By Dr. Sarah Gaumer

When is the right time to start therapy for panic attacks? Although it’s never really too early to reach out for support from a professional, there are times when it becomes even more important to seek help. Read more to learn about panic attacks and how therapy can help.

What is a panic attack and what does it feel like?

Shortness of breath. Tight chest. Muscle tension. Racing heart. Sweaty palms. Feelings of terror. Nausea. Shakiness. Dizziness. Fear of losing control. Fear you are going to die. 

These are all symptoms of a panic attack. A panic attack is a sudden onset of acute, severe anxiety that results in intense emotional, somatic, and cognitive symptoms. 

These symptoms can be mistaken for a heart attack or stroke. These sensations are also similar to what our bodies experience during or after strenuous activities like exercise. As a result, people experiencing panic attacks sometimes end up going to the emergency room for examination.

Panic attacks can be triggered by specific events like phobias or trauma, but they sometimes occur without warning like when you’re driving, walking the dog, shopping, at school, or even during sleep. Although panic attacks are not inherently dangerous and on average last about 10 to 15 minutes, they can be extremely uncomfortable, frightening, and have a negative impact on quality of life. 

How common are panic attacks?

Panic attacks are common and are a natural response to stress, acute trauma, grief and loss, and unexpected life changes. Current research shows that up to 11% of adults in the United States experience a panic attack every year (Cleveland Clinic), and about 33% of people will have at least one panic attack during their lifetime (Web MD). 

When panic attacks become a problem

If you’ve had multiple unexpected panic attacks and spent long periods of time terrified of another attack, you may have something called Panic Disorder. Panic disorder is less common than isolated panic attacks. About 2-3% of adults suffer from panic disorder, and it affects twice as many women as males (Anxiety and Depression Association of America).

Panic attacks are the main feature of panic disorder but they are not the only feature. Just because someone has a panic attack does not necessarily mean they have panic disorder. Simply, not everyone who has had panic attacks has panic disorder, but everyone who has panic disorder has had panic attacks. 

So, when do panic attacks become panic disorder? There are a few conditions that indicate someone could have panic disorder, which are the following:

• Experience recurrent, unexpected panic attacks (e.g., no identifiable trigger)
• The panic attack produces at least 4 physical sensations such as shortness of breath, chest tightness, dizziness, feelings of choking, shakiness, heart palpitations, numbness,  fear of losing control, etc. 
• Persistent concern or worry about having additional panic attacks after experiencing one
• Excessive concern about the consequences of having another panic attack (e.g., health concerns, social concerns, concerns of “going crazy”)
• Avoidance of things that could trigger panic attacks, such as exercise, certain foods, or unfamiliar situations 
• Attempts are made to minimize the effects of a panic attack like carrying medication or changing one’s typical schedule to make sure help is available in the case of a panic attack

Agoraphobia

Panic disorder frequently occurs with another anxiety disorder called Agoraphobia, which is the fear of being in certain places or circumstances (e.g., crowds, public transit, open spaces, etc.) that may cause a feared outcome and from which there is no escape. A person suffering from agoraphobia is scared to venture to new places as they worry about not having access to help or feeling stuck if they experience a feared consequence such as anxiety, embarrassment, or a panic attack. 

However, panic disorder and agoraphobia can exist independent of one another. For example, someone with panic disorder may avoid an activity such as exercising for fear that would trigger a panic attack but would not actively avoid visiting a gym. Someone with agoraphobia may avoid visiting the gym for fear there would be no help or escape if they experienced a feared consequence. 

In other words, panic disorder is more focused on not wanting to have another panic attack, while agoraphobia is more concerned about avoiding situations where there could be no access to help or where there is no escape from a feared consequence, which could or could not be having a panic attack. Panic disorder and agoraphobia are two distinct illnesses that can occasionally coexist.

When is it time for therapy?

The biggest indication that it is time for therapy is when the panic attacks and resulting behavioral symptoms start to impact daily life. If you have panic attacks and your attempts to avoid or manage them are starting to interfere or take you away from spending time with family and friends, going to school, holding a job, or doing things you love to do, then it could be time to consider seeking out mental health therapy. 

The good news is that panic disorder is one of the most easily treated anxiety disorders. Evidence-based treatments for panic disorder include cognitive behavioral therapy (CBT), acceptance and commitment therapy (ACT), and medications like selective serotonin reuptake inhibitors (SSRIs). 

There is no need to be alarmed if someone has one or two panic attacks. Consult a mental health professional if your panic attacks become more frequent and intense, start to occur for no apparent reason, or interfere with your daily life. 

If you or a loved one are experiencing panic attacks that are starting to impact your life, give us a call for a free 15-minute phone consultation.