Panic Disorder

A panic attack can feel like a medical emergency. Your heart races, your chest tightens, you cannot catch your breath, and your body is telling you with absolute certainty that something is seriously wrong. Many people who experience their first panic attack end up in an emergency room or a cardiologist's office, convinced they are having a heart attack. When the tests come back normal, the relief is temporary, because the fear of it happening again has already taken hold.

That fear is what turns a single episode into a disorder. Panic disorder is not just having panic attacks; it is the persistent dread of the next one and the changes a person starts making to avoid triggering it. Someone stops driving on highways. Someone else avoids crowded stores. A teenager refuses to go to school. The world gets smaller one avoided situation at a time, and the pattern reinforces itself because avoidance feels like the only thing that works.

For many patients, the turning point is not just that the attacks become less frequent. It is that the places and situations they had given up start to feel possible again.

What most people do not realize is that panic disorder is one of the most responsive psychiatric conditions to treatment. The attacks themselves, as terrifying as they feel, are not dangerous, and with the right medication and support, the frequency and intensity can decrease significantly. Many patients describe the change as getting their life back.

Signs and Symptoms

Panic attacks are sudden surges of intense fear or discomfort that peak within minutes. The physical symptoms are what make them so frightening. These include racing or pounding heart, chest pain or tightness, shortness of breath, dizziness, nausea, trembling, sweating, tingling or numbness in the hands or feet, and a feeling of being detached from your own body.

Many people experiencing a panic attack are convinced they are dying, losing control, or going crazy. That conviction is part of the attack itself, not a rational assessment of danger. The intensity of the physical symptoms is what drives so many patients to emergency rooms and cardiologists before they ever see a psychiatrist.

Panic disorder is diagnosed when a person has recurrent, unexpected panic attacks followed by at least a month of persistent worry about having another one. That worry often leads to avoidance behaviors that can grow over time. A person who initially avoids only the place where the first attack happened may gradually begin avoiding any situation where escape would be difficult or help unavailable.

In children and adolescents, panic disorder can be harder to recognize. Younger patients may not have the vocabulary to describe what is happening. They may express the experience as a stomachache, a headache, or simply a desperate need to leave. School avoidance, clinginess, and physical complaints that spike in anticipation of specific situations are common presentations.

Panic disorder frequently co-occurs with agoraphobia, generalized anxiety, depression, and in some cases substance use, when a person turns to alcohol or other substances to manage the fear.

How We Approach Panic Disorder Treatment

We start by getting a clear picture of what is happening: how often the attacks occur, what they feel like, what you or your child have been avoiding, and whether other conditions may be contributing. A careful evaluation matters because panic symptoms can overlap with medical conditions, other anxiety disorders, and depression.

For many patients, medication is the most direct path to reducing the frequency and severity of attacks. We explain the options, what each medication does, and what the adjustment period looks like. Some medications take effect quickly; others build over weeks. We monitor closely, especially early in treatment, and adjust as needed until the response is right. If you are seeing a therapist, we work alongside them, because medication and therapy together tend to produce the strongest results.

The avoidance patterns that develop around panic disorder are often as disabling as the attacks themselves. As the attacks come under control with treatment, many patients find that the situations they had been avoiding become manageable again. That process takes time and sometimes deliberate effort, but it starts with getting the panic itself under control.

What to Expect

Your first appointment is an in-office psychiatric evaluation. Dr. Teitelbaum will review your history, ask about your symptoms, and take the time to understand what is going on before recommending a treatment plan. For children and adolescents, a parent or guardian is part of that conversation.

Follow-up visits are scheduled based on your individual needs. When starting or adjusting medication, more frequent check-ins help us monitor your response. Once treatment is stable, visits are typically less frequent.

After your first in-office visit, telehealth appointments are available for patients located in Florida. An in-office visit is required at least every six months.

When to Seek Help

If you have had one or more panic attacks and find yourself worried about when the next one will happen, a psychiatric evaluation can help. If you have started avoiding places or situations because of that fear, that is another sign worth taking seriously. If your child is having sudden episodes of intense physical distress that do not have a medical explanation, that is worth looking into as well. You do not need to have a diagnosis to call. You do not need to be in crisis.

For non-emergency questions about scheduling or whether our practice is a good fit, call us at (561) 630-8530.