to do with false and unknown triggers for the "fight or flight" response. There never seemed to be a cause on the outside, except that it always seemed to be worse in the heat of summer (may have had something to do with more sunlight, for some reason). It took a long time for doctors to understand that what she was experiencing was not in her "head," but that it could be controlled with those special medicines. She's doing great now but medicine and regular excercise have played a huge role. Dr. Raison is on the mark. I know.

      August 17, 2010 at 12:27 | Report abuse |
    • Tired o'Morons

      Wow, Kelly, you know so much! Why are you relegating only to commenting on news boards? You should be on Oprah!

      August 17, 2010 at 13:24 | Report abuse |
    • julie

      I think most things are somehow stress related. I wonder if anyone could really describe themselves as really "happy." We often look at hollywood and all its money, but even people with everything aren't happy. they commit suicide, overdose, and have all kinds of problems too. I have had problems with panic attacks, but for me they were stress related.

      August 17, 2010 at 14:42 | Report abuse |
    • sue

      The doctor is right. I have panic disorder with agoraphobia. It manifests itself in a very physical fashion but, those symptoms go away as the disease is treated.

      August 17, 2010 at 20:49 | Report abuse |
    • Richard Polley

      we all exist in a s'mental' state of consciousness with all the emotional extras. Most of us are primarily emotional and fewer are primarily unemotional or less emotional, living in a different, intellectual or abstact thought state of 'mind'. Some are more abstract , perhaps 5-10 percent of the population. The rest of us are emotional, listen to emotional music, watch emotional shows, wallowing in it, stepping through it...etc. We live in a state somewhere between coma and psychosis. it is actua;lly amazing that we function as well as we do. Finally, one must look at success and balance in life, what are those factors? after all, we are all 'bi-polar', sleep/awake, hungry/full, thirsty.sated, angry/love...everything in our perspective is dualistic, evenour brains were once seen as two large lobes, but anyway, we can be SELF AWARE AND SELF CONTROLLED.
      LISTEN TO SOOTHING MUSIC WHEN PANICING AND LISTEN TO ROCK N ROLL WHEN DEPRESSED, HOT/SPICY WHEN DOWN, PABLUM WHEN EXCITED. UNFORTUNATELY, MOST JUST DO the impulsive thing. Poor training, upbringing, not so much genetics. Poor self control. Poor thought processing......that is the best effect ofd an education...better thought processes. Finally, yes, the universe is beyond us, here we are in the middle of the unfathomable...that alone may drive a few to nuthood. So, ZI believe in something BIGGER THAN ME- God and however you may conceive of god, I suggest He is about improving self control and our thought process and calming us down and helping us to live happier lives together. Because we are here together. Let's help each other.

      August 19, 2010 at 09:26 | Report abuse |
    • diz19552003@yahoo.com

      I have fought this for 25 years – the doctor is right. Listen to him.

      August 23, 2010 at 08:05 | Report abuse |
  2. George B from Ohio

    I suffer/suffered from panic attacks. There was no apparent trigger to them (i.e. giving a speech, family turmoil etc.) they would could occur during the most stress free days. Typically I would wake up in the middle of the night with a pounding heart and a sense of dread that I cannot fully explain (as someone one said, take an anxiety attack and multiply it by 1000). It was a couple of years of hell until I found a doctor who told me I wasn't losing my mind, my nuerotransmitters were out of wack. I take Lexapro every day (before I go to bed) and have had no indidents in years. Stop taking the seratonin-uptake meds for a few days and things start to get a little shaky. So you tell me if it is mental or physical.

    August 17, 2010 at 11:47 | Report abuse | Reply
    • JB

      I think it's a physical expression or outlet for a mental situation. The mental situation is often very difficult to define, pinpoint and overcome so meds can be required.

      August 17, 2010 at 12:13 | Report abuse |
    • Linda

      I also suffer from a panic disorder. It is not a mental condition because I can not stop the attacks once they start. If it was a mental condition, I could "think" my way out of it and believe me I have tried.

      August 17, 2010 at 12:32 | Report abuse |
    • Kelly

      JB is a moron. It can be physical or psychological. I have had them myself with ZERO warning. In the middle of happy episodes. Friends describe me as a happy person and no its not fake. I know my FREAKING body. This jerkoff of a doctor needs to do the world a favor and shoot himself because he is helping no one with this misinformation. Stop demonizing patients and help them you scum.

      August 17, 2010 at 14:33 | Report abuse |
    • JB

      Kelly I'd say based on your vitriol you definitely have some mental issues (calling a stranger on the internet a moron) and you don't know yourself as much as you think. Perhaps an educated 3rd party who studies this type of stuff instead of your friends opinions can do you some good. There are alot of things going on in the subconsious that give rise to these "out of the blue" episodes. Just look at the number of posts that say they happen while waking up in the middle of the night. I started my comment with "I think" which means it is my opinion. What makes yours more valid?

      August 17, 2010 at 14:48 | Report abuse |
    • AGeek

      Linda: they're *purely* mental. Having been through them for 22 years, there is no "thinking your way out" because the fight or flight response comes from the primitive brain. It's a survival mechanism which operates at a level you cannot simply "think" your way out of. It's designed to keep you alive. Basically the same part of your brain that's responsible for you breathing, blinking, and keeping your heart beating. You can't think your way out of a panic attack any more than you can think your way out of stopping breathing.

      August 17, 2010 at 16:13 | Report abuse |
    • Rhonda

      You sound like me. I suffered with severe panic attacks from the time I was nine years old until I started taking Lexapro about 6 years ago – I'm 45 now. I'm ok as long as I take my meds. Take them away from me and things definitely become a little "shaky".

      August 17, 2010 at 16:29 | Report abuse |
    • Claes

      Linda I think you have misunderstood something rather terribly. Every noticed that sometimes an idea just pops to your mind? It's because there are unconscious parts of the psyche. Believe me, if I hadn't realized that my problems were psychological rather than physical, I'd be in a really bad shape right now – keeping on fooling myself about feelings, not taking steps to correct certain things in my life... The psyche exists in a physical medium – there is nothing magic about it – but it's "more" than this medium in the same sense that a human is more than her atoms. For example, if we want to add energy to our body, we are well adviced to take this "moreness" into account and not just hook up 380V to our noses – I mean energy is energy right? Of course it's not. Still, of course, this means that the psyche is accessible from two directions: tuning a transmittor substance is a poweful but blunt tool

      August 17, 2010 at 17:42 | Report abuse |
    • DW

      Right, It's not mind over matter or analyse your way out of it . You can't think your way out. It operates in another part of the mind. Something triggers the "Fight or Flight" syndrome where brain interprets the triggering as life threatening even though it isn't. The part of the brain experiencing this is the primitive part so it pumps out the adrenderline into your system. It's the like a feeling you would get if someone would toss you off a 50 story skyscrapper. Over time you go into avoidance mode accept the problem escalates and spills over into other areas. Over time you build neuro pathways in the brain so when a "trigger" comes along the brain thinks it's a life and death situation. As long as you keep experiencing these negative events, your neural pathways become entrenched.

      The cure is to desensitize yourself to the triggers. Instead of avoidance, you must engage gradually the triggering event. You do this by assessing your feelings and when you feel unconfortable, you back away. You always want to have a positive experience because you are training your brain that this is not a life threatening situation. By doing this you are developing NEW nerual pathways. The GOAL is that over time when you face that trigger, the brain no longer considers it life threatening. The desensitization process can be helped by CBT or medication such as Xanax.

