Get helpful tips from the experts on all things panic.

1. Kevin Chapman PhD

In honor of Mental Health Month, the Anxiety and Depression Association of America held a Twitter Chat under the #GotPanic? ADAA members Dr. Debra Kissen @LightOnAnxiety, and Dr. Kevin Chapman @drkchap answered Twitter's questions about symptoms, management & treatment of the panic disorder.

1. What is Agoraphobia? How can it be treated?

Dr. Kissen: Agoraphobia can be a combination of a variety of factors. Some people feel more comfortable in their hometown than others. Others are more comfortable at home. Agoraphobia is when you avoid certain activities out of fear of anxiety. The key to getting past agoraphobia is not to let pressure dictate your life. Instead, you should take control of your destiny and choose where and what you will do. You are in control of your own life and not anxiety.

Dr. Chapman: Agoraphobia is anxiety about situations or places where escape might be difficult or embarrassing. They were driving, in crowds, waiting in lines, enclosed spaces, theaters, bridges, etc. CBT Works are incomplete without exposure therapy.

2. What is the relationship between panic and anxiety?

Dr. Kissen: Anxiety and panic are bi-directional. Avoiding panic feelings can increase anxiety, which will only lead to more terror. You can get stuck in a vicious circle of panic and fear.

Dr. Chapman, Dr. An antidote for panic is to stop the downward spiral of anxiety. This relationship can be best explained in the psycho-education phase of CBT.

3. Are panic attacks "out of the blue strong>?

Dr. Kissen: Panic attacks can feel entirely out of the blue. Sometimes, the brain may stumble upon a false alarm or threat trigger that is not obvious to one's awareness. The brain believes a Lion is eating you, but your rational front brain knows there isn't one.

As I race to answer chat questions, I feel sensations similar to panic, such as rapid breathing and an increased heartbeat. However, I know these sensations are related to this experience. Therefore, I don't interpret these feelings as dangerous.

Dr. Chapman: Dr. Kissen got this one right. Nope. Nope. It's similar to pulling a false alarm of danger when there is no fire.

4. People with panic should not avoid caffeine or exercise.

Dr. Kissen: People with panic disorder should not avoid exercise or caffeine. Your brain must be taught to handle a variety of sensations.

Dr. Chapman, CBTWorks: The answer is no. Chapman: Symptom induction is an essential component of CBTWorks. Getting used to panicky physiological arousal is critical to enhancing exposure therapy.

5. What makes me feel like I'm going crazy when I panic attack?

Dr. Kissen: A panic attack occurs when the body is in flight/fight mode without a threat. The body needs extra oxygen to survive.

This extra oxygen is not used as there is no "REAL DANGER," and it can cause lightheadedness. A common fear during panic attacks is that one will faint. However, the truth is that it is possible to stay awake and not fall asleep. Panic attacks are associated with increased blood pressure. Passing out is related to a drop in blood pressure. Blood harm phobia is an exception.

Dr. Chapman: Your core is vital when you are in danger. Fear and panic can trigger adrenaline, which floods the body into "action." Blood & oxygen flow to the body's core, away from other parts. You feel good!

6. What is your best tip to get over panic disorder?

Dr. Kissen: You should love what you're doing. It is essential to focus on the most important things when you feel anxious and to ground yourself in what you want this moment to be.

Dr. Chapman: Panic can be described as a false alarm. It is an unpleasant but not dangerous bodily sensation that can be inducible by many activities. Many of these we enjoy (e.g., espresso). Avoidance of panic increases anxiety. However, staying in a situation can lead to victory. In other words, panic symptoms can indicate that your body responds to danger if you are experiencing fear. This is why panic attacks are called false alarms. What is the difference? Fear is a way to pay attention to the threat, not our bodies.

7. What medication and treatment is most effective for panic disorder?

Dr. Kissen: CBT is the best treatment for panic disorder. Interoceptive exposure is the critical element of CBT for panic disorder (learning to play with anxiety sensations vs. running from them). You can treat panic disorder. Don't lose heart!!

Be careful with benzos as they reinforce your brain's belief that you are in danger. More evidence supports SSRIs to treat panic.

Dr. Chapman: Signing Doc here. Naturally. I would add the psychoeducational component of teaching clients about the relationship between anxiety, panic, and fear.

8. What can I do to help panic attacks that make me feel like my control is being lost?

Dr. Kissen: It is not the same feeling as losing control. Imagine a person who seems out of control. What is the cause? This is panic spam mail.

Dr. Chapman: Slow and controlled breathing can be helpful to reduce hyperventilation and stay in certain situations. It is essential to choose your thoughts ahead of time. Feeling "out of control" and losing control are two different things. Ask yourself, "How many times have you lost control?"

9. Do I feel this way for the rest of my life? This is my new normal.

Dr. Kissen: There are many reasons to be optimistic. Panic disorder can be treated. You can find a mental health professional who offers CBT for panic. This will help you to get relief quickly through hard work and support.

Dr. Chapman: Anxiety can be overcome and doesn't have to be a new norm. For many resources, please visit adaa.org. Many skilled practitioners can provide effective, structured treatment.