Do You Struggle with Panic Attacks? Turned Leaf Psychiatry Can Help

Imagine you are sitting at your desk, driving home, or simply relaxing on the couch when, out of nowhere, your heart starts racing. Your chest tightens, the air feels too thick to breathe, and an overwhelming wave of dread washes over you. You feel like you are losing control, having a medical emergency, or even dying.

If this sounds familiar, you are not alone. You may be experiencing panic attacks, a profound and disruptive form of anxiety that affects many people.

At Turned Leaf Psychiatry, we understand how frightening and isolating these episodes can be. You don't have to live your life waiting for the next wave of fear to strike. Let's break down what a panic attack is, how it's diagnosed, and how evidence-based treatments can help.

Recognizing the Signs: What Does a Panic Attack Feel Like?

A panic attack is a sudden surge of intense fear or discomfort that peaks within minutes. Because the physical symptoms are so severe, many people mistake a panic attack for a heart attack or another life-threatening emergency.

According to clinical standards established by the American Psychiatric Association, a full-symptom panic attack involves the abrupt onset of at least four of the following physical and psychological symptoms:

Physical Symptoms

• Heart palpitations: a racing, pounding, or skipping heart rate.
• Chest pain: tightness or sharp discomfort in the chest area.
• Shortness of breath: feeling smothered or hyperventilating.
• Choking sensation: a feeling of tightness or a "lump" in the throat.
• Dizziness or lightheadedness: feeling unsteady, faint, or woozy.
• Sweating and chills: sudden hot flashes or cold sweats.
• Trembling: visible shaking or internal body tremors.
• Numbness or tingling: prickling sensations (paresthesia) in the hands, feet, or face.
• Nausea: stomach upset, cramping, or sudden gastrointestinal distress.

Psychological Symptoms

• Derealization/depersonalization: feeling detached from reality or from your own body.
• Fear of losing control: a distressing feeling of "going crazy" or about to lose control.
• Fear of dying: an overwhelming, impending sense of doom.

These diagnostic criteria are detailed in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5-TR).

Navigating the Diagnosis: Is It a Panic Attack or Panic Disorder?

Anyone can experience an isolated panic attack during a season of extreme stress. However, if these attacks become a regular occurrence, they may cross the threshold into Panic Disorder.

At Turned Leaf Psychiatry, our diagnostic process is comprehensive. We use a multi-step evaluation to help arrive at an accurate diagnosis:

• The one-month rule: Per DSM-5-TR criteria, a diagnosis of Panic Disorder generally requires recurrent, unexpected attacks, followed by a month or more of persistent worry about having another attack, or significant changes in daily behavior to avoid them (such as avoiding exercise or crowded spaces).
• Ruling out medical causes: Because panic attacks can mimic cardiac or endocrine issues, we help consider medical conditions like thyroid dysfunction, blood sugar changes, or heart arrhythmias, coordinating with other providers as needed.
• Differential diagnosis: We consider how Panic Disorder differs from other conditions. For example, if panic occurs only around public speaking, it may be Social Anxiety. In Panic Disorder, the core fear is often the panic attack itself and the accompanying bodily sensations.
• Clinical assessment scales: We may use validated tracking tools, like the Panic Disorder Severity Scale (PDSS), to help measure symptom frequency and track progress over time.

The Path to Relief: Evidence-Based Treatments

The goal of treatment isn't just to stop a panic attack in the moment—it's to help the nervous system stop interpreting normal physical sensations as emergencies. Evidence-based approaches include:

Psychological Therapy

Cognitive Behavioral Therapy (CBT), including techniques such as interoceptive exposure and Acceptance and Commitment Therapy (ACT), can be highly effective for panic symptoms. These approaches are typically delivered by a trained therapist, sometimes involving carefully guided exercises to help the brain relearn that certain physical sensations are uncomfortable but not dangerous. Turned Leaf Psychiatry does not provide therapy directly, but we can help coordinate referrals to qualified therapists as part of a treatment plan.

Medication Management

When appropriate, medication may be one part of a treatment plan:

• Daily options (SSRIs/SNRIs): Medications like sertraline or escitalopram are sometimes prescribed daily to help lower baseline anxiety over time. Any decision about starting, adjusting, or combining medications should be made with your prescriber based on your individual history.
• As-needed or short-term options: Medications such as beta-blockers can help manage some physical symptoms of anxiety, while other short-term medications may be used selectively under a clinician's guidance for active symptoms. These decisions are individualized and made collaboratively with your provider.

Clinical literature generally suggests that combining medication management with therapy can support better long-term outcomes than either approach alone.

How Turned Leaf Psychiatry Can Help

Living with the worry of the next panic attack can be exhausting. At Turned Leaf Psychiatry, we provide thorough diagnostic evaluations and individualized medication management, and we can help coordinate referrals for therapy when appropriate.

Reach out to Turned Leaf Psychiatry today to take the first step.