      For instance for me, I couldn't travel over bridges in a car so with medication, I was able to get close to them and gradually over time I was able to cross the bridges with no problem because I developed the proper neural pathways that told the brain this is not life threatening. Hope this helps.

      August 19, 2010 at 01:38 | Report abuse |
  3. Don F from Nashville

    I have suffered from panic attacks since 1996, age 36; I was rushed to the hospital because I thought I was having a heart attack. There are really no words to describe a panic attack, except perhaps sheer and utter terror, thinking you are going to die. As much as I hate it, I have to take medication every day just to be "normal".

    August 17, 2010 at 12:11 | Report abuse | Reply
  4. wise one

    cut caffeine out of your life entirely and watch the panic attacks go away

    August 17, 2010 at 12:21 | Report abuse | Reply
    • Bravo1

      Cutting out caffeine helped a little, but certainly didn't cure, my panic attacks. Beware of blanket statements.

      August 17, 2010 at 12:33 | Report abuse |
    • Tired o'Morons

      "Wise One," do you REALLY believe it's that simple? Do you?
      Hold a press conference and educate the thousands of professionals who've spent so many years in school. Please!

      August 17, 2010 at 13:26 | Report abuse |
    • themama

      I have had panic disorder since the age of 4. I am now 34. Coffee/caffeine, has nothing to do with it.

      August 17, 2010 at 13:54 | Report abuse |
    • mttrailboss

      What a stupid comment. 'wise one'.., more like dumb one. LOL Mike in Montana

      August 17, 2010 at 14:19 | Report abuse |
    • AGeek

      Wise One: Caffeine is one small part, but in no way, shape, or form the whole thing. Not even remotely.

      August 17, 2010 at 16:14 | Report abuse |
  5. Juan

    I too have had the dreaded "Panic Attack". For about a year I would wake up almost every night with a racing heart, clammy hands and in full on cold sweat. I don't wish this feeling upon my worst enemy. I guess I wasn't dealing with my issues and it eventually crept up on me one day while high on Marijuana. My mind would think irrationally and I would work myself into a frenzy. My life was hell for that year I would hardly sleep. Through Therapy and physical exercise I was able to control the panic and have succeeded in doing so, without drugs. I am now much more in tune with my body and my mind and I can truly appreciate the power of the mind. If you let your mind win it will F@#$ your body over. I think all people are different as well as triggers. We are all unique and need custom help. My 2 cents.

    August 17, 2010 at 12:22 | Report abuse | Reply
  6. Michael

    I first had a panic attack then several weeks later quintuple by-pass surgery. I have suffered from depression for over 20 yrs. It's usually always there,some days when I am busy doing something I like,it seems to disappear,but one day a week,it can make you -numb.and wishing it would just end.I can't and will not go on living like this. I have tried most of the serotonin reuptake inhibitors. I tell you ,depression is worse than cancer.At least with cancer it usally ends. My best friend recently died from Ca of the lung,brain and liver and it is sad to say,I would have gladly traded places with him if I could.

    August 17, 2010 at 12:44 | Report abuse | Reply
    • SweetStuff

      Michael, your post struck a cord with many of us I suppose. We all feel the way you do many times during our lives. Coping with the injustices in life are a challenge to say the least. There are treatments and this can be controlled, you have just not found the right combination. For me it was reading books to take my mind off 'my troubles', and 6 months of Lexapro and Remeron. I discovered that sweating for 30 minutes everyday helped immensely when weaning off the meds. Getting your heart rate up, yoga and lifting weights are a great companion to the meds. My goal was to get off of them and I have so far for over 4 years. We all have so many things inside, like an ocean of tears, that we have to deal with at some point in our lives. Talk to someone, that is ultimately the great cure. It is all very physical as well as the 'brain noise' we all have to silence. My turning point was reading Tolle's books, I am a Christian and had a hard time with some of the suggestions, but I got through them and use the stillness exercises everyday to cope with the cruelty we see throughout our lives. You will make it through this if you have the desire to, if you can't think of a reason to get better, find one. This is treatable and manageable, I think the ones of us who have panic disorders are the sane ones, I know this sounds contradictory but I really believe it. I think we see life in a different way and really despise hate and injustice to the point that it affects us literally in every way. I now only try to control myself and no one else, how I act and react is in my control and that has helped immensely!!! Enjoy today, it is possible. Good luck!!

      August 17, 2010 at 13:54 | Report abuse |
    • AGeek

      Michael: I've walked in your shoes for 22 years. SSRIs didn't help much. What helped the most was Clonazepam (*not* xanax!!). This helped my brain 'level set' but at the cost of a blurred memory. I remember the first three years of my youngest child's life like it was a sketchy movie ..ditto the first six years of my older child's life. The upside is I was able to function (most of the time) and be happy (most of the time, from what I can remember). I wasn't relegated to staying inside and not going anywhere, like I was before taking Clonazepam.

      Investigate switching from SSRIs to clonazepam with your doctor. Brain chemistry is unique from person to person and I can't say they *will* help you, just that they did help me immensely. I wish you peace.

      August 17, 2010 at 16:19 | Report abuse |
    • JenniferCA

      I had tried all the SSRI's to without much help. Finally got prescribed Effexor, which is a SNRI (acts on seratonin and norephrin receptors) and it finally worked. It turne dout my anxiety was fueling my depression so this was the combination for me. There are some annoying side effects but n othing as bad as wanting to put a bullet in my head everyday. Good Luck

      August 17, 2010 at 16:40 | Report abuse |
  7. scottk

    There is no doubt that this is a real occurance that is based in the brain that causes physical actions in the body. It is really difficult to distinguish between the "mind" and the physical makeup of the brain. Your thoughts are chemicals and connections that make up the nerves and those chemicals and wiring make up your "mind". A thought affects the physical structures of the brain. Panic attack is caused by a cycle of fear of loss of control of body that amplifies as you sense your heart racing etc that feedback to further increases the fear. You can break that cycle by just laughing out loud. It basically breaks the circuit and restores your conscious ability to exert control of your body.

    August 17, 2010 at 12:55 | Report abuse | Reply
  8. TC

    I'm just recovering from a month of panic attacks that started with stomach problems. I was convinced something was wrong and after two ER visits for panic/high blood pressure found out there was no problem with the stomach. How did a one-time extreme heart burn turn into a month of Adavan popping anxiety, panic and eventually Zoloft which has been very helpful. Was it the brain or the body, I'm still perfectly unsure. The stress was just there waiting for a good excuse is more likely.

    August 17, 2010 at 13:26 | Report abuse | Reply
    • Unnamed

      Wow TC, that is my exact experience. Had a jerkoff doctor at the E.R. just assume it was all my fault. I NEVER had panic attacks in my entire life before that instance. After numerous tests, doctors, and buttloads of money, I found out it was FOOD ALLERGIES that caused it for me!!! No joke. Something triggered in my body after that experiences so that now I cannot tolerate any milk products. I tested it and start having breathing problems, indigestion and anxiety. I kid you not. ADULTS HAVE FOOD ALLERGY PROBLEMS but we get overlooked.

      Do not beleive the lie that only kids have them. The media is responsible for this misinformation.

      Get a food allergy panel test done. It is well worth it. DEMAND IT. You may get a doctor or two that will not do it because they dont want you to find out whats really wrong, they want to give you life long medications instead. I am much better now. 🙂

      August 18, 2010 at 15:15 | Report abuse |
  9. Rebecca Berlier

    I have anxiety and panic attacks so frequently. I have looked on Web MD and I have every single symptom. I am on Xanax, but it is so addicting and they claim there is nothing that can give you to help without the danger of addiction. This is NOT just a mental problem, in that it manifests itself in medical symptoms. There are reasons for mine, but sometimes an attack will just come on me. I have been in the ER at least 4 times in the last few months. I too would not wish this on my worst enemy. I feel it is ruining my life and I have a hard time finding joy or anything that interests me. I am a 56 yr old woman who lives out in the country with just one vehicle at the time, and the isolation I feel l know does not help my condition. I wish they could treat this with something that helps the symtoms but don't make you addicted...

