Dual Diagnosis Treatment for Panic Disorder and Addiction

Feeling some anxiety in certain situations—like before a big test, a job interview, or an unfamiliar task—is completely normal and not a sign of a deeper problem. However, waking suddenly in the middle of the night with intense fear or physical symptoms, known as a nocturnal panic attack, may indicate a panic disorder. While panic disorders and anxiety disorders share similarities, they are distinct conditions that affect people in different ways and require specialized approaches to treatment.

While a panic disorder diagnosis is less common, an anxiety disorder is considered the most common mental illness in the United States. According to the Anxiety and Depression Association of America (ADAA), anxiety disorders affect 40 million U.S. adults over age 18 each year, equating to 18.1 percent of the total U.S. population. Individuals with anxiety disorders are three to five times more likely to be in the hospital due to psychiatric disorders than those who do not have an anxiety disorder. On the other hand, panic disorders affect a smaller part of the population.

According to the National Institute of Mental Health (NIMH), 2.7 percent of U.S. adults were diagnosed with panic disorder in the previous year. The prevalence was higher in females at 3.8 percent than it was for males at 1.6 percent. The same statistics found that an estimated 4.7 percent of adults will experience a panic disorder at some point in their lives. Although the figures differ significantly compared to anxiety disorders, both conditions can cause debilitating symptoms.

Now, we know that one difference panic disorders and anxiety disorders don’t share is their prevalence in society. One is far more widespread than the other, but what other similarities and differences are there?

What is a Panic Disorder?

A panic disorder is a type of anxiety disorder characterized by recurring and unexpected panic attacks—sudden episodes of intense fear that trigger physical symptoms such as a racing heartbeat, shortness of breath, dizziness, or chest pain. These attacks can occur without warning, even in situations where there is no real danger, leaving individuals feeling overwhelmed and fearful of when the next episode might strike. Over time, the fear of experiencing another panic attack can interfere with daily life, relationships, and overall well-being, making early recognition and treatment essential.

According to WebMD, 10 percent of adults in the United States have panic attacks each year. These typically start around the ages of 15 to 25, but children or adults are also at risk of panic attacks. An estimated 33 percent of people have at least one in their life, but most won’t go on to meet the criteria of a panic disorder. An estimated 3 percent have it, and it’s far more common in women than men.

Panic Disorder Symptoms

A panic attack is something that comes on strong and leaves you feeling fearful. It can happen anywhere, at any time. If you have a panic disorder, you’ll have four or more of the signs below:

• Sweating
• Shortness of breathing or a feeling that you are being smothered
• Fast or pounding heartbeat
• A sense of impending doom
• Tightness in your throat
• Shaking or trembling
• Cramps in your stomach
• Chest pain
• Feeling faint or dizzy
• Headache
• Feeling as though you’re choking
• Hot flashes or chills
• Numbness
• Tingling
• Fear that you’ll die
• Fear that you’re losing control
• Feeling that you’re going crazy

Panic attacks typically subside within five to 10 minutes, but lingering effects can persist for hours. It might feel as though you’re having a heart attack, causing many people with panic disorders to seek emergency medical care. Most with the condition can pinpoint the cause of their panic attack and start avoiding those places. It can lead to something called agoraphobia, a fear of leaving their home. However, others may not know the cause of the panic attack, leading to an irrational fear that it’ll happen again.

What is an Anxiety Disorder?

An anxiety disorder is a type of mental health condition that causes you to respond to situations with fear and dread. It can also cause you to experience physical signs of anxiety, including sweating and a pounding heart. As mentioned above, the occasional anxiety is normal. In some cases, anxiety can be beneficial as it helps us recognize danger and focus our attention to avoid getting hurt. However, we move past that with constant anxiety when it’s affecting the quality of our life.

