August 30th, 2011
10:34 AM ET

How can I control my panic attacks?

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 Stephanie via e-mail

I've been having a lot of panic attacks, almost every day; sometimes when I'm working, dealing with the kids or just nothing at all. I'll get shortness of breath, chest hurts on both sides or just one side, and a lot of my heart skipping a beat. And it scares me. I'm 29 years old and in good health. How can I control this?

Expert answer:

Dear Stephanie,

I don't need to tell you that panic attacks are among the most hideous experiences a human being can have. They are such strange occurrences. While being in no physical danger at all, you feel as if you are in mortal peril. In the midst of perfectly good health, you feel as if you are on the edge of sudden death. And telling yourself that there is no real danger is of almost no help whatsoever.

My strongest piece of advice is that you make an appointment to see your doctor immediately. Many primary care doctors feel comfortable treating panic disorder or will know a clinician who does.

Like everything else in psychiatry, treatment options come in two general flavors: medications and psychotherapy.

The best proven psychotherapy for panic attacks is similar in many ways to the type of therapy that I've described several times before for obsessive-compulsive disorder. It has two main components, neither of which is pleasant, but which are in the aggregate often highly effective. First, the therapist would work with you to gradually expose yourself to situations that cause panic. Then, once you are in these situations, he or she would teach you to tolerate the terrible panic feelings when they arose.

I suspect that just thinking about doing this might have you breaking out in a cold sweat, which is why it is so important to get professional help.

Among psychotropic medications, two classes are particularly effective for panic, and they are very different from each other. Benzodiazepines, like Valium, Ativan or Klonopin, have powerful anti-anxiety effects that happen very rapidly after they are ingested. If you have long panic attacks, or attacks that come in prolonged volleys, these medications work quickly enough that they can interrupt things in mid-attack.

Most antidepressants also treat panic attacks, but unlike benzodiazepines, they require several weeks of being taken daily before their effects are usually seen. For this reason, many clinicians will start patients on an antidepressant and a benzodiazepine. Once the antidepressant has been on board for several weeks, the benzodiazepine can often be discontinued.

Let me alert you to a few challenges in these treatments. Psychotherapy is great, but depending where you live and the state of your finances, it can be hard to find and expensive. Benzodiazepines work extremely well but have addictive potential when taken long term. If you elect treatment with an antidepressant, make sure that your clinician starts you on the lowest dose possible, because - paradoxically - antidepressants can cause panic attacks when they are first taken and can certainly worsen them in people already afflicted.

The good news is that all these treatment options are effective, so it is very likely you will be able to gain control of your symptoms, find relief and continue with your life.

Follow @CNNHealth on Twitter.

Ask our doctors a question

soundoff (415 Responses)
  1. EncoxHtf

    cialis 20 mg cheap cialis online no prior prescription cialis free offer

    June 7, 2021 at 19:03 | Report abuse | Reply
  2. EncoxGtv

    canadian pharmacy world coupons canadian addiction treatment pharmacy safe online pharmacy canada

    June 7, 2021 at 23:13 | Report abuse | Reply
  3. EncoxGtv

    canadian drug online pharmacy hydrocodone canada over the counter drugs

    June 7, 2021 at 23:50 | Report abuse | Reply
  4. EncoxDev

    pharmacy conversion course canada walmart pharmacy store locator cialis 5mg canada pharmacy

    June 8, 2021 at 05:32 | Report abuse | Reply
  5. EncoxAni

    how to buy prescription drugs from canada safely super saver pharmacy best online pharmacy no prescription

    June 8, 2021 at 12:05 | Report abuse | Reply
  6. EncoxAni

    sildenafil online pharmacy cvs pharmacy store locator canadian pharmacy price comparison

    June 8, 2021 at 15:47 | Report abuse | Reply
  7. CrulkAsd

    cialis generic cambodia orginal cialis cialis en mexico

    June 8, 2021 at 22:51 | Report abuse | Reply
  8. MileSwa

    order cialis soft tabs cialis online without where can i buy cialis

    June 8, 2021 at 23:34 | Report abuse | Reply
  9. EncoxDev

    pharmacy world rx b pharmacy jobs in canada canadian pharmacy phone number

    June 12, 2021 at 12:16 | Report abuse | Reply
  10. Zisseloh

    superman combo viagra cialis is cialis over the counter in usa generic brand for cialis

    June 12, 2021 at 17:51 | Report abuse | Reply
  11. ZisseVed

    generic cialis canada cialis vision loss dosage for cialis

    June 13, 2021 at 07:44 | Report abuse | Reply
  12. hydroxychloroquine bnf

    hydroxchloroquine chloroquine autophagy hydroxychlor

    June 13, 2021 at 10:59 | Report abuse | Reply
  13. CrulkAsd

    cialis professional vs cialis super active cialis on line sell cialis generic

    June 13, 2021 at 12:00 | Report abuse | Reply
  14. MileSwa

    best price cialis gen how much is a cialis .cialis

    June 13, 2021 at 13:35 | Report abuse | Reply
  15. ZisseVed

    viagar vs cialis cialis super active 20 mg get cialis to work

    June 13, 2021 at 20:14 | Report abuse | Reply
  16. EncoxHtf

    cheapest cialis tadalafil 20 mg cheap viagra and cialis accessrx cialis

    June 13, 2021 at 20:40 | Report abuse | Reply
  17. Colbyoty

    methods and in addition online dating discrepancies

    little known online dating secrets and techniques,

    I listen to it as often as needed "i thought this was started so great, soon after which the girl faded available on my opinion motive why? so what happened we were while having such a thrilling time using them. my name is bored with this developing i have to date gorgeous the woman, yet I desire them to stick around. generate numerous courting strategies for me,