    August 17, 2010 at 13:30 | Report abuse | Reply
    • SweetStuff

      Rebecca, your post is so heartfelt and crying out for answers. The Xanax is a quick fix and intended for very short usage. I used it after weeks of not being able to eat because of panics, and weaned off it as the anxiety meds kicked in. If this is the medical advise you are getting you need to seek better care. It is addicting and can lead to more problems, not less. Don't stop cold turkey, get good medical care and another med to accompany the weaning. Xanax is better used during an active attack, not for depression or isolation issues. You can feel alone in a large room of people when you are in the thick of this disorder. I had/have anxiety issues, but depression was never part of it, they are 2 different issues. Many times they accompany each other, but not inevitably. Find out what you are dealing with, depression, bi-polar or anxiety and get started treating it, not putting a terrible bandage on it!! Good luck!!

      August 17, 2010 at 14:09 | Report abuse |
    • geogirl

      I have been diagnosed with panic disorder. Now that I look back I have had anxiety issues all my life. I have done the therapy thing, tried to eat well, exercise, etc. The only thing that keeps my anxiety/panic disorder in check is my antidepressant. I am on 10 mg of Lexapro and have been for about 7 years. It does wonders. It is not addictive like xanax or ativan. I have ativan for those quick fixes of massive panic attacks that can happen suddenly. Try going to your doctor and asking about an SSRI so you can get off of the addictive xanax. I know it's stressful! I can feel your pain!

      August 17, 2010 at 14:43 | Report abuse |
    • Teena

      Rebecca, you should try Buspirone. I have struggled with Panic Disorder for may years and they kept trying to treat with me Anti-Depression medication. I am not depressed, but I felt depressed from having Anxiety and Panic attacks. This is the only drug that has made a difference and it is not addicting. Good luck!

      August 17, 2010 at 15:18 | Report abuse |
    • AGeek

      Rebecca: *please* find a different practitioner. Panic Attack/Panic Disorder should not be countered with Xanax. a) Xanax has too short a half-life to be effective, b) it's addictive, and c) it's about 20 years out of date as a treatment. Clonazepam tends to be FAR more effective. It's also a benzodiazapine (like Xanax), but is formulated differently, acts longer, and is less addictive. However, it does have tradeoffs. *WARNING* BOTH Xanax and Clonazepam, depending on dosage, should *never* be discontinued abruptly. Benzodiazapines can cause seizures and other life-threatening conditions if you stop taking them from a full dosage. Work with your doctor to switch off Xanax.

      I was on Xanax for many years. Then I found a new doctor who explained why Xanax was bad, switched me to Clonazepam, and now I can leave the house. I'm not perfect, but I'm miles from where I used to be.

      August 17, 2010 at 16:30 | Report abuse |
  10. RoscoeChait

    "Because the mind and body cannot be separated (except perhaps by the guillotine!)..." Hey doc, I bet you're sorry you made that comment. It turned an otherwise interesting description into something grisly and horrible. It brings up images from Dickens' Tales of Two Cities where the villain, Madame deFarge, in the French Revolution, sits in her rocking chair knitting while watching heads cut off with the guillotine. In real life, so many were unjustly executed by using this barbaric device.

    August 17, 2010 at 13:36 | Report abuse | Reply
    • Kelly

      I agree. This doctor is a complete quack. Please stop posting his idiotic articles.

      August 17, 2010 at 14:36 | Report abuse |
    • JB

      Kelly, anger and fear are closely related. I think bringing your anger issues up with a good therapist may be the start of a wonderful recovery from your condition.

      August 17, 2010 at 14:53 | Report abuse |
    • Ralph

      I have tried just about every anti-depressant on the market—from my experience, all classes of these products produce a lethargic mental reaction and reduce proactive motivations such as exercise, and all I want to do is eat, sit or sleep all of the time. The main question that I try to answer (for myself) is whether “fight or flight” is a survival mechanism in humans with real peril present (like being a coal miner, or living in caves and getting dizzy if there is methane present) or is it just a mental process gone amuck which sets off a series of hormonal “attacks” on the body or both?

      August 17, 2010 at 18:14 | Report abuse |
    • Dale

      JB, don't be such a prick.

      August 18, 2010 at 15:17 | Report abuse |
  11. Sheila

    Unfortunately, in many cases where the mind may be involved, psychiatrists are too quick to put the patient on psychiatric medications than to analyze the physical symptoms and sent the patient for further medical evaluation with the appropriate specialists. Sometimes a patients symptoms may require 2 or 3 specialists.

    Depression is often an underlying sign of physical change in the body, such as a hormone imbalance (such as peri-menopause in women), an undiagnosed disease, even a dying or injured nerve. Depression can be brought on by anesthesia's such as the epidurals during childbirth or anesthesias for surgery, or even those used in the dentist office.

    Foods can also bring it on. A long time ago, I used to get depressed whenever I ate a particular item at a major fast food chain. I am convinced it was something in the bun...a preservative perhaps or someother non-food chemical. It doesn't happen anymore, so maybe they changed suppliers or a different recipe is used.

    Psychiatrists need to quit being lazy and quit padding the bank accounts of Big Pharm and get serious about finding the underlying problems that are really contributing to people's problems. A prime example is Diabetes which can "appear" as bipolar disorder because of the up and down swings in blood sugar.

    August 17, 2010 at 13:37 | Report abuse | Reply
  12. Kristen

    I went to the ER back in December thinking I was having a heart attack (slightly plump, non-smoker). I realize now that it was a panic or anxiety attack. I denied it at the time because I was not stressed about anything. At all. I was actually happy around that whole time. I really do't think these attacks are "in my head". Of course, if you go in with chest pain they only treat you for heart attack, not trying to figure out what is actually wrong (thnaks to all those wrongful death lawsuits). Now I realize that if my chest hurts and I can't breathe that I need to slow down, and breathe carefully. So far being able to recognize that the pain will not last forever and that I am not in fact dying helps a lot. If the symptoms progress then it will be time for medication. Wonder why this all started after I turned 40.

    August 17, 2010 at 13:41 | Report abuse | Reply
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  13. Charles

    When I went to the ER for the first time because I was obviously having a heart attack – I was checked out and everything was fine. The following four times – I was fine. Physical stress test, blood tests, electrocardiograms, etc. Nobody said anything about panic attacks. During this 2 month period, I did a good job (considering) keeping a third eye open and not completely going crazy not knowing what was wrong with me. Finally, I did have a minor something-or-other (not a panic attack) and went to a clinic and begged for something to calm me down from worrying about not knowing what was wrong.

    Finally, my doctor said, “You need to go to a psychiatrist.” That’s all he said. While I knew I was going crazy (from worry, not from the hypertensive emergencies), I thought he was crazier than I was. Whatever this was wasn’t psychological. I refused to go.

    I talked to a friend of a friend who wasn’t a doctor but worked in a doctor’s office. She said it sounded like I was having panic attacks. While I had been all over the web searching for hypertension and heart attacks and whatnot, I had never considered panic attacks. I really didn’t know anything about them. I thought they happened to people in situations – not just out of the blue. And – after two months of absolute hell – there was no way I was going to accept this diagnosis.

