What You Need to Know About OCD and Panic Attacks

In today’s fast-paced world, stress and anxiety are common. In fact, anxiety is so common that it almost feels like a normal stress response; however, in some cases, the feelings of stress and anxiety can become so overwhelming that it leads to panic attacks and other concerning symptoms.

Panic attacks, like obsessive-compulsive disorder or OCD, are typically addressed with a multi-treatment approach, consisting of cognitive-behavioral therapy (CBT), exposure-response and prevention (ERP) therapy, medication, natural remedies, and self-help tools. If you are wondering if there is a connection between panic attacks and OCD, you have come to the right place. This article will explore the relationship between panic attacks and OCD. Keep reading to learn more about this topic!

What is OCD?

OCD is an anxiety condition characterized by involuntary and repetitive, distressing thoughts (obsessions) and/or ritualistic behaviors (compulsions). Obsessions involve unwanted, intrusive thoughts that trigger stress and anxiety. Compulsions are designed to ease the stress and anxiety causing the obsessions. Common obsessions include a fear of germs, contamination, or a need for things to be “just right” (perfectionism).

Common compulsions include excessive recleaning, reordering, recounting, repeating and redoing, or rearranging. While OCD affects everyone differently, the common thread among individuals with OCD is the desire to feel less stressed or anxious. In other words, OCD sufferers simply want relief of some kind. Understand that no one wants to have OCD. They just want the distressing thoughts to go away.

Unfortunately, OCD is often misdiagnosed and misunderstood, which sometimes makes treating it challenging. The good news is that there are a variety of effective treatments, like therapy, medication, natural remedies, support groups, and online OCD recovery programs, like Impulse Therapy, on the market that can help become OCD-free

What is a Panic Attack?

A panic attack is a sudden rush of intense fear and anxiety that comes on out of the blue. During a panic attack, you may have feelings of dread, doom, fear, or terror that something bad is going to happen to you, or that you are about to lose control, and have a nervous breakdown. Some panic attacks only last a few minutes, while others can last for hours.

People, who have frequent or chronic panic attacks tend to struggle with other conditions, as well, such as obsessive-compulsive disorder (OCD), agoraphobia, phobias, social anxiety, generalized anxiety disorder (GAD), post-traumatic stress disorder (PTSD), and depression. People with panic disorder can have frequent and recurrent panic attacks, often over a fear of what could trigger a future attack.

What is Panic Disorder?

Approximately 4% of US adults will develop a panic disorder at some time in their lives. Studies suggest that panic disorder is more common in women than men. Like OCD, panic disorder is a type of anxiety condition, that involves sudden, unexpected, and repeated panic attacks involving intense fear and worry, accompanied by chest pain, heart palpitations, shortness of breath, dizziness, a fear of losing control, a feeling of being detached from others and oneself, a sensation of choking, a fear of dying, trembling, hot flashes, and/or abdominal distress. These attacks can also occur suddenly, but not be linked to a known fear, trigger, or stressor.

The primary characteristic of panic disorder is a history of panic attacks, along with the following symptoms:

• Constant anxiety about having future panic attacks
• Excessive worry and concern about the consequences of the panic attacks
• Significant changes to daily activities to avoid the people, situations and/or places, triggering the fear of having a future panic attack, such as driving a vehicle, flying in a plane, riding in a train, taking the subway, sitting in a dark movie theater, going to a loud concert, sitting a stadium, sitting in a classroom, eating in a restaurant, walking around malls, or shopping in a grocery store.

How Are OCD and Panic Attacks Related?

According to studies, OCD is linked to panic attacks. Researchers have found that OCD sufferers are at risk of experiencing panic attacks, and people who experience panic attacks are at risk of developing OCD. People with panic attacks may develop OCD as a way to cope with the distress caused by these attacks. More specifically, a person with panic disorder, or who experiences frequent or chronic panic attacks may engage in rituals or routines to ease their stress, anxiety, and emotional distress.

Panic attacks can elevate your heart rate and blood pressure, and cause your breathing to become shallow, which can be extremely upsetting. These changes could cause you to hyperventilate, triggering dizziness and lightheadedness. If you struggle with OCD, you may react to these sensations by engaging in certain compulsions, such as excessive cleaning or rearranging things to make yourself feel better.

How Are OCD and Panic Disorder Related?

