Panic Disorder

Panic Disorder Treatment in Baltimore

Panic disorder is a type of anxiety disorder that is characterized by recurrent, unexpected panic attacks. Those suffering from panic disorder face the fear of enduring sudden, extreme episodes of dread and discomfort that can last anywhere from minutes to hours. This can lead to a decrease in quality of life and significant disruption in daily routine.

As an experienced psychiatrist, Dr. Neal Ranen has seen the significant impact that panic disorder can have on individuals and their families. While this condition can be extremely distressing and impairing, there is hope. Effective treatments are available that can help individuals manage their symptoms and reclaim their lives. Read further to learn more about panic disorders and Dr. Ranen’s approach to treatment.

What is panic disorder?

Unexpected and recurrent panic attacks are the hallmarks of panic disorder. Experiencing a panic attack can be overwhelming and terrifying – it may last for several minutes to a couple of hours with physical symptoms like trembling, heart palpitations, perspiration, and breathlessness. People affected by a panic disorder may be constantly in fear of a potential panic attack.  This fear lends to evading circumstances or activities that are associated with past episodes. This can have an impact on previous daily routines and overall quality of life.

What are the symptoms of panic disorder?

Panic disorder has a number of symptoms that can vary from person to person, but some common indicators include:

  • Unexpected and intense episodes of fear or distress, panic attacks can last anywhere from a few minutes to several hours.
  • Nervousness-induced physical symptoms may include an accelerated heartbeat, sense of heart pounding, perspiration, trembling, difficulty breathing or hyperventilation, feeling as though one can’t get in a full breath, tightness in the chest area, faintness or disorientation, and nausea.
  • Feelings of terror, dreading the possibility of losing control, an intense fear of death and mortality, a numbing feeling that one is not entirely present in reality, and believing disaster is close at hand are all common psychological symptoms.
  • Putting off activities and places associated with past episodes of fear. This is known as avoidance behavior.
  • In between panic attacks, some with panic can experience a relentless fear of the next episode and an overpowering apprehension toward public spaces.
  • Additional features can include interference with everyday life, sleep deprivation including nocturnal panic (waking out of sleep with a panic attack), a decline in work or school performance, and disruptions to social relationships.
    • For some, panic attacks are sporadic, for others all-consuming.

What causes panic disorder?

Although the precise source of panic disorder remains unknown, it is believed to be a consequence of various elements, including:

  • Genetics: If your family has a history of anxiety or mood disorders, it is possible that you may be at greater risk for developing panic disorder.
  • Brain chemistry: Imbalances in neurotransmitters, among other brain chemicals, may be a contributing factor to the onset of a panic disorder.
  • Environmental factors: When individuals are exposed to a traumatic event, such as the loss of someone close or violence, panic disorder can be triggered.
  • Medical conditions: Panic attacks can often be mistaken for other medical issues such as heart disease or thyroid problems due to their similar symptoms.
  • Substance abuse: The misuse of alcohol and drugs can drastically raise the likelihood that someone will develop panic disorder.

It is important to recognize that panic disorder can coincide with other mental health issues. For example, someone may suffer simultaneously from both depression and agoraphobia (fear of public places). Therefore, it is imperative to seek out a comprehensive evaluation by a licensed mental health professional in order to accurately diagnose the underlying cause or causes behind an individual’s panic attack.  Dr. Ranen can provide the professional due diligence necessary to arrive at a proper diagnosis and treatment plan.

How is panic disorder diagnosed?

To accurately diagnose panic disorder, it’s essential to seek a professional assessment from either a psychiatrist, or psychologist. Such an evaluation would likely include the following steps:

  • Medical history: To better understand the patient’s history, a mental health professional will evaluate any prior or existing physical and emotional ailments and any current medications being administered.
  • Symptoms Evaluation: The individual will be requested to explain their signs, including the regularity and intensity of panic attacks and any connected physical and mental symptoms.
  • Mental health assessment: To ascertain whether the individual is suffering from panic disorder as specified by the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). A mental health professional will conduct an extensive mental health assessment.
  • Ruling out other conditions: In some cases, additional tests, such as laboratory tests or imaging studies, may be necessary to rule out underlying physical health conditions that could be contributing to the symptoms.


What are the types of panic disorder?

There are several subtypes of panic disorder, including:

  • Panic disorder with agoraphobia: The hallmark of this is Panic Attacks plus increasing avoidance of places and activities. People suffering from this subtype of panic disorder experience recurrent bouts of anxiety or fear, as well as stay away from potential sources they believe could trigger such attacks, and fell they can only be in what they see as safe spaces.
  • Panic disorder without agoraphobia: This specific variant of panic disorder is distinguished by the occurrence of panic attacks without any attempt to avoid places or scenarios that could potentially prompt them.
  • Substance/medication-induced panic disorder: If you experience panic attacks induced by taking drugs, medication, or exposure to a hazardous material, this type of panic disorder may be the diagnosis.
  • Panic disorder due to another medical condition: This subtype of panic disorder is diagnosed when panic symptoms are a direct result of another medical condition, such as a heart condition or thyroid disorder.


What are the treatments for panic disorder?

The treatment of panic disorder typically involves a combination of therapy and medication, and may include the following:

  • Psychotherapy: Overcoming panic disorder can be difficult, but there are two psychotherapies that have proven to be highly effective: cognitive-behavioral therapy (CBT) and exposure therapy. CBT involves uncovering and questioning harmful thought patterns while exposure therapy includes taking a gradual approach toward facing feared situations.
  • Medication: Selective serotonin reuptake inhibitors (SSRIs) and some serotonin and norepinephrine reuptake inhibitors (SNRIs) are considered first-line medications. Benzodiazepines are also sometimes considered.
  • Other Behavioral Approaches: There are a number of ways to reduce the symptoms of anxiety and panic, including relaxation techniques like deep breathing and progressive muscle relaxation. Another way to reduce symptoms is by maintaining a healthy lifestyle, which includes things like eating a balanced diet and getting regular exercise.
  • Combination therapy: To effectively regulate their symptoms, some people may find it beneficial to combine psychotherapy with medication and other behavioral approaches.


Why choose Dr. Neal Ranen?

When it comes to treating panic disorders, Dr. Neal Ranen is an excellent choice for those looking for personalized care and attention. Dr. Ranen has extensive experience working with patients suffering from panic attacks, as well as co-occurring conditions and related disorders, such as post-traumatic stress disorder, major depressive disorder, obsessive-compulsive disorder, general anxiety disorder, and social anxiety disorder. He provides individual therapy tailored to each patient’s unique needs. His comprehensive approach to care includes a blend of evidence-based treatments, such as cognitive behavioral therapy, and medications. If you are experiencing symptoms like those mentioned here, please reach out to Dr. Ranen for further assessment and treatment.