Post-traumatic stress disorder (PTSD) and panic disorder have much in common. The traumatic life events and biological factors that lead to PTSD are also highly associated with panic disorder. In fact, many people who have PTSD also suffer from panic disorder. Are they the same? The short answer is no. But if you or someone you know suffers from PTSD, panic disorder, or both, there are a few things to know.
What is PTSD?
PTSD may develop after experiencing a traumatic or near-fatal event. Sometimes even the shock of witnessing a high-stress event is enough to trigger the onset of PTSD. Recent reporting on modern combat confirms that even the remote experience of death can lead to serious psychological problems. For example, in 2022, the New York Times reported a climbing incidence of PTSD among drone strike pilots, who were not counted as combat troops.
The symptoms of PTSD include a wide range of thoughts, emotions, and feelings. Generally, patients report flashbacks, low self-esteem, insomnia, intrusive thoughts, unpleasant emotions, and difficult-to-control outbursts. Other symptoms of PTSD can include avoidance of anything that triggers the symptoms or intense feelings of guilt and shame.
What is Panic Disorder?
Panic or anxiety attacks are most commonly associated with panic disorder. Most people will have one or two panic attacks over their lifespan. Like most mental disorders, panic disorder diagnoses are about how much the symptoms interfere with your life. If you’ve had four panic attacks and are often distracted by the fear that you may have another, you likely have panic disorder.
For those who experience them often, panic attacks are unmistakable:
- Racing pulse, pounding heartbeats, or heart palpitations
- Shaking or trembling
- Shallow or labored breathing
- A feeling of weakness in the legs
- Tingly or numb hands
- Chest pain
- Stomach pain or nausea
- Fear of “losing your mind” or dying
- A feeling of being disconnected from your body
Most attacks are relatively short, lasting five to twenty minutes, with some lasting about an hour. However, the feeling of terror associated with these attacks can make five minutes feel closer to one hour, so the intensity of the feeling is important to keep in mind.
While these are certainly frightening episodes, they are not dangerous. The primary reason for treating panic disorder is its interference with your quality of life. Avoiding situations in which you’ve had panic attacks or may cause panic attacks can lead to isolation, unfulfillment, and disappointment.
Treating PTSD and Panic Disorder with Ketamine
Traditional methods of treating panic disorder include anti-depressant prescriptions and talk therapy like cognitive behavioral therapy. Typically SSRIs are prescribed for panic disorder and PTSD. However, a 2018 study found that only 1 out of 7 people treated for panic disorder with SSRIs received relief from their symptoms.
Current research suggests that the positive effects antidepressants have on the brain are due to their slow interaction with the neurotransmitter glutamate. You can think of glutamate as a traffic director for your brain and neural growth. When it is appropriately excited, this neurotransmitter can trigger new synapses to form. These synapses give your brain more opportunity to use other neurotransmitters associated with mood.
Although antidepressants have come a long way, the primary issue is that they work on glutamate indirectly. Some work through serotonin, others work on norepinephrine, while others work on a combination of the two. For many people, these are dead ends.
Ketamine, on the other hand, almost indiscriminately works directly on glutamate found outside of neural cells. Many scientists are still working hard to understand precisely how and why ketamine works on the brain the way it does. But the bottom line, for now, is that 75% of patients see rapid, short-term relief from their symptoms, with most seeing long-term relief after several sessions of ketamine treatment.
PTSD and panic disorder are difficult to live with. Both often involve a sense of lost control over one’s thoughts, one’s actions, and one’s life. While the two are diagnostically separate, there is much that binds them. Those experiencing either disorder may find their quality of life deeply diminished, with excessive energy devoted to keeping an even keel. While some find relief through traditional means like antidepressants or talk therapy, many are left without a clear solution in modern mental health.
We at Relevare are passionate about restoring hope and helping individuals live valued, meaningful, and dignified lives. The clinic is led by Jennifer Mallek, MD, a fellowship-trained, board-certified anesthesiologist with extensive experience. We focus on personalized intravenous infusion treatments and elective solution-oriented suggestions to help patients implement desirable behavioral changes into one’s life.