    It took me two weeks – mainly reading about panic disorder on the web – until I finally said to myself, “This is it. Obviously. Non-agoraphobic panic disorder. Genetic. Evolutionary.”

    And it was. The concurrent ‘worry’ stopped. When I’d have any sort of panic attack I knew what it was and dealt with it. With a new doctor, I was put on Zoloft and given some Xanax.

    But why wasn’t this explained to me the first time I walked in the ER? At least as a strong possibility? For two months I was lying in my bed taking my blood pressure every five minutes or having limited or full panic attacks. I almost did ‘go crazy’ because nobody told me I wasn’t crazy. Mind-body meld. Fine. I’ll buy that. But TELL me.

    As soon as I realized that I had panic disorder – I haven’t had a major panic attack. Tons of small ones. They come and go, no trigger I can discern.

    If the doctor in the ER the first time had said, “There is a very good chance that you had a panic attack, might have panic disorder. Here is some literature. Research it. Tell me what you think,” – then I probably would have accepted it after a bit of research – and wouldn’t have gone through two months of absolute hell.

    August 17, 2010 at 13:41 | Report abuse | Reply
    • Betty

      Glad that you were able to take Zoloft to improve your situations. Zoloft made my system rev up to 130+ pulse the two times that I tried it which caused some anxiety until I figured out the connection. Fortunately I knew enough to check my pulse. As for the ER doctors not diagnosing your panic attacks, if you didn't seem like a nervous person, they were going to look for valid medical reasons. Unfortunately you weren't able to find the anxiety diagnosis earlier, but fortunately you have since then. Now we have these websites where we can learn more and pass information around to maybe help us. On another note, at least the doctors didn't just give you a psychiatric diagnosis instead of trying to find a medical answer......

      August 17, 2010 at 15:58 | Report abuse |
  14. lewax00

    I've only had a panic attack once...it definitely has physical symptoms: I started hyperventilating enough to throw off my blood pH and cause my hands to go numb. A paper bag is useful in such a situation, but only if you have control of your hands so you can actually use it.

    August 17, 2010 at 13:49 | Report abuse | Reply
  15. Pamela2010

    I disagree with this article. This man sounds like a real piece of work. He is probably some balding, pot-bellied, middle aged white man who treats his wife like crap, hates the 'illegals', and think all women's diseases are because they are being irrational. He sounds like he fits in the 1950's. Too bad he didn't die back then. What a jerk.

    August 17, 2010 at 14:38 | Report abuse | Reply
    • JB

      You could just list a bunch of insults and preconceptions about this doctor, or you could list some things about the article you disagree with and propose an alternate viewpoint. Which would be more helpful to the discussion?

      August 17, 2010 at 15:04 | Report abuse |
    • Liz

      Pamela2010 – your comments are frightening. Your angry comments could only come from someone who is very unhappy and looking for a place to unload it. This doctor makes valid and documentable comments. Perhaps you need some help – – therapy or medication to deal with your anger issues.

      August 17, 2010 at 16:14 | Report abuse |
    • Oscar

      I agree with Pamela though she was pretty harsh. This guy is a major quack. I looked him up and he should seriously have his licence revoked.

      August 18, 2010 at 15:20 | Report abuse |
  16. geogirl

    I am a high school science teacher and I wouldn't believe in what this doctor is saying unless I have been there. I have been diagnosed with panic disorder and it's real. I can teach all day and be fine. No stress there and then suddenly I'll get struck with a panic attack for no reason.

    I have been checked twice for gall bladder problems due to terrible pain. It always checks out fine. Yes, there are physical ailments associated with this disorder. It can be different for different people. I don't think psychiatrists are lazy at all. They are dealing with the nerve center of our body. I can say that without my pdoc and his work with me and my meds I wouldn't have any quality to my life. Because of my lexapro I can teach, push the limits of my phobias (heights, claustophobia, etc.) and be okay. I can be there for my kids. Imagine the flare-up I had when I found out I was having twins. I have raised those babies, who were premature, and haven't had as many panic attacks as I would have had without those meds!

    August 17, 2010 at 14:50 | Report abuse | Reply
    • JB

      geogirld, you say you get struck with a panic attack "for no reason" then go on to list your fear of heights, claustrophobia, fear of the difficulties of having twins, of not being able to teach. Perhaps a combination of these things are the reason? Have you added a therapist to your treatment instead of just a psychiatrist? Just throwing some ideas out there. No need to respond with negativity if you don't buy it.....

      August 17, 2010 at 15:00 | Report abuse |
    • geogirl

      Just to clarify–I have never had a fear of teaching. Most people would have this, with or without panic attacks. My point is–some things could trigger the attacks such as fear of heights, which I can finally confront, yet other situations that would normally be stressful to the majority of populations wouldn't have an effect on my panic disorder. I have done therapy. I have done eating well and exercising. Both my doctor and I decided that for me, I needed to be on medication because I have a chemical imbalance. Just for the record–anyone who says that having twins wouldn't be a stressor in ones life would be lying! Although it's empowering, it's also a cause of some major stress: two infants/toddlers needing you at the same time–that will get your adrenaline going!

      August 17, 2010 at 17:05 | Report abuse |
    • JB

      I say this because I have a fear of women. I know it sounds weird but I have a hard time talking to a women. I feel very inadequate in many areas. My first time with a woman, she laughed at me because she could not believe how small I was. I have a condition that prevents me from..ahem. It really bites. Now I drown my sorrows in ice cream and video games. Needless to say I get panic attacks too.. but at least I know why.

      August 18, 2010 at 15:22 | Report abuse |
  17. Beth

    I am 21 years old and have suffered from panic attacks as far back as I can remember. I remember being in kindergarten and going to the nurse every single day with "a stomach ache" and super nausea. I was too young to understand what was happening or how to express what I was feeling to those around me. Once I got older, around 12, I was diagnosed with Major Depression and Severe Anxiety. I remember when I realized that those "stomach aches" were actually panic attacks.. it all made sense to me. I still have horrible panic attacks, even though I am medicated for it. They mostly happen in the morning when I first wake up. My thoughts race, my heart beats, I cry, and eventually it leads to me vomiting. I had to quit my last job because I was having panic attacks so frequently and intensely.

    Honestly, the only thing that instantly calms me down when I start feeling an attack come on is smoking pot. It instantly takes away my nausea and calms me down to where I can actually think rationally and stops my head from becoming a vicious circle of panic-stricken thoughts. Even though the medicine I'm on has reduced the frequency of my panic attacks, pot is the only thing that makes them subside them once I start to have them. I don't know why smoking works, and it will probably be disputed for years to come, but in my own personal situation, it has helped me to overcome my anxieties and become a functioning member of society, with a good job! =]

    August 17, 2010 at 15:01 | Report abuse | Reply
    • Patty

      I haven't tried 'pot' myself for a number of reasons including nausea from the odor, but did know of others who had hallucinations after use. It's not a sure cure remedy for anxiety attacks if it's from social situations. Personally I've had panic attacks from too many close encounters with sober reckless drivers on land as well as on boats let alone 'high' ones, Beth. And I'm the one now who needs to take occasional RX for anxiety and go talk to someone occasionally.

      August 17, 2010 at 15:47 | Report abuse |
    • Beth

      Well, like I said, I'm not sure why it works for me. It just does – without any side effects too. I never have had any type of hallucinations, but then again never smoke more than a few puffs. I feel its more dangerous for me to take Xanax and then get in a vehicle than it is to smoke a little and then drive. Again, I'm not speaking for anyone else.. it just my opinion and what works for me.

