Can depression cause panic attacks?

14 answers | Last updated: Nov 11, 2016
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 Answers

Kenneth Robbins, M.D., is a senior medical editor of 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.

Community Answers

The practical expert answered...

Depression and Anxiety are two different diagnoses, though if a person has depression, having anxiety attacks too is not uncommon.

There are meds for each diagnosis and some cover both. These drugs usually fall into a class called SSRIs and many have side effects too. There are natural alternatives to try before going to perscrition meds and a major way to help is learning cognitive therapy which means developing a tool box of tricks to use when depressed or having anxiety to help prevent and/or reduce it. Developing this bag of tricks can even eliminate the need for meds or at least reduce the need. Find a therapist that does cognitive therapy is great and is not forever, read about it in books and on websites. You learn when leave, what your triggers are and how to avoid or deal with them, coping mechanisms, etc.

Over the counter products you can try are: Melatonin at night for sleep, is a natural substance we produce less of as we age.

Take a good quality multi-vitamin and a good quality multi-B complex vitamin daily.

Omega 3 (fish oil, or borage oil or flaxseed oil) of 2400mg day will help with depression.

5-HTP daily increases your brain's seratonin levels. You can start with the 50mg and see how it works and progress from there. You cannot take this with perscrition anti-depressants though. SAM-e you can though but it is much more expensive.

Increase vitamin C to 2000mg a day too.

Jsilverj answered...

My name is Charles. I suffer from Panic attacks and depression.-- (I think).. I really feel it is more appropriate for a person with this illness to describe what they feel than someone, even a doctor, who has never been through it. When I was 21 I was diagnosed with Panic Disorder and mild depression. I was prescribed Prozac. It worked very well. Then at 30, while I was off the Prozac, I had another attack and the Dr. again wrote me a script for Prozac. I took it that evening and in the middle of the night I had the most intense scariest episode ever. I woke in a State of major depression. The only thoughts I had were to swallow a bottle of pills because I couldn't take that feeling and you always think it will last forever. It lasted 2 days with the heaviest intensity that night. My point is that our bodies don't always react to the same medication. My dilemna, however, is what do I have Panic disorder or depression. Well, it just came back the past couple of days and I believe its depression. I just get so scared its amazing. I don't wanna live when these feelings arise. The scared feeling is panic but the general feeling is sadness. I imagine telling my children " Time for Daddy to go give him a big kiss " and I start crying because I imagine killing myself after that. Then the intrusive thoughts start.. my daughters severed head on a platter...I mean it's incredible!!! I am ok to write this now and I find those thoughts ridiculous, but I didn't want to forget what I was thinking so I can tell the psychiatrist. The other reason I feel I needed to write this is I don't have many of the symptoms of either panic disorder or depression. I have some but everytime I fill out a survey i come up normal. As far as panic... I never called an ambulance.. never thought I was dying, well only once on my first first attack. I never have cold sweats, never have clammy hands, etc... I just feel incredible terror so much it can't be described. Then with depression.. I never want to stay home or away from people, in fact seeing and talking to people make me feel better. I never sleep all day, never change my behavior but I do get those sad sad thoughts. Will someone please tell me what it is I suffer from? Thank you

Blahdeedah123 answered...

Dear Charles, your answer right above mine had me identifying with you right away. I know just how you feel, i felt the same way but recently I got help from God. He's the only one that was able to help me get through the panic attacks . I suggest prayer and for you to speak to a pastor as soon as possible. I too had those intrusive thoughts and felt like dying when the panic attacks came by and Im only 18 so it seems like not many people my age go through this but I was able to get help at church and with a lot of prayer. Only God can truly help and I pray that God blesses you and helps you get through this as He has helped me!

Seekersusie answered...

To the Practical Expert: I have worked in Health Care for 30 years in various capacities; hopice and nursing assisting mostly. I personally don't experience panic attacks, but do know what depression is. I have found a formula which works for me.

