Patient handout
Panic disorder
You have been diagnosed with panic disorder. This page explains what that means, how it is treated, and what you can do now.
What it is
A panic attack is a sudden surge of intense fear with a pounding heart, shortness of breath, dizziness, or a sense that something terrible is happening. It peaks within minutes and passes. Panic disorder is when attacks recur and fear of the next one starts shaping your life. The attacks are frightening but not dangerous, and the condition is very treatable.
Common signs
- Racing or pounding heart, chest tightness, shortness of breath
- Dizziness, shaking, sweating, nausea, tingling
- Feeling unreal or detached, fear of losing control or dying
- Attacks that come out of the blue, including from sleep
- Worry between attacks about having another
- Avoiding places where escape feels hard: driving, stores, crowds, travel
Why it happens
A panic attack is the body's fight-or-flight alarm firing without real danger. After a frightening attack, the brain starts treating ordinary sensations, a skipped heartbeat or a flush of heat, as threats, which triggers anxiety, which amplifies the sensation, which spirals. Bracing, fleeing, and seeking reassurance teach the brain the alarm was justified, so it keeps firing.
How it is treated
- Therapy: cognitive behavioral therapy with exposure is first-line. Deliberately bringing on the feared sensations, called interoceptive exposure, teaches the brain they are harmless. Acceptance-based approaches work comparably.
- Medication: SSRIs or SNRIs, taken daily, when attacks are frequent or severe. They take four to six weeks and are started low because they can briefly increase jitteriness. Benzodiazepines are not used for daily or long-term treatment at this practice.
- Supportive therapy is part of every visit here, and a referral for structured exposure work can be arranged.
- Follow-up: every one to two weeks at first, then monthly, then every three months once stable.
What you can do now
- During an attack: do not fight it. Let it peak and pass, breathe slowly out, and stay where you are if you safely can.
- Afterward: do not check your pulse, search symptoms, or rearrange plans around the fear.
- Cut caffeine; it is the most common trigger.
- Get a medical check once, if you have not already, so you can stop wondering about your heart.
- Keep doing the things panic wants you to avoid.
Get help right away if
- Chest pain, shortness of breath, or fainting that is new, different from your usual attacks, or does not pass within minutes (call 911; a first episode should always be checked)
- Attacks so frequent you cannot leave the house or function
- New or worsening thoughts of hurting yourself, especially in the first weeks of a new medication
- Thoughts of hurting yourself or not wanting to be here: call or text 988 any time, or go to the nearest emergency room
Good to know
- Recovery does not mean never feeling a panic sensation again. It means you stop fearing them, and they lose their power.
- Nocturnal panic, waking from sleep in an attack, is common and is treated the same way.
- Alcohol and cannabis can trigger attacks, especially as they wear off.
Questions about your diagnosis or treatment?
Alice Tran Psychiatric Care · 3060 Williams Drive, Suite 300, Fairfax, VA 22031
Call: (703) 791-9099 · Text: (703) 791-9031 · info@alicetrannp.com · alicetrannp.com
This handout is for education and is not a substitute for the instructions you received at your visit. Follow the dose on your prescription label. If anything here differs from what you were told, call the office. In an emergency, call 911. If you are in crisis, call or text 988.