    certainly, i truly do. each and every I go to a working man what kind of person informs me this excellent, I seek she has taking the very same mistakes a great deal of individuals try, dating flaws that will end it's chances of easily hot ladies. simply, I provide him a small amount of going out with tactics to go through the roof your partner's riches suffering from alluring the women. you will notice quite simple ones:

    matchmaking goal 1: may not appointment. obviously, you got that right never will the present day. think about a traditional "dating" it's usually filled up with anxiety, awkwardness, examination and it typical is painful. what now,where do you turn above "kinds partner, a meal, video, make out goodnight, your own woman should not pay out an individual's phone messages. Or there is beers, and then try to "take the particular choice, And every person rrn which that many winds up. enhanced (together with cheapest) to find when considering cup of joe it truly is fun and positive with none of the normal relationship prospects.

    dating recommendation 2: all the lower you are and after that proclaim, the actual jane is attracted to you. maximum adult males strive to make an impression mostly pretty women of all ages, or maybe "create a rap" on it. desirable women know everthing before. yet,yet somehow, If you may well ask her relating to compact, close up moving up and as well as respond, moreover show a smaller degree of great interest, she'll start to super the actual reason why you just aren't slobbering everyplace the doll. she is going to want to search for more right now you're hard, so sexy those are attracted to not very easy online marketers. why? when they actually live up to one. This is a huge dating fall.

    relationships some words of advice 3 turn into a "freakish young boy, an additional lar escort trick. remember the "program clown" from serious type the specific male who had previously been "mind-boggling and as a consequence funny" each of while doing so? when you're addressing captivating girl, create shocking or mischievous commentary, the sort which move on folks debating, "i can't believe hangover remedy,hangover remedy testified that so I prefer it, this particular explains skinny mothers you just aren't impressed by this special glances, you will want to see more. that is certainly so totally different from what normally the company is employeed to they can aide just getting interested in. I are unable to emphasize the importance of this personals guideline.

    relationships guideline 4 hinder every scripted select product lines, "sitting a hip hop, properly virtually any "appearing, beautiful women know a great deal previously, And when you spout one, that you're in a flash a JAG (yet another folk). and furthermore JAG's aren't getting hot chicks don't forget this relationships a suggestion!

    dating sites concept 5 alluring people may be greeted colliding with on the 20 so that it will 30 schedules each and every. chnlove scam This is their united states to gain access to it, you'll need to be completely different from the 20 all that have yet been to their. (learn romance technique 3 for how to be varied to naughty wives).

    escort method 6 check her assessments. alluring females (of course, almost females) would certainly test you to see if you'll be able to stand up to them. individuals stand up to jane's, You dislike up on her. any time your darling requires buy the girl's factors, that's a make sure an appropriate opportunity coordinator,being "naughty little boy" (go to romance guiding light 3). assert something similar to, "what can I be similar to an atm machine bike? you should obtain everyone sothing, just by the freedom because of passing time with me at night. i recommend attractive women who pick me products, This is said inside the playful thus far flat system who permits the actual woman's acknowledge may possibly aboard. as soon as you pass the companies studies, It disks beautiful women outrageous thanks to plan. quite important relationship guiding light.

    relationship tip 7 time amount sexy gals simultaneously, and be sure the others comprehend it. appealing girls really enjoy some guy who is appealing to other, and we intend to contend that can "succeed a person will, (discover an additional dating sites end: just for proof this, browse through anything good make an impression on world wide). when you need to start a family, You can come up one, however she will always determine you may targeted courtesy of – other attractive as well as in an unusual way, this creates much more obsession with regard to. which personals a suggestion for you is actually a option, But it very effective complete with beautiful those.

    right, everyone, there you have it for this informative article. surely there are a lot other going on a date advices, methods as well secrets to put to use, nevertheless, if you tune in to these a new relationship helpful tips, you'll certainly be a heckuva lot more fortunate and enthralling mothers. becoming, become re studied the particular seeing ideas.

    June 22, 2021 at 08:41 | Report abuse | Reply
1 2 3 4 5 6 7 8

Leave a Reply to EncoxAni


CNN welcomes a lively and courteous discussion as long as you follow the Rules of Conduct set forth in our Terms of Service. Comments are not pre-screened before they post. You agree that anything you post may be used, along with your name and profile picture, in accordance with our Privacy Policy and the license you have granted pursuant to our Terms of Service.

About this blog

Get a behind-the-scenes look at the latest stories from CNN Chief Medical Correspondent, Dr. Sanjay Gupta, Senior Medical Correspondent Elizabeth Cohen and the CNN Medical Unit producers. They'll share news and views on health and medical trends - info that will help you take better care of yourself and the people you love.