I definitely agree with your stated answer here;looking for natural ways to build health and becoming more aware and responsible for our own health. I have found that the usual orthodox medications lead to complications and dependency, rather than developing tools to find solutions to the issue. I study natural health; alternative medicine. I have found that taking Vitamin D3 @ 5000 mg daily along with CoQ10 and Vitamin C @ 1000-5000mg daily, along with a natural source of Multi-vitamin w/ B-12 lifts my spirits, strengthens the immune system, gives positive energy even when stress and isolation points towards depression, for myself and many others. D3 and CoQ10 has been shown through substantial scientific studies to also be highly effective aids supporting bone health, and counteracts gum disease; an all around effective treatment plan. seekersusie, a new member

Seekersusie answered...

I forgot to include, somehow, my very recent experience helping a couple of friends who are in their late 90's and live down the hall from me. I have been involved in their care especially when I discovered he had a temp of 102. I called 911 and he went to the ER...then admitted to the hospital. He and his wife of 40 years had long been depressed. Five days after he was admitted his wife had a panic attack; couldn't talk, or catch her breath, so went to the ER also, then home, then had a stroke and back to the ER again. Their religious beliefs have meant experiencing life as victims, and when I have suggested she, especially, learn how to release her worries and ever present anxiety, she saw that as yet another thing to do, so put it on a list of to do's. They are both intelligent, and are actually now open to the theraputic help they are currently being offered! They don't like taking pills and want to stay independent. I learn a lot from them. seekersusie

Jman653 answered...

Yes , indeed I'm am no doctor but my depression started with 2 panic attacks. The first one was small , but I believe the first one made the 2nd one much easier too occur cause it was easy to have one after u have had one. My 2nd panic attack was by far my worst. I seriously thought it was going to kill me. Which then remembering the panic attacks and the thoughts I had scared me slowly caused depression and before u know it it consumes your day. Like the doctor wrote above I quickly learned that alcohol stops depression and in which stops panic attacks. But it's only temporary once it wears off u still have the same depression. Another thing I noticed was when my girlfriend was around it was much easy not to get depressed especially if we were engaged in flirting or kissing or in a serious discussion. So it really helped having her around. I hope I have helped people by talking about my experience !

A fellow caregiver answered...

I believe depression can cause panic attacks. I have dealt with depression throughout my life, and have also had panic attacks (not as much now--I'm taking antidepressants/antianxiety medication). I have, however felt that the depression I am still experiencing lately (my husband left me after eight years of marriage, and he left the same week we had to bring my mother to a dementia unit in a nursing home). It's been approximately a year or so since these changes have taken place, and I still wake up full of fear. I don't always get a "full-on" panic attack (though I've had them)--but I get panicky and scared. I feel this way most of the time. The only thing I have found that has helped me to talk myself out of a panic attack has been to remember that it IS just a panic attack, and I try to think specifically what was I thinking about right before it happened. If it's something from the past that I was upset about, I remind myself I can't change the past. If I was worrying about the future; I remember that I need to stay in the present and worrying about the future doesn't and has never helped with anything. I've worried about many things that never even ended up happening.

A fellow caregiver answered...

I've heard anxiety and depression described as "the evil twins", meaning that they tend to often show up as a pair. At times, the lethargy and extra effort it takes to do daily tasks when depressed triggers anxiety and fear. Self-critical thoughts and fears of "what's wrong with me" and "am I ever going to feel better" can quickly feed a down-ward spiral.

A good physical and lab work is important - checking thyroid, vitamin B and D levels as well as for anemia; sleep study if indicated, etc. These were "part" of the answer for me. Just my opinion, but steer clear of people with quick fix or one size fits all answers. Changing thoughts and behaviors in small ways helps too.

If the doctor suggests meds - just know that it doesn't mean it's forever - it may be your body and brain just need some temporary help so you can get your balance back. Truth is that our tool kit for managing this needs to include a variety of tools of different types - sleep, deep breathing, changing self-talk, taking time to do something creative - especially if we give ourselves permission to just enjoy it and not be good at it); doing one simple thing that absorbs our attention in the moment that increases our feeling of self-control.

