The Toughest Thing About Panic Attacks

It’s Tuesday.  That means Dr. Raison, The Chart’s resident mental health expert answers a reader’s psychiatric question.  Today Dr. Raison answered Stephanie’s (not me) question about panic attacks and their treatment.  Dr. Raison did a nice job discussing treatment options including psychotherapy and medication. 

Dr. Raison’s post got me thinking about panic attacks.  They are buggers (understatement) for several reasons:

They can make you feel like you are dying.  Trouble breathing, chest pains, dizziness – all symptoms of panic attacks.  And, oh by the way, the same symptoms as heart attacks. That’s why it’s important to talk to your physician about your overall health if you start having panic attacks – it’s better to be safe than sorry.  Once you get a clean bill of health, it may be easier (albeit marginally) to realize you are not dying when a panic attack hits.

They can make you feel like you are going crazy.  I’m not sure what the official definition of “crazy” is, but panic attacks can make you feel like you have arrived there. Folks often tell me they feel like they are losing their minds when panic sets in.  While disorienting, experiencing panic attacks doesn’t mean you are headed for psychosis, it just means you might need to learn a few coping strategies.

They can make you feel embarrassed.  People who suffer panic attacks often feel a level of embarrassment after they’ve had one, as they are sure the people around them could tell what was going on.  The good news is, they usually can’t.  While panic attacks feel ovewhelmingly awful to the person having them, the folks around them are typically oblivious to what’s going on.

*They can happen anytime.  And here is the toughest thing about panic attacks – they can happen anywhere, anytime.  Many of us assume we’ll have an attack when we are feeling stressed or nervous (right before giving a big speech or driving over a bridge).  That might happen, but they can also happen when you are happily eating a slice of chocolate cake while watching Dirty Dancing.  What’s the deal with that?  I’m not sure.  But I do remind my clients that panic attacks can strike at any time, and it doesn’t mean they have a phobia of Patrick Swayze.  It just means that panic attacks are irritating and unpredictable.

The good news is, there are a lot of treatment options available for people suffering from panic attacks.  For some thoughts about treatment, check out the American Psychological Association’s Help Center.

Antidepressants, Therapy, Side Effects, and Efficacy


CNN’s The Chart is one of my favorite blogs.  I particularly look forward to Tuesdays when Dr. Charles Raison writes about the world of mental health and

Photo by JasonTromm

psychiatry.  A couple of weeks ago Dr. Raison responded to a question about the safety of long-term antidepressant use. Dr. Raison did a much better job than I can describing the recent findings on antidepressants, including their long-term use, use  in pregnancy, and their effectiveness compared to placebos.  What he didn’t write about (and he usually does) is how psychotherapy is used in treatment of mental illness.

Obviously, given my chosen field, I am a believer in the power of mental health counseling and psychotherapy.  While I am not at all anti-psychiatric medication (far from it) I do believe that no conversation about antidepressants is complete without at least a brief mention of psychotherapy.  The reason is that psychotherapy/counseling (the terms are interchangeable) are a crucial part of the treatment plan for all forms of mental illness that I know of.  Schizophrenia, depression, ADHD, bipolar disorder – they can all be helped by psychotherapy.  In fact, the latest research tells us that therapy is just as effective as medication (if not more so) for many mental health disorders.  Research also suggests that a combination of therapy and medication is the best course of treatment for several diagnoses including many types of anxiety and depression.

Other than being highly effective, perhaps the coolest thing about psychotherapy is its lack of side effects.  We’ve all heard the list of unpleasant side effects that can be experienced on psychiatric medications (sexual problems, stomach upset, headaches, etc).  But therapy’s list is comparatively short.  In fact, some would argue there are no negative side effects at all.  I’m not sure I’d go that far (for example, sometimes talking about painful experiences can be tough and cause thoughts about these experiences to increase in the short term), but I agree that the risks of therapy are dramatically lower than for medication.

With therapy’s efficacy and lack of negative side effects in mind, it makes sense why it should always be included in any discussion of mental health treatment.