Like a heart attack.
When someone comes into an emergency room complaining of a heart attack, they are treated as though they are having one. But they may be having a panic attack. The symptoms — difficulty breathing, cold sweat, chest pain, rapid heart beat — are identical. Panic attacks occur unpredictably, and are not associated with any particular situations, unlike social phobias. Basically the body has gone into fight-or-flight reaction, dumping large amounts of adrenaline into the bloodstream.
What causes panic attacks?
A panic attack, or something that appears to be a panic attack, could be associated with a medical condition such as hypoglycemia or hyperthyroidism. It could be the result of extreme stress or anxiety. Stress may be related to current stressors. Anxiety may also be due to situational stress, but also may have deeper roots in upbringing or even trauma.
Therapy or medication?
If you think you’ve had a panic attack and suffer from chronic anxiety you may want to consider psychotherapy, which can be quite effective in treating anxiety. Therapy takes time, but research has shown that its effects are longer lasting than medication. In some cases, therapy and an anti-anxiety medication are more effective than either alone. My own bias is to try therapy first — and then see if the anxiety persists. A few sessions of psychotherapy frequently provides a remarkable amount of relief from symptoms.
Advantages and disadvantages of anti-anxiety medications.
We live in a society where the use of psychotropic medications has become the norm. In extreme cases, there are a number of effective anti-anxiety medications available. Unfortunately, these can be addicting, and people tend to develop a tolerance to their use. When the medication is stopped, some suffer from what is termed “rebound anxiety,” in which the symptoms return in full force. The class of medications most often prescribed for anxiety, benzodiazepines, are highly addictive, and can cause seizures upon withdrawal. The withdrawal from benzodiazepines is very difficult. This is why medication is often combined psychotherapy — the anti-anxiety agent can be tapered off, while the therapy continues. Generally, this has good results.
Rule out a medical condition.
The bottom line is that chronic anxiety is treatable. First, see a physician to rule out a medical condition. If your doctor thinks you are a candidate for medication, then I would recommend that you consult with someone that really knows the medications, i.e. a good psychiatrist. There are many professionals able to prescribe psychotropic medications, but a good psychiatrist will be up on the latest medications, which are most effective, and how to use them in conjunction with any other medications. Currently, other prescribers simply do not have the same knowledge of and experience with psychotropic medications. (This may change when psychologists get prescription privileges.) Then, if you think it’s appropriate, find a good psychotherapist.
Kalea Chapman, Psy.D.