For me, thinking too much about what's happening and why (symptoms), etc. makes it worse. Do what you can - make a doctor's appt., then doing something else as distraction works better. The more I try to force an answer, the worse the anxiety and discouragement become. Just some tips from my journey with the "evil twins".

Sunnymoon answered...

I believe depression and panic attacks are different illnesses but But both easily found in those who who suffer chronic illnesses. I was diagnosed with Fibrosis in the early eighties and was treated with prednisone, which only made my condition worse. My doctor kept me on this medicine for two years and iIt nearly destroyed mr. But at the time I had no idea what is was or that my aggressiveness , weight gain an anxiety were from the medicine. Then in the late eighties I found a clinic in Charlotte, NC that was diagnosing Chronic Fatigue and Fibromyalgia and they knew immediately my immune system was not functioning properly and began treatment that helped. But then my home was robbed by someone I knew and trusted and she stoke over $10,000 worth of my good jewerly. And a few months later, I was mugged and robbed. I did not get help since I thought I was was handling it well. It was a year before I began experiencing sever panic, anxiety and flash backs. Then I became so ill, with weakness and debilitating fatigue, mild depression, chronic head aches, mental fatigue, and my Fibromyalgia muscle aches and pain were also exacerbated. I continued to get so bad, I could no longer drive, had chronic IBS, lost 60 pounds, and afraid to leave my home. Then last August, I had an accident and severely broke my wrist. My bones were so crushed the surgeon was not sure it could be repairs. He put rods and pins on both sides of my wrist but, I eventually had to have one removed. It also caused major nerve damage. I am in chronic pain from this everyday but, I am thankful that although I have limited use of my arm and hands. However, this accident has caused major flash backs, exacerbated the other chronic illness and caused mr to become severely depressed.

And a major problem with illnesses others cannot see, don't understand and will say You don't look sick which means there is no way they can understand how severe these blind illnesses are. It use to hurt me that some refused to believe I was so ill. But in fairness to everyone, it is difficult to understand something that cannot be seen or that you have never experienced. My major heartache is every Christian self help book I read blames it on the one who cannot think positive and have enough Faith to overcome your illness. I am a Christian who loves The Lord and believe in the power of prayer . But I understand nature and illnesses and though faith helps overcome many health issues, it does not heal all of our problems. And get so frustrated when I am told to have faith and let go. If it were as simple as changing your thinking, I would be well or never have gotten these health problems. What we need is for others to be more compassionate, learn more about mental issues and encourage others, not blame us for our health problems. If I had cancer, they would have compassion. In fact, when I broke my arm an it was in a cast everyone seemed so caring and concerned. I pray one day society will understand mental Health issues are real illness like my broken arm. And for the care takers, my hearts goes out to you. I feel I am dragging my dear husband down and feel so guilty for the total responsibility he has had to take over during this severe depression. I try hard to make sure he keeps an active enjoyable life while having to care for me. I do all I can not to put too much on him. I need him healthy and happy. He is truly a blessing and I appreciate more than ever. But, I know it is even more difficult for him at times than it is for me. Being a caretaker is so difficult and those of us who has someone who loves and understands our illnesses, are truly blessed beyond measure and I know God will bless each of you through your own personal pain and suffering. The sacrifices of being a caretaker requires unconditional love and special strength and endurance and my heart goes out to each of you. There are no easy answers for the sick or their caretakers.

A fellow caregiver answered...

This is for Sunnymoon specifically but maybe it'll make sense to some others too.

