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MN Psychiatrist
MN Psychiatrist, Psychiatrist
Category: Mental Health
Satisfied Customers: 792
Experience:  Physician for 17 years, adult psychiatrist for 13 years working with a wide variety of patients.
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Is it normal to have panic attacks on and off for 2 or 3 days

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Is it normal to have panic attacks on and off for 2 or 3 days and then they go away for a week or two and then come back. Also do they feel like a heart attack and cause chest pain? I went to the er last night with shortness of breath, chest tightness, and shaking. Chest X-ray and EKG were normal and I was fine after like an hour. Is this typical!
Submitted: 5 years ago.
Category: Mental Health
Expert:  MN Psychiatrist replied 5 years ago.
Hello, I am a psychiatrist.

I'm sorry you're struggling with this.
This sounds like panic disorder. People can definitely have chest discomfort and chest tightness. They an be constant, or come and go, or be sporadic, or disappear for a while and then come back.
The good news is that for as miserable as panic is, it's one of the easier things to treat in psychiatry. Family doctors and general medical doctors treat this, as do psychiatrists.
Customer: replied 5 years ago.
So if everything was normal in the er, I don't need to worry if I'm having the same symptoms tonight. They are not nearly as bad as last night though.
Expert:  MN Psychiatrist replied 5 years ago.
Just so long as it's been verified that you were/are not having an kind of medical problem, this is correct. In fact, some people just live with untreated panic, since they know it won't hurt them (I wouldn't, but some people do).
Customer: replied 5 years ago.
What can make it better? It really feels like you could die of heart attack or something but chest X-rays and ekg is normal. It's very unnerving. Other than a Xanax a day, I take about three .25 pills a week, what can I do?
Expert:  MN Psychiatrist replied 5 years ago.
The way panic is treated is to take an SSRI (serotonin) antidepressant (Prozac, Paxil, Zoloft, etc.) daily. They call them antidepressants because that is their main use; but they are used for a variety of things. Anyway, at an appropriate dose, they will often completely stop panic attacks from happening. In the meantime, while one is being started or increased, an agent like Xanax is used. Xanax is a quick-acting antianxiety medication that will stop panic attacks that are already in progress, although 0.25mg is a very small dose. I frequently start patients on 0.5-1mg of Xanax, up to 2-3 times daily as needed. The idea behind using the SSRI is that since they can often get the panic to stop happening, you don't have to then take Xanax all the time in order to be panic-free; this is a good thing, as Xanax and other medications that work like it can become addictive. That said, I've never, ever seen a patient get close to being addicted to Xanax during the early stages of treatment when we're still trying to get the panic to go away.

Does this make sense?
Customer: replied 5 years ago.
Yes, I understand the treatment and will talk to my doctor about it. But... Are the scary, dying feelings normal during panic attacks?
Expert:  MN Psychiatrist replied 5 years ago.
They don't happen to everyone, but they happen to a lot of people who have them. I'm sorry that you're one of those people.
Be encouraged, though - panic disorder is very treatable.
Customer: replied 5 years ago.
So I'm not physically sick, just having typical attacks?
Expert:  MN Psychiatrist replied 5 years ago.
If the ER doctor verified that you're not having a medical problem, then there shouldn't be anything wrong with you, and yes, what you're having is fully consistent with panic.
MN Psychiatrist and other Mental Health Specialists are ready to help you