The DSM-V characterizes both panic disorder and OCD as anxiety disorders, primarily because both conditions involve extreme angst and irrational worries, concerns, and fears. Moreover, some people with panic disorder may “obsess” about having future panic attacks, and thereby, compulsively avoid people and situations that they feel may trigger a panic attack.

Similar to OCD, panic disorder can cause significant emotional and psychological distress. Moreover, both conditions can cause noticeable academic and professional impairment in functioning, while also having an extremely negative effect on relationships, especially friendships and romantic relationships. Both panic attacks and OCD are cyclic, in nature.

An OCD cycle involves intrusive thoughts, fears, urges, mental images (obsessions), and compulsions (rituals and routines) that OCD sufferers use to reassure themselves, avoid, and reduce the stress and anxiety causing the obsession. A panic attack cycle works the same way. This cycle involves intrusive thoughts, fears, urges, mental images that cause the attacks, and compulsions to ease the stress and anxiety causing them.

4 Tips to Help With Panic Attacks

Panic attacks can be frightening and unnerving anytime, but especially if you have never experienced them before. If you are fairly new to panic attacks, you may not know what to do when they arise. If so, you are not alone. Millions of people around the world have the same dilemma. The good news is there are ways to cope with these panic attacks in a healthy way.

Listed below are healthy coping skills and strategies you can use to prevent or stop a panic attack:

• Immerse Yourself in Mindfulness Meditation

  If you are feeling stressed and anxious, immerse yourself in mindfulness meditation. Try focusing on your breathing. Clear your mind and take a few deep breaths. Try to tune into the rising and falling of your chest. This is a great way to focus on something other than your negative thoughts and feelings.

• Stop Fighting It

  Fighting a panic attack will only make you feel worse. Instead, focus on keeping yourself safe, while accepting that the attack will eventually pass. So, stop fighting the feeling.

• Write Them Down

  In other words, write down your concerns, fears, and worries. If negative thoughts tend to have racing thoughts, jot them down in a journal, notebook, diary, or on a piece of paper. Writing down your concerns, worries, and fears can help you let go of them. It can also help you see them for what they really are – just thoughts – nothing more and nothing less.

• Practice Self-Care

  In other words, take care of yourself. Eating healthy foods, exercising, and getting plenty of sleep can help you ward off panic attacks. Don’t forget to do something nice for yourself – something you enjoy, such as hanging out with friends, taking a warm bubble bath when you feel stressed, binge-watching that series you have been dying to see, getting a massage, meditating, practicing yoga, etc.

3 Ways to Manage OCD Caused by Panic Attacks

Sometimes, panic attacks can trigger OCD. When this occurs, OCD eases the stress and anxiety causing the panic attacks. When OCD is caused by panic attacks, it typically involves rituals or routines, such as counting to 100 when you start to feel an impending panic attack arising or when a panic attack has started and you want it to stop. Or, it could involve rearranging the dishes in the house over and over again, compulsively cleaning the house – all to prevent a panic attack or stop one in its tracks.

Fortunately, there are ways to get a handle on your OCD-related panic attacks, such as:

• Seek Help!

  The sooner you get help for the panic attacks, the better. Start with your primary care physician or psychiatrist, and work from there. There are many different panic attack therapies and treatments, so find the one that works best for you.

• Don’t Turn a Blind Eye to Your Symptoms

  In other words, pay attention to what is happening in your mind and to your body. Also, keep track of what is triggering panic attacks – and how you are reacting to them. Do you follow a certain ritual or routine when you feel a panic attack arising? How do you stop a panic attack once you are in the middle of it? Do you count, repeat phrases or mantras, visualize something that makes you happy, etc.? Do you do this routine or ritual over and over again until you feel better?

  You also need to determine what is causing your OCD symptoms – why you turn to this or that behavior. Once you get your panic attacks under control, start working to address your OCD symptoms. OCD symptoms can be effectively managed with therapy, medication, like SSRI antidepressants, and self-help tools, like CBD, OCD podcasts, vitamins, and Impulse Therapy, an online OCD recovery treatment program. The key to getting your panic attacks and OCD under control is to know the signs and be self-aware of your mind and body.

• Be Positive Even When It’s Hard

  Panic attacks and OCD can be scary, especially when they occur in tandem. However, being negative or getting depressed over them will only make things worse, causing prolonged, frequent, chronic, and intense panic attacks, and non-stop, and unwanted compulsions. So, be positive – or at least try to be positive.