      August 17, 2010 at 15:55 | Report abuse |
  18. Erin16

    I have suffered from panic attacks for almost 10 years now...im only 20. Whenever I had an attack it was the worst feeling in the world! It effected my friendships, family relations, school, and body. Instead of going to soccer practice after school, I was huddled up under the covers in my room waiting for my attack to end or cramped in a therapists office so i could talk about my feelings. They happened whenever...no triggers whatsoever. After 3 years of just living with this and not knowing what was wrong with me (and multiple ER trips) they finally prescribed Paxil. I have been taking it everyday ever since and I feel 120% better. I appreciate my life now and I can't wait for a new adventure or outing. Even though this took so much of my childhood, I'm slowly able to gain my life back.

    August 17, 2010 at 15:04 | Report abuse | Reply
    • Beth

      Girl, I know exactly what you mean – when you have panic attacks its affects every single aspect of your life. My adolescence was spent hiding in my room. I never went to social activities.. football games, dances, parties.. count me out. I'm so glad to hear you're on the road to recovery.. because I can definitely relate to everything you said.

      August 17, 2010 at 15:14 | Report abuse |
  19. Justin

    I have been diagnosed with panic disorder for 12 years, I have tried certain drugs to see if they would help me. Within the past two years I have been given Atavan to help curb my anxiety and it helps. Nothing else helped, in fact Zoloft increased the frequency AND the intensity at which I would have panic attacks. I exercise and help maintain healthy eating habits but if it wasn't for the Atavan I think I would have curbed a lot of things I do now, I would never attempt.

    August 17, 2010 at 15:13 | Report abuse | Reply
  20. RWK

    I suffered from panic attacks, both triggered and aparently random, for many years before being diagnosed. I have also suffered from depression for much of that time. While my life has been far from perfect, I don't think there is any trauma or other experience that would have caused these problems. In other words, it is nature, not nurture. I am currently on lorazepam and wellbutrin, and these help somewhat, but there is the addiction problem and the depersolaization problem. Psychiatry is helping, but it is far from curing me. Psychology (therapy) helps me by identifying the problems caused by my physical condition and helping me avoid them, and reversing the damage that years of psychiatric neglect caused me. I am really glad I live in a country like the United States where psychiatry is respected, as opposed to Germany where it is stigmatized, and many medications simply not available because of the risk of dependancy.

    August 17, 2010 at 15:21 | Report abuse | Reply
  21. Liz

    Kelly – wow. I think you need some serious behavior drugs or therapy. Your comments are so angry. Name calling and suggestions for the doctor to shoot himself. Get some help. I've had depression/mania and anxiety problems most of my adult life. After ruling out physical or causative factors, psychiatric docs helped with talk therapy and medication. The reasons for such problems vary from patient to patient but medication can help. As bad as depression was, anxiety attacks nearly drove me off the edge at 100 mph. It's acute, ice-cold fear that is suffocating. When you're in so much mental and physical pain, if nothing else helps, get a good psychiatrist and take the drugs. It gave me back my life.

    August 17, 2010 at 15:22 | Report abuse | Reply
  22. Corster

    I'm 37. I've had panic attacks for the last 8 years. My very first one happened while I was relaxing watching television while the family was out of town. All of a sudden my pulse spiked to like 140 for no reason at all. I wasn't "stressed" or "worried" about anything. I have a good job and a good life with no "major" problems. When my family came home the next day I asked to go to the hospital thinking I was having a heart attack. My pulse was at 150 and my blood pressure was 180 over 120. I was in the cardiac unit for 3 days when the doctors concluded that "it must be anxiety". I still get panic attacks all the time, but I've learned how to deal with them. As long as I know "it's just a panic" attack, it feels nothing more than a nuisance since worrying about it makes it worse. I keep meds with me in case they get really bad, but for the most part I don't need them at all. I'm not sure if I agree with the blanket statement that "it's purely psychological" This may be true in some cases, but it certainly does not apply to me. I love my family, I love my job and I'm pretty much considered a "down to earth" kind of guy. As far as prevention goes, I try to keep in shape (running on the treadmill for 20 minutes 3 times a week) and I drink ZERO caffeine. Caffeine triggers my panic attacks like gas on a flame so I don't even take chances with it anymore.

    August 17, 2010 at 15:23 | Report abuse | Reply
  23. Corster

    I also forgot to mention that I've tried paxil and other anti-anxiety drugs, but they tend make my anxiety even worse. Instead, my doctor gave me nadolol (which is simply a blood pressure medication to lower blood pressure and pulse) and lorazempam to handle sudden severe panic attacks. The latter is only to be used as an emergency when it is "the worst I have ever felt" since it is extremely habit forming.

    August 17, 2010 at 15:27 | Report abuse | Reply
  24. Jackie D

    I recently have been diagnosed with anxiety. I take 10mg of Cipralex a day to help and I have turned to books for some more support. "Add more -ing to your life" by Gabrielle Bernstein has been helping me a lot lately. She walks you through different techniques of meditating to release the negative feelings i have been bottling up over the years. I have chosen to deal with my body by taking medication and reading to deal with my mind. So in a sense...it is both. But this doesn't completely stop my aniexty attacks...those come and go like the sunrise!

    August 17, 2010 at 15:28 | Report abuse | Reply
  25. Long time panic sufferer (30 years)

    Panic attacks originate in the amygdala area of the brain. This is the primitive area of brain responsible for the fight or flight response.
    No amount of talk therapy, e.g., CBT, is of any use. Cymbalta is a wonder drug for panic disorder.
    Try it, you'll like it.
    My hope is that the neuroscientists will start investigating the source of the panic, the amygdala of brain, and develop a blocking agent for its transmitter signals.

    August 17, 2010 at 15:31 | Report abuse | Reply
  26. lin

    From the various comments that I took the time to read through, it seems like there could be physical connections with system imbalances that help to cause the anxiety attacks. The number of people who could be helped through physical lab tests would greatly appreciate the help of psychiatrists and/or researchers. My emotional and physical health has benefited from some RX as well as some supplements and improved nutrition. If researchers do find more connections in the near future to solve emotional problems and some of the anxiety and/or panic attacks, I'm sure that Dr. Raison could still find some other health mysteries to help solve and help others out.

    August 17, 2010 at 15:31 | Report abuse | Reply
  27. Rusty

    Not sure about the article but many of the comments are really interesting and helpful. I have never taken a drug to help me iwth my anxiety. What has been helpful is having a counselor that really challenges my thinking (man, would I like a break for my thinking!!) and gets me to see things in a different way. I can't tell you how many times I translated physical sensations into some kind of life-threating situation when in fact it was just my brain mis-interpreting things. Thanks for all the information, it's good to know I'm not alone and that there are ways through this.

    August 17, 2010 at 15:36 | Report abuse | Reply
  28. Think1002

    I've suffered anxiety (or panic) disorder for the past 15 years. When first diagnosed by my family doctor, she prescribed zoloft to address the anxiety and a blood pressure med to reduce my major symptom: elevated blood pressure. She also sent me to a psychiatrist specializing in Cognitive Therapy. There I learned the "mechanics" of an anxiety or panic attack, then how to dismantle an attack when it would occur. Between the meds and learning the mechanics of attacks, I'm virtually attack free. In the rare times when I do feel a twinge of an attack starting, I can smother it within seconds based on what I learned in Cognitive Therapy. It's quite the heady experience to know I can squelch these things!

