Smoking and Panic Disorder

[Anthony-Philips]

Posted by Anthony Phillips on June 17, 1999 at 00:53:04
Sirs,
    I am a 30 year old male who up until a few years ago thought I had very good health, even though i have been a smoker for 14 years. I went through a very stressful period in my life about five years ago, and began having panic attacks during this time. It took my doctor and his medical associates 2 and 1/2 years to tell me they could find nothing physically wrong with me, after numerous test and procedures, I do thank thenm for their consistency though, but I was diagnosed soon after by a psychotherapist who said after a few sessions and some testing on her part, that I had severe depression and panic disorder. I have been on Paxil, 20mg a day, for about the last 2 and 1/2 years, and my depression is gone, and the panic attacks very rare and mild when they do occur. My question is this, I want to quit smoking, and I haven't found a good way to help me yet, I've tried gum, Zyban, and cold turkey, but I can't seem to let go of this addiction. I want to know how the smoking is effecting my panic disorder, if it is at all, or if it could in someway have been a contributing factor in having gotten panic disorder in the first place. The fears I have now are towards a heart attack or cancer, and I know my panic situation doesn't help with those. Any advise you could give would be appreciated.

Posted by R.S., EdD, HVMA on June 17, 1999 at 23:13:31
I'm glad you've made as much progress as you have with your depression and panic disorder.  Nicotine is a stimulant and a powerful one at that.  Anybody with a panic disorder should avoid stimulants like the plague.  Not only can they precipitate a panic attack physically, but sometimes people start to notice the increased heart rate they produce and that can get their anxiety spiraling upward toward panic. I suppose it's possible that, if you were vulnerable to anxiety, your smoking could have been "the last straw" that got your panic attacks started.  I think it's more likely that your one of the 15% of the population that suffers from an anxiety disorder in the course of their lifetime.
As far as stopping smoking, keep trying. It's not something that happens the first try.  In fact, the average number of attempts to stop smoking before being successful is about 4.  Also, you may want to try using the gum or Zyban for a longer period (provided your doctor gives you the go ahead).  Smoking is tough to kick because it becomes associated with so many behaviors, thoughts and feelings.  So the triggers or cues to smoke are all over the place and take a while to begin to fade - sometimes up to six months.  Even if you still smoke occasionally, or even relapse fully, don't stop trying.  Even switching to a brand with less nicotine would be a step in the right direction.  Stopping smoking is a process that happens over time, often years.  You've started your process, so keep trying and give yourself credit every day you don't smoke or smoke less than usual.