  Being negative will open the door for panic attacks and OCD to take over your life. You do not want that so explore your interests, concentrate on your passions, spend time with loved ones, help others in need, recite positive affirmations, focus on what makes you special, and look at life as “half-full instead of half-empty.” Less stress and anxiety will lead to fewer panic attacks and OCD symptoms.

Treatments for OCD and Panic Attacks

Because OCD and panic attacks involve stress and anxiety, they are often treated in the same manner. Treatment for OCD and panic attacks typically involves therapy, medication, and/or natural remedies.

Listed below are treatments for OCD and panic attacks:

• Cognitive-Behavioral Therapy (CBT)

  The first-line treatment for OCD and panic attacks is cognitive-behavioral therapy (CBT). The goal of CBT is to help OCD sufferers and people with panic attacks alter their thought processes, and in turn, alter their behaviors. Cognitive-behavioral therapists help their clients look at situations from a different perspective – a more positive perspective, in the hope that it will change the way they react or respond to them.

  For people with panic attacks and OCD, this means instead of thinking of the world as a scary place, think of it as a place of wonder, excitement, and happiness. Or, instead of avoiding people out of fear, look at the situation as a chance to have support when life gets hard. Other forms of CBT that can be used to treat OCD and panic attacks are cognitive therapy, cognitive restructuring, exposure-response and prevention (ERP) therapy, interoceptive exposure, and in-vivo exposure therapy (a variant of ERP therapy).

• Mindfulness-Based Cognitive-Behavioral Therapy

  The main goal of mindfulness-based cognitive-behavioral CBT is to learn how to accept upsetting, stressful, challenging, and uncomfortable psychological experiences – without judgment. Advocates of mindfulness suggest that much of people’s psychological distress stems from trying to control and/or get rid of the uneasiness and discomfort of their unwanted and intrusive thoughts, feelings, urges, doubts, beliefs, mental images, negative emotions, and sensations.

  In the case of panic attacks and OCD, the ultimate goal of mindfulness-based CBT is to help people with these conditions develop a willingness to fully experience their distressing or uncomfortable thoughts, emotions, urges, doubts, fears, worries, mental images, sensations, etc., without reacting with compulsions, reassurance-seeking or avoidance behaviors, and/or mental rituals, like counting or repeating phrases or mantras.

• Exposure-Response and Prevention (ERP) Therapy

  Exposure-response and prevention (ERP) therapy is usually the go-to treatment for OCD and panic attacks. ERP therapy is designed to gradually expose a person to his or her triggers to help lessen their power over him or her. The goal of this treatment is to destigmatize the person so he or she no longer reacts or responds to the trigger.

  In the case of OCD and panic attacks, ERP therapy helps reduce the effect of the trigger that is causing the panic attacks and OCD behaviors. The hope is that if the panic attack trigger no longer influences the individual, he or she will be less likely to engage in compulsive behaviors, like counting or rearranging, to ease the stress and anxiety, causing the panic attacks.

• Imaginal Exposure Therapy

  Imaginal exposure therapy involves writing short stories based on your OCD-related fears. These short stories are considered exposure therapy tools, designed to help you become more “exposed” to the scary, upsetting, and feared situations you have envisioned in your mind.

  For example, having a panic attack while eating at a restaurant, riding on a rollercoaster, driving on the interstate, or flying in a plane. When combined with ERP therapy, cognitive restructuring, a CBT technique, can significantly reduce the frequency and severity of your obsessions with having a panic attack, and help you become less sensitive to your panic-related thoughts, fears, doubts, urges, and mental images, thereby, also reducing your OCD compulsive behaviors (rituals or routines).

Medications

When therapy alone does not work, a doctor may prescribe medications to help reduce your panic attacks and OCD symptoms. The most common medications used to help both conditions are antidepressants. Although antidepressants are designed to help people with depression, they may also help people suffering from anxiety conditions, like panic attacks and OCD, by easing their stress and improving their moods. 

According to a 2018 review, antidepressants may be an effective treatment for both OCD, panic disorder, and panic attacks. However, more research is needed to determine their long-term effectiveness in the treatment of panic attacks and OCD.

Listed below are the most common antidepressants used to treat panic attacks and OCD:

• Selective-Serotonin Reuptake Inhibitors (SSRIs)

  The most common antidepressants prescribed to treat both panic attacks and OCD are selective-serotonin reuptake inhibitors (SSRIs). SSRIs are prescribed to people with these conditions, because people with mental health conditions, like panic disorder/panic attacks and OCD, tend to have low levels of serotonin in their brains. Serotonin is a hormone/neurotransmitter or chemical messenger in the brain that is responsible for transferring messages between brain cells. 