    August 17, 2010 at 15:51 | Report abuse | Reply
  29. DW

    Panic Attacks or anxiety attacks are very treatable and can entirely be eliminated. Unfortunately psychiatry is the only branch of medicine that treats a disorder without able to examine or measure bio chemical physiology of the brain. It's a guesstimate. Ok here is what is happening in the brain. Because of a trauma or experience the brain experiences the "flight or flight" syndrome. When a particular event is later experience adrenaline is pumped throughout the body but unlike other people, there is a chemical that doesn't turn on or stop the this rush. Overtime, the brain develops entrenched neuro transmitters or pathways so that when the brain experiences the event, it immediately feels threaten and you freak out. To overcome these entrenched 'false' neuropath ways, desensitization is used via CBT to gradually desensitized the 'false' neuro pathways and establish healthy neuro pathways. Xanax is used to desensitize the negative reactions while enforcing the positive by gradually exposing yourself to those trigger events. It helps by eliminating the panic feelings that flood the brain. Over time the brain develops a set of new neuro pathways which it transmits over, healthy neuro pathways, and the panic attacks will disappear. The key to desensitization is not to overdo it by pushing yourself to where you fill uncomfortable, otherwise who are just reinforcing the entrenched neuro pathways and not developing healthier ones. Also avoidance of the incident that cause the panic attacks may lead to develop or spreading panic attacks over other areas. I became trapped on a chair lift and became claustrophobic to enclosed places. Soon I couldn’t drive in rush hour traffic or cross bridges etc. Through desensitization, I eliminated my fear of these events. I had to do it on my own as many therapists dodn’t understand the process or the best procedure that worked and I tried all the know therapies out there until I studied how the brain processed information. Hope it helps.

    August 17, 2010 at 16:26 | Report abuse | Reply
  30. Girlfromcalifornia

    I am just sharing my experience and by no means offering any clinical or other advice to anyone. I have anxiety attacks sometimes randomly, I will wake up @ 2am heart pounding, sweat beading on my forehead and not being able to breathe properly. The only thing that helps me is telling myself " CALM DOWN, THIS DOESN'T LAST FOREVER, CALM DOWN" and praying and breathing deeply. I will go outside and sit in the cold air, and my dogs surround me and just sit down with me to make sure I am ok. This may sound silly but I can literally feel the anxiety leaving me and I get better when they are there. It hasn't happend to me in a long time THANK GOD! and I have never taken medicine, some people might need it though and I believe the body and mind are so closely connected , and that everyone is different what works for me might not for someone else. If I could offer any advice to anyone I'd tell them not to be ashamed, it happens to a lot more people than you think. Also consult your physician , they are really helpful and they do care let them know and dont be ashamed to tell them things, TRUST ME they have heard it all. ❤ GOD bless you guys feel better soon.

    August 17, 2010 at 16:27 | Report abuse | Reply
  31. TCRB

    I had panic attacks at puberty, again in my twenties, and later, whenever recovering from a bad viral illness, such as the flu. They have physiological, not mental origins. The panic attacks at puberty were triggered by hormonal changes; the one in my twenties by a high-estrogen birth control pill. When I was a child, no one understood the problem - a miss-triggering of the "flight of fight" syndrome, as one poster notes above, that results in the body being flooding with adrenalin. I learned to control the attacks with diet - no caffeine, no food additives (read labels) - and exercise, including relaxation exercises that help me defuse the symptoms. Fortunately, as an adult, I do not require medication. Misdiagnosing panic attacks as a "mental" illness causes much suffering and frustration. I began "getting better" when I started ignoring the psychiatrists of the day and figuring out on my own how to deal with my symptoms. I had to learn how to cope with the attacks (e.g., breathing exercises) so as to interrupt the hormonal flow, and also how to avoid the 'trigger" foods (sharp cheeses, e.g.) and substances (high dose hormones).

    August 17, 2010 at 16:48 | Report abuse | Reply
  32. dm

    I had panic attacks for 20 years before i did anything about it. I thought i was dying. My attacks happened in the car, the grocery line, anywhere i was able to be alone and think. I saw a doctor and have been on Paxil since 1991. It took a little while but it works. I haven't had an attack since about a month after taking Paxil. My doctor told med to look at the medicine as if it was for diabetes or a heart condition, it is something i need everyday to live. I would tell anyone suffering from this debilating condition to seek help and not worry about what other people think. If it helps then it's the right thing to do.

    August 17, 2010 at 17:01 | Report abuse | Reply
  33. Claes

    Right, no psychiatric illnesses left. So bascially you can be abused through childhood, be out of a job and with economical problems and have no friends – and it's just a physical disorder, so with a couple pills you'll be ok. Doesn't sound very likely. I'm a scientist myself, and I think medicine's fear for psychology is easy to understand. First it's a methdological fear – they'd rather reduce it to chemistry, and what do you know? Gradually that's what they attempt to turn it into. Result. Here is Sweden at least, a psychiatric ward means: medication, electric shocks, shackles and if you're lucky enough to get a humane nurse you might have somebody to talk to – no psychologists – why have them? it's just chemistry anyway! Its bs and despite it being repeatedly shown (as necessary really as showing that the sun is hot in the summer) it's just overruled. Of course medication is one component of treatment, but that's also exactly what it is. The second thing is that medications can be put into bottles and sold, but only if they are chemical substances, so a lot of money is going that way.

    August 17, 2010 at 17:34 | Report abuse | Reply
  34. Mike OMD

    Stress is everywhere...it easy to go downhill...just take gotu kola to prevent & treat it.
    Or if possible , focus about 2 inch below the navel area -it will calm you down in instant because it is the center of your body.

    August 17, 2010 at 17:58 | Report abuse | Reply
  35. scottk

    I am sorry for you that are suffering from this. It is a real condition but you really can treat it. You should get professional help with this. You can also try to laugh the next time that you are starting to experience an attack. There is a real reason for this to help alleviate the attack. Thoughts are chemicals and chemicals are thoughts. The panic attack is caused by the activation of the fight or flight center of the brain. The main two components that activate this center are fear or anger. Our brain is wired such that the laugh response inhibits the activation of the fight or flight center. Once you know that this works you will not fear the onset of the attack and will be able to control the activation of the center breaking the feedback cycle. The fear or anger may be emotions that we are experiencing or emotions that we are repressing somehow in our daily life. This is why some people wake up with the night attacks as our sleep is a way for the brain to relieve built up repressed thoughts and emotions. There is a good biochemical reason that many of the drugs help as likely would CBT and even hypnosis. But really try to laugh the next time and see how it works for you. Laughing never hurt anyone and it has no side effects!

    August 17, 2010 at 18:30 | Report abuse | Reply
  36. SherryH

    I too suffer from panic attacks which are triggered by the fight or flight mode buried in our subconscious. I my case, I am deadly allergic to shellfish and have been taken to the hospital in very serious condition called anaphylaxis. Now, just the sight of shellfish can send me into a panic mode even though I rationally understand that I cannot develop anaphylaxis just by looking at the stuff. My heart starts pounding as the adrenaline kicks in and I develop sweaty palms. I can calm myself down but it is very unnerving.

    August 17, 2010 at 19:19 | Report abuse | Reply
    • scottk

      SherryH. I think that this would be considered a conditioned response which is pretty common for panic attack people. You go into the same situation or whatever and it triggers the panic attack. I encourage you to try using laughter the next time you see shellfish. Once you know that you can control the response the conditioning is broken. You might also want to consider hypnosis or CBT for that.

