Is there a relationship between panic attacks and depression?

Well, the short answer is YES… Here’s the details:

In the first place, chronic panic disorder can easily cause depression. This is most likely to occur in people who are exhausted from the chronic anxiety that can come with panic disorder, and also people who have developed agoraphobia (i.e. the avoidance of activities due to a fear of panic attacks) to such an extent that it is forcing them to retreat / hibernate from life (i.e. not going to work, not socializing with friends, no longer driving or leaving the house because of a fear of panic attacks). When panic disorder is clearly causing depression, patients often report that the panic and/or agoraphobia gets worst FIRST, then the depression comes later. They are also likely to report that if I could make their panic and / or agoraphobia go away, then they would no longer be depressed. Such patients would probably benefit from focusing on their panic disorder first rather then their depression per se (unless the depression is so bad that they are having serious thoughts of ending their life).

Very intense depression can sometimes trigger panic attacks. For a large percentage of people, depression and a least some level of anxiety come hand in hand. When the anxiety is intense, this kind of depression is sometimes referred to as an “agitated” depression. If the anxiety component of the depression is strong enough, it can definitely lead to anxiety attacks (i.e. where you can’t stop worrying about the problems in your life) but can also sometimes (more rarely) trigger panic attacks (i.e. intense episodes where you feel like you are dying or going crazy right then and there). Patients who have panic attacks triggered by depression report that their depression got worst FIRST, and that they never have panic attacks unless they are depressed. They would most likely benefit from a treatment that focuses on their depression first.

One final possibility: some people have both panic disorder and depression independent of each other. In other words, they sometimes have panic attacks when they are NOT depressed, and they also sometimes experienced depression when they were NOT having regular panic attacks or agoraphobia. In this situation, the panic can trigger a depressio
AND the depression can trigger panic (i.e. for most people with panic disorder, any significant change, whether it’s depression, a cold, lack of sleep, or a hangover, can trigger panic because they are so sensitive to their bodies). In these situations, it is best to start with treatment that addresses whichever problem seems the most intense right now. Luckily a number of medications (i.e. SSRI’s, if started at a LOW dose so as not to trigger panic) and / or psychotherapies (i.e. such as cognitive behavioral therapy) work well for both panic disorder and depression.

I hope this information was helpful. Good luck in your fight against panic disorder and/or depression. n