You have had a really bad time. Repeatedly. You have all my sympathy. I was recently assaulted by a stranger in a hooded top not long after moving to a new town as well and this not long after losing a long term job. I would say that I've always had issues with fear and panickiness anyway and I recall having my first really terrifying panic attack decades ago when about to board a plane to visit an Arab and to my mind, very alien country for a few months. I'll never forget that terrible day. I was so terrified I actually started hallucinating at one point. ASNyway with all the problems I was having with my life, this attempted mugging just tipped me right over a precipice. I allowed myself to become very negative, aggressive with others who were when all is said and done only trying to be helpful or friendly, and often reluctant to leave my house. I began having big panic attacks, then had what I would like to call a breakdown but I suppose these days would be called psychosis. I was arrested for breach of the peace. There is still graffiti all over my lounge wall. It's not very nice and I'm going to have to redecorate soon. On and off I had very dark thoughts and on at least two occasions thought of killing myself. My immune system took a nose dive and I got pneumonia. I am now taking SSRi's and hoping to be starting some sort of therapy, possibly CBT soon.

This is the important part though, Sunnymoon, since any one who has experienced both panic attacks and severe depression already knows that stuff I have recounted in the paragraph above from the inside.You said, "If only it were as simple as changing the way you think -" Changing the way you think is not impossible. These self help books which advise you to break the cycle of negative thoughts are quite correct and they are also, not dismissing your illness or the serious nature of it one little bit. It is the negative thinking that makes us so ill.

However you choose to do it, with faith, therapy and antidepressants or maybe deciding it is time for a mid life crisis, buying a Harley and going on the road trip of a life time, it is time to take control of your thoughts. They have been controlling you and this, cannot go on Sunnymoon.

I read your post and I really did sympathise with you, you have had a lot of unfairness and rotten luck. But I also noticed that you spent a lot of time feeling bad that you are burdening your husband, who loves you and that is why is he is still there caring for you. Stop beating yourself up, it is not your fault. Be less negative. Don't do yourself down. Self intervene. Stop negative, and looping thoughts as soon as you realise they are happening. You can do it. You are the master of your mind, not the other way about.

Good luck to every one who has posted their story here, I hope you all find a solution to your illness that works for you, and very importantly, I hope you all get yourselves educated on how depression and panic attacks do the things they do. Know your enemy, it's tthe only way to beat the Bastard.Just remember, with mental illness, sometimes, YOU are your own enemy.

A fellow caregiver answered...

I have yet through my doctors over the years found an antidepression medication to help inhibit panic attacks period. The only medication that will truly get me through a stressful situation are Benzodiazapines ie; Klonapin, etc. I have been diagnosed with moderate to severe depression, severe panic attacks (feels like a stroke etc.), ADD, with some Bi-Polar characteristics. I've been tried/tested on most all of the different anti-depression meds over the past 12 years and finally found two brands that help with the depression but never with the panic attacks that seem to always happen in front of large groups of people and is embarrassing along with the degradation of my career within the same field for 28 years. I feel and pray for people that go through life with this perceived fear!

Peta answered...

I experienced it first 4 or 5 years ago. It was horrifying. The symptoms are not the exact ones that are explained for them. Sometimes I feel dying but mostly I have panic in its real meaning . This feeling is so horrible that at the time I want to end my life. I want to attach to some one to protect me to to something to make me better. I want o talk but I do not know what to say and even I feel if I say they wont understand. I feel a distance between me and others, so creepy and scaring.

Tidewater slim answered...

I am currently suffering a bout of depression even as I write this and I have been having anxiety attacks with this bout and a bout I have had a while ago.....I mean impending doom. If i had a sore throat I would swear my throat is closing. My wife and I about a month ago experienced a great loss. I initially cried and went through the sad feelings thinking at least the worst of it was done. Then all of a sudden, no warning, no trigger. Just a wave of anxiety and panic, then came the depression and since its been beating me down but I have been experiencing the anxiety attacks too. I dont know if they are hand in hand but in both of the worst episodes I have had the anxiety. This is the first time I just felt uncontrollably SAD. I usually take the angry all the time approach for my depression so this time is real crazy. I dont have any answers just my 2 cents. And in typing this and kind of talking about it made me feel a little better. Thank You