      August 17, 2010 at 19:53 | Report abuse |
  37. SCOK

    1. I suffer from severe panic attacks.
    2. I did not suffer from any panic attacks until my psychotic break.
    3. Try and succeed to somehow make the general public understand what actually transpires with an attack is fruitless and more importantly exhausting reliving your memory (or the parts you remember).
    4. Your statement "mental processes affect the functioning of the body. And bodily processes affect the functioning of the brain" is somewhat surprising. I thought our major obstacle was stigma – not reinventing the wheel.
    Thank you for your concern/contribution/research. Mental health in general needs desperately needs those traits.


    August 17, 2010 at 20:15 | Report abuse | Reply
  38. Jack Slater

    I would rather have a bottle in front of me than a frontal lobotomy!!!

    August 17, 2010 at 20:31 | Report abuse | Reply
  39. Mark S.

    I have suffered from anxiety and stress my entire life, including panic disorder and OCD. All I will say is that if I am ever diagnosed with incipient dementia associated with severe stress early and continuously in life, it will be the day before the last day of my life. People who have never suffered from these conditons don't know s**t about what they are talking about. I would wish it on them, but I am not that evil. I am aware of the indicators that seem to suggest that persistent stress is associated with the potential - not certainty - of dementia later in life. I have thought about this long and hard. If after suffering what I have suffered throughout my life my reward is such a diagnosis, that's it. Game over. Done. Sayonara. Nothing can dissuade me of that, so it does settle the mind to some degree.

    August 17, 2010 at 21:09 | Report abuse | Reply
    • Mary

      Mark S. – There's going to be more information from research about dementia. From articles that I've read, good nutrition and exercise (physical and mental) are helpful to postpone some mental reduction. Keep on checking for information as possible. Personally I made those changes as well as changing some amalgam fillings and I'm feeling better than I did at earlier times. Other people recommended some books to help with anxiety issues. Having a good friend or family member to talk things over with might help? Learning some relaxation techniques might help to help work through some of the anxiety. Think as positive as possible and try to make each moment as positive as possible. I probably sound like a therapist, but not one. In extra stressful times seeing a counselor that you're comfortable might be helpful though. Worked for me to help figure out the key factors for the stressful times. Seemed to work better for me than group-type therapy sessions for stress issues.

      August 19, 2010 at 22:06 | Report abuse |
    • Mary

      Mark S. – I had just glanced through the comments and was so 'anxious' to connect with your concern about dementia that I didn't notice that it was Mark S. (you?) who had recommended reading those books that I mentioned in my first reply to you.
      Feel a little silly if that is how it turned out to be.... Ordinarily I would have felt bad/silly for a longer time, but trying to change and not make a mountain out of a mole hill as the saying goes. More recently I found out that I had some system imbalances so I now know that there were physical factors that helped cause problems for me. Low cortisol as well as low serotonin. So it's a constant goal to get the proper nutrition daily with added RX and supplements. Finding the right doctors with the right tests for the physical problems and a friend or therapist to cover the emotional situations has helped.

      August 19, 2010 at 22:26 | Report abuse |
  40. I like my coffee, so whatcha gonna do about it?

    I found the book "10 Simple Solutions to Worry" helpful.
    Make a list of the things that make you feel most calm (a hot cup of herbal tea? Playing with your dog? Reading? Going for a walk/jog/bike ride/swim? Talking on the phone with a relative or buddy? Writing? Playing certain music?) and pull out the list when you're feeling stressed. Do something on the list.

    Don't be afraid to go to a doctor or psychiatrist and ask for help with your depression or anxiety. This is a positive step, and you can always see how helpful you find it and reevaluate later.

    Love and Hugs to you all!

    August 18, 2010 at 05:20 | Report abuse | Reply
    • Thais

      Some good things to npveert, and control em are, working out regularly(so you burn off extra hormones, and adrenaline), and work on being in the moment, The Power of Now is a great book, that gives you very practical advice on how to be calm, and in control of your life, no matter what's going on.And when you feel the panic rising, try and give a controlled, but active response to it, usually panic is triggered when we feel something is getting out of control, or goes against our feeling of what's right, if you actively respond to try and right, the wrong about to happen, you'll notice, you'll become more relaxed, and the next time, you won't have as strong a reaction.

      April 8, 2012 at 21:12 | Report abuse |
    • Thomas

      First, you must make sure that what you are experiencing is ieendd a panic attack. Panic attack symptoms are sometimes similar to a heart attack or other serious conditions. Diagnosis is generally negative , in the sense that if all other medical conditions are excluded, then most probably what you are experiencing is anxiety. The basis of most treatments is that you have to understand that your panic attacks are triggered off by your fear of them. There are a few quite effective self-help methods on the web. My favorite two are Panic Away and the Linden method.

      April 14, 2012 at 13:02 | Report abuse |
  41. Just Me

    I think this article hits the nail on the head. I am a 29 year old female & was diagnosed with panic disorder at 25 or 26 after my 3rd trip to the ER for what i thought was a heart attack and multiple trips before for other pains and everything else under the sun. After being diagnosed and reading up on the disorder,which descibed my attacks & feeling word for word,I realized I have suffered from this the majority of my life. My panic attacks can strike at any moment with no apparent triggers. i can be relaxing on the couch, in a great mood,having had a fantastic day & BAM! The feeling is overwhelming and definitely both mental & physical. The physical symptoms that can accompany the attacks can be incredibly painful. Sometimes i feel like there is a rock or as I like to describe it, a fist is in my chest. It makes me want to rip my chest open and get whatever it is out, is maddening. I hyperventilate. My blood pressure shoots thru the roof. My muscles tense up to the point of causin pain. The sense of dread & the feeling that you are going to die is overwhelming.i cant think clearly,.i become overwhelmed and irrational.I cant complete simple tasks I have abandoned full carts of groceries,left movies theaters, run away from family and friends so as not to have to explain my sudden change of mood and freak out behavior I have awaken in the middle of the night with the racing heart and sweats as others have posted. Ive also awakened absolutley terrified but now sure why,and unable to speak out or move. In a state of paralysis.And when it's all said and done and the attack has finally passed, I am exhausted, bothe PHYSICALLY & MENTALLY. Like I ran a marathon and while simultaneously solving algebraic equations of the worst kind. The attacks infiltrate every aspect of your life. And sometimes leave you feeling embarrased. People dont understand, say you're dramatic,overreacting, or my favorite,call you a hypochondriac. Its affected how,when & what I do with my children..If it were all just mental, I would just think myself out of iit as another person posted.At least now I know what's happening and can concentrate on just seeing it thru without thinking Im dying. Knowing whats actually happening helps, but doesnt stop them or lessen them. An attack can last minutes,hours and sometimes even days. Ive tried changing my diet,cutting out caffiene and every type of medicine on the market,some having better resutls than others. .Ive tried every drug in the benzo family,with Xanax and more recently clonazepam before bed(as I hate the slow groggy feeling and this gets it in your system while you sleep),seeming to work the best.ive tried every antideppresant on the market as they are supposed to help with anxiety.Zoloft made the attacks worse. I actually went a little crazy on that one and contemplated kicking holes thru walls to escape a room.sMy dislike of the side affects of the medicines cause me not to take it reguarly or premptively as prescribed. Most often Im in a full blown attack before I remember that i have someting to take that will help.For those who have never actually experienced any of this and still feel as if you have a right to speak on the matter and judge those of us that have and the doctors who treat us,I PLEASE JUST BE QUIET. Not to be ugly, but what gives you the right? Do you really even have to post on these? we're all entitled to our own opinion, but unless you have experienced this, either personally or thru a loved one, what exactly are you basing your opionion on?do yourself a favor and DONT share your oppinion as it makes you appear ignorant and who wants to appear ignorant if they dont have to? I ALMOST wish just ONE of these episodes on you. So that you might have a little foresight and experience to pull from before you decide to share your oppinion. Almost. I dont really wish this feeling on anyone. And so sorry for the long, over informed post.Panic disorder is very real, bothe mentally and physically and has affected my life that much.

