Can depression cause panic attacks?

A fellow caregiver asked...

Does depression cause panic attacks? My doctor wants me to take antidepressants to cope with depression and panic attacks, which happen a few times a week.

Expert Answer

Kenneth Robbins, M.D., is a senior medical editor of Caring.com. He is board certified in psychiatry and internal medicine, has a master's in public health from the University of Michigan, and is a clinical professor of psychiatry at the University of Wisconsin-Madison. His current clinical practice focuses primarily on geriatrics. He has written and contributed to many articles and is frequently invited to speak on psychiatric topics, such as psychiatry and the law, depression, anxiety, dementia, and suicide risk and prevention.

Panic attacks are are the sudden onset of severe anxiety associated with a number of physical symptoms. The most common associated symptoms are sweating, shortness of breath, heart pounding, dizziness and chest pain. They are very frightening, and, if you are experiencing panic attacks, you may end up in emergency rooms because you are afraid you are experiencing a heart attack or some other medical emergency. These attacks are more common when someone is depressed, and depression is common amongst people with panic attacks, but they more often occur in the absence depression. These attacks are so troubling, there is a high incidence of alcohol abuse amongst people who experience panic attacks and panic attacks are a risk factor for suicide. You may find as these panic attacks continue that you start isolating yourself at home. This is because you will reflexively avoid places you had panic attacks, and because you may feel embarrassed or more anxious when you have panic attacks in public. This can lead to agoraphobia, a fear of open spaces, and this can be quite disabling.

Your doctor is on the right track with the recommendation of antidepressants, but that should only be part of the treatment, and they may not be necessary. The first step for treatment is education. You must be taught these attacks are not life threatening and each attack will go away on its own, generally within 10-30 minutes. It is helpful for most people to learn relaxation techniques to help decrease the emotional response to these episodes. A talk therapist who is skilled in treating panic attacks can teach you guided imagery skills as well. This will help distract you from the frightening symptoms and perhaps will help to decrease the symptoms themselves. Panic attacks often occur in clusters and it is common the cluster is preceded by something stressful. Talk therapy can be helpful in identifying and managing the stressor and in decreasing avoidance behaviors that can lead to agoraphobia. You may find it helpful to get together with others who struggle with panic attacks to provide each other support and ideas. There are over 6 million people in this country who have them and they are more common amongst women than men.

Antidepressants are very helpful in the treatment of panic attacks, in fact they are more effective at treating panic attacks than they are at treating depression. The fact antidepressants are so effective in the treatment of panic attacks, however, does not mean it is because you have depression. These medications are very helpful in the treatment of panic attacks whether or not you also have a problem with depression.