Anxiety disorders occur when it interferes with your ability to function normally in life, you overreact to certain triggers of your emotions, and you can’t control how you respond to the situations. Anxiety disorders make it much harder to get through a day. However, many treatments exist. There are various types of anxiety disorders, including the following:

• Phobias
• Panic disorder
• Generalized anxiety disorder (GAD)
• Separation anxiety

Symptoms of Anxiety Disorder

These symptoms will vary based on the type of anxiety disorder you’re diagnosed with but include the following:

• Muscle tension
• Cold or sweaty hands
• Dry mouth
• Heart palpitations
• Shortness of breath
• Nausea
• Numbness or tingling in your hands and feet
• Nightmares
• Panic or fear
• Uncontrollable or obsessive thinking
• Flashbacks of traumatic experiences
• Inability to remain calm
• Insomnia

Differences Between a Panic Attack and an Anxiety Attack

Many people talk about panic attacks and anxiety attacks as if they are the same. However, they’re different conditions, meaning their symptoms are different. Anxiety attacks are not mentioned in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). Still, it defines anxiety as a number of common psychiatric disorders, with panic attacks being defined as something that comes on suddenly. Panic attacks, which involve intense and overwhelming fear, are accompanied by shortness of breath, a racing heartbeat, and nausea. They’re categorized as unexpected or expected.

Unexpected attacks are exactly what they sound like, something that comes on without a cause. Negative external stimuli, such as stress or a phobia, cause expected panic attacks. Panic attacks can happen to anyone at any time, but what indicates that you could have a panic disorder is the amount, severity, and frequency of these attacks.

Anxiety typically stems from the anticipation of a stressful event, such as a job interview, boarding a plane when you’re afraid of flying, or going on a hike where animals might be present. Since the DSM-5 does not recognize it, the symptoms are open to interpretation. When someone is described as having an anxiety attack, their symptoms can differ from someone else’s attack but still be considered an anxiety attack.

Treating Panic Disorder and Anxiety Disorders

Since these two conditions share some similarities, their treatment approach will also be somewhat of the same. Treatment can include psychotherapy, medication, or both.

Cognitive behavioral therapy (CBT) is a widely used and effective means of treating anxiety and panic disorders. It can help you see your worries in a new way. Counselors will assist you in developing new strategies to manage your triggers when they come on. CBT can also help you pinpoint and neutralize unwanted thoughts that worsen an anxiety disorder.

Exposure therapy is another method used to control and help with anxiety. Controlled exposure to situations that make you anxious helps you learn how to confront these fears in a different way. Doctors will also suggest breathing exercises when an attack arises.

If therapy alone isn’t working, doctors may suggest medication. This can include antidepressants, beta blockers, or anti-anxiety drugs like benzodiazepines. All these drugs have the potential for adverse effects, but your doctor will recommend the best treatment in your situation. In most cases, you will go through a combination of therapy with medications if your condition is severe enough to warrant it. Speak to your doctor to find out what works best for you.

Dual Diagnosis Treatment for Panic Disorder and Addiction

Dual diagnosis treatment for panic disorders and addiction is designed to address the complex relationship between recurring panic attacks and substance abuse. Many individuals with panic disorder turn to drugs or alcohol as a way to manage their overwhelming anxiety and physical symptoms, such as rapid heartbeat, shortness of breath, and dizziness.

Unfortunately, self-medicating often worsens both conditions over time, leading to a cycle of dependence and heightened panic. A dual diagnosis program recognizes the need to treat both the mental health condition and the addiction simultaneously, providing a more sustainable path to recovery.

Therapy

In these programs, therapy is tailored to help individuals understand the underlying triggers of panic attacks while teaching healthier coping strategies. Cognitive behavioral therapy (CBT) and exposure therapy are commonly used to help patients manage panic symptoms without relying on substances.

At the same time, medical professionals oversee detox and withdrawal to ensure safety, since substance misuse can complicate anxiety symptoms during the recovery process. By addressing both disorders together, patients are less likely to relapse, as they learn to manage their anxiety in healthier ways.

Support

Supportive therapies, such as mindfulness training, relaxation techniques, and group counseling, also play an important role in helping patients regain control over their lives. These tools not only reduce the severity of panic attacks but also strengthen resilience against addictive triggers.

With comprehensive care that treats both panic disorders and addiction, individuals have the opportunity to break free from the cycle of fear and dependence, allowing them to build a stable and healthier future.

Contact Serenity at Summit

If you or a loved one is struggling with addiction, don’t wait to get help. Reach out to us today.

Our team at Serenity at Summit is here to guide you through every step of your recovery journey, offering hope, healing, and long-term success.