    August 18, 2010 at 11:01 | Report abuse | Reply
  42. Rusty

    Just Me, thanks for the post. Have to agree that folks who have not experienced an attack need to chill on their comments. I even have trouble believing the doctor understands. While it's nice that some folks say it can be completely cured I doubt it. I do believe I can learn to live with and manage my situation but it will be with me till I die and that SUCKS.

    Thanks for your thoughts and I will keep you in my prayers.

    August 18, 2010 at 15:06 | Report abuse | Reply
  43. gigi

    I too suffered panic attacks due to huge stress at work–feels like a heart attack. The ER let me know right away it was anxiety because they did some kind of heart test to rule out a heart attack. Cymbalta is really effective for overall feeling well, but remembering the panic attacks makes me avoid all the situations that could bring them on, so now I can rarely leave my house. The job was causing so much stress that I felt like I had no alternative but to quit...I lost my health benefits and I am close to foreclosure on my house, but I felt like if I kept having the daily panic attacks, I would acquire something else like cancer or stroke because I felt like I was dying! I only have panic attacks now when I start thinking about the job. I feel so much better, and I don't have that awful chest crushing pain. I wish I could understand why I am becoming agoraphobic and do not want to leave my house!

    August 19, 2010 at 00:46 | Report abuse | Reply
    • ILikeAllCritters

      Gigi, I feel for you. It sounds like you need to find a therapist who specializes in anxiety disorders. Try to work out a payment plan, but keep seeking help. I wish you all the best!

      August 19, 2010 at 05:22 | Report abuse |
    • Tina

      Gigi: Through personal therapy sessions, I started learning how to dissect the parts of life that seemed to be more stressful. Sometimes you just have to slow down and think things through in small detail to figure out the problems and then move to finding a solution. Maybe have a close friend help you to pay attention to your anxiety times and help solve them before you resort to letting yourself become agoraphobic if that truly seems to be happening to you. Stress can feel like a 'blanket' over your life. Sometimes we let one or two situations cause an avalanche of emotions. Checking out other jobs/features might help you find answers and maybe a new less stressful job. Wish you the best too.

      August 19, 2010 at 22:45 | Report abuse |
  44. Mark S.

    Just Me, I hear you totally. The best thing about forums like this is that it tells us that we are not alone. I will not tell you how many years I have suffered from a simiilar set of symptoms because I don't want to upset you. It has only been in recent years that panic disorder is recognized as a specific problem, and my symptoms predate the DSM designation. I strongly recomment Dr. Robert Leahy's book "Anxiety Free" as well as Dr. Shipko's book "Surviving Panic Disorder," both on Amazon. There are many others, including Dr. David Burns "When Panic Attacks." Bibliotherapy is an accepted form of self-help because it demystifies some of the most terrifying symptoms, like the intrusive thoughts that accompany severe anxiety, especially if you are blessed with OCD too, as I am. Awful... Also the emotional numbing and feelings of depersonalization/derealization. I know you are going through those too, but you are too afraid to say so. It is a "normal" component of a severe anxiety disorder, which is what panic disorder is. You are not "going crazy." Knowledge is power, and the knowledge that the crap you are going through is mostly smoke and mirrors and DOES NOT mean you are crazy can really help. Please, take if from me, I am not a "snap-out-of-it!" A-hole. I have been there and am still there with you and probably always will be. But we are not abnormal, we are just humans with the kinds of issues that can go haywire with the most advanced and sophisticated nervous systems the planet, God and evolution have ever created. I have made my living as a writer for the last 40 years and anxiety disorders are statistically more common among "creative" types than the population at large. As Mr. Monk often said in that delightful and insightful TV series, "It's a gift and a curse." Hang in there...

    August 19, 2010 at 09:45 | Report abuse | Reply
    • Kakaa

      every human every soul either good or bad ,angle or evil want to live as a good habmnueing . -requests to guruji and all to pray, enemities,quarrels ,old evil intelligence , veangins,enemities to destroy , spoiling others, hates for others all bad evil wisedom, bad thoughts, be change to good intelligence noble and betterment for others .and save every soul , (grand soul) paramatma , humans , balas in back bones , kundlani power , every molecules .

      April 8, 2012 at 14:26 | Report abuse |
  45. dan

    If you have had difficulty diagnosing a panic disorder take a look at the condition: postural orthostatic tachycardia syndrome
    A cardiologist is the best type of doctor to help and second is an endocrinologist.
    The cause in general is from autonomic nervous system dysfunction.

    August 19, 2010 at 13:31 | Report abuse | Reply
    • lin

      Did you have the postural orthostatic tachycardia syndrome or are you still dealing with it? I've had a similar health problem but not so much with the tachycardia part. Just wondered how the cardiologist and/or endocrinologist were able to help. I've had trouble with anxiety at times. Part of that was from dealing with the postural orthostatic problem every morning and feeling like I could never get up and get going like most other people. Usually I had a lower BP. Feeling somewhat better now. Hope that the medical people were able to help with the panic disorder situation.

      August 19, 2010 at 23:04 | Report abuse |
  46. dan

    I have had 2 cardiologist and 1 endocrinologist appointments and was unable to diagnose my condition. I am using a description of my symptoms to prescreen cardiologists and hope to find one who really understands postural orthostatic
    tachycardia syndrome.

    August 20, 2010 at 21:53 | Report abuse | Reply
  47. Jim

    My niece suffers from this so I put up a blog.

    September 27, 2010 at 19:39 | Report abuse | Reply
  48. Amanda

    I was reading through this article and everyone's postings and thought I would respond. I am 21, and have never had anxiety/depression/panic attacks anything like that. Roughly 3 weeks ago I started getting 'electric shocks' through out my body as well as numbness/tingling in certain body parts (with sensation restored..Thank God!), which have slowly subsiding over the course of the 3 weeks, not ultimately but are very minor than they were (or maybe I just don't notice them as much), I then started to get a really tight feeling in my chest..frequently..nausea, and diaherra. Then comes horrible horrible muscle pain down my neck and back along with this horrible burning feeling on my muscles for about 2 days. All of these random symptoms that I had never experienced, for the most part unless I had a cold/flu, have been hitting me..out of the blue..of the course of the last 3 weeks. I was not stressed or anxious at the time, but after 6 visits to the ER (2 different hospitals), all different diagnosis, 5 ekgs (on account of feeling like I was having a heart attach), 3 chest xrays, 2 ct scans, and tons and tons of labs...Here I am. It's just really driving me 'up the wall' as I normally feel perfectly fine :knock on wood: and now I have become completely obsessessed because no one seems to give me a legit answer. Some say anxiety, paresthesia, low magnessium/potassium (only a few points..'nothing to worry about' according to these Drs..well yes, they is something I'm going to worry about), and now just having a cold/sinus infection I can't seem to win for losing. I just don't know what to do or think or ANYTHING anymore. I have..almost..lost my Mind, over the fact that every diagnosis was different when I was giving the EXACT SAME symptoms everytime. They actually started to act rude towards me for even being there. I'm scared and am just hoping and PRAYING that it is nothing serious they have overlooked..or it's nothing serious in general. I just don't know what to do. And having no health ins. doesn't help the situation either.

    September 29, 2010 at 02:20 | Report abuse | Reply
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