  A serotonin deficiency can lead to racing thoughts, mood swings, and compulsive behaviors. SSRIs are designed to restore the amount of serotonin in the brain, and as a result, reduce the frequency and severity of panic attacks and OCD behaviors. Even though SSRIs were created to ease depression, they can also be used to help people with panic attacks and OCD experience less anxiety. The most common SSRIs are Zoloft, Lexapro, and Paxil.

• Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs)

  If perchance, SSRIs do not reduce your panic attacks and OCD symptoms, your doctor may switch you to an SNRI. The goal of SNRIs is to boost your serotonin and norepinephrine levels in the brain, alleviating your stress and anxiety symptoms, so you no longer have panic attacks or OCD symptoms. Like serotonin, norepinephrine is a hormone/neurotransmitter that is responsible for your emotions, energy level, focus, and alertness. The most common SNRIs used to treat panic attacks and OCD are Effexor and Cymbalta.

• Tricyclic Antidepressants (TCAs)

  Similar to SSRIs and SNRIs, the purpose of tricyclic antidepressants (TCAs) is to boost your serotonin and norepinephrine levels in the brain, however, these medications tend to have more side effects than SSRIs and SNRIs, primarily because they are first-generation (older) antidepressants, while SSRIs and SNRIs are second-generation (newer) antidepressants. The most common TCAs are Tofranil and Anafranil.

Conclusion

OCD and panic attacks are separate conditions that often coincide. Both conditions stem from stress and anxiety, and both conditions can be “paralyzing.” Fortunately, there are a variety of effective treatments for panic attacks and OCD, such as hypnotherapy/hypnosis, OCD forums, and healthy coping skills and strategies. Panic attacks, like OCD, can be isolating and lonely, so it is imperative that you seek treatment if you are suffering from OCD caused by panic attacks. Don’t allow these conditions to take control of your life. With the right treatment, you can overcome OCD-related panic attacks, and regain control of your life.

References

• Yonkers, K. A., Zlotnick, C., Allsworth, J., Warshaw, M., Shea, T., & Keller, M. B. (1998). Is the course of panic disorder the same in women and men? The American Journal of Psychiatry, 155(5), 596–602. Retrieved from https://doi.org/10.1176/ajp.155.5.596
• National Institute of Mental Health. (n.d.). Panic disorder. Retrieved from https://www.nimh.nih.gov/health/statistics/panic-disorder
• Bighelli, I., Castellazzi, M., Cipriani, A., Girlanda, F., Guaiana, G., Koesters, M., Turrini, G., Furukawa, T. A., & Barbui, C. (2018). Antidepressants versus placebo for panic disorder in adults. The Cochrane Database of Systematic Reviews, 4(4), CD010676. Retrieved from https://doi.org/10.1002/14651858.CD010676.pub2
• Torres, A. R., Ferrão, Y. A., Shavitt, R. G., Diniz, J. B., Costa, D. L., do Rosário, M. C., Miguel, E. C., & Fontenelle, L. F. (2014). Panic disorder and agoraphobia in OCD patients: Clinical profile and possible treatment implications. Comprehensive Psychiatry, 55(3), 588–597. Retrieved from https://doi.org/10.1016/j.comppsych.2013.11.017
• Vigne, P., Simões, B., de Menezes, G. B., Fortes, P. P., Dias, R. V., Laurito, L. D., Loureiro, C. P., Moreira-de-Oliveira, M. E., Albertella, L., Lee, R., Stangier, U., & Fontenelle, L. F. (2019). The relationship between obsessive-compulsive disorder and anxiety disorders: A question of diagnostic boundaries or simply severity of symptoms? Comprehensive Psychiatry, 94, 152116. Retrieved from https://doi.org/10.1016/j.comppsych.2019.152116
• Sipe, W. E., & Eisendrath, S. J. (2012). Mindfulness-based cognitive therapy: theory and practice. Canadian journal of psychiatry, 57(2), 63–69. Retrieved from https://doi.org/10.1177/070674371205700202
• Singer, J. (2016). OCD and imaginal exposures. Psych Central. Retrieved from https://psychcentral.com/lib/ocd-imaginal-exposures#1