Can Panic Disorder Cause Depression?

Living with panic disorder can feel like being trapped in a cycle of fear and distress, where each panic attack leaves you feeling more exhausted, disconnected, and uncertain. Over time, the constant worry and physical toll of these episodes can take an effect on your emotional well-being. If you’re experiencing both panic disorder and symptoms of depression, you may be wondering: Can panic disorder actually cause depression?

At Marsh Psychotherapy, we understand that navigating both conditions simultaneously can be overwhelming. The good news is that with the right support, both panic disorder and depression can be treated effectively. In this blog, we’ll explore the science behind the relationship between panic disorder and depression, and how therapy can help break the cycle.

The Link Between Panic Disorder and Depression

Panic disorder is a mental health condition marked by recurring and unexpected panic attacks—intense periods of fear or discomfort accompanied by symptoms like rapid heart rate, shortness of breath, dizziness, chest pain, and a feeling of losing control. Panic attacks can be incredibly distressing, and over time, individuals with panic disorder may develop intense fears of having another attack, leading to avoidance of certain situations or places.

While panic disorder is centered around episodes of acute anxiety and physical symptoms, its effects can extend far beyond the attacks. For some individuals, the persistent worry about future attacks, the avoidance behaviors, and the disruption to daily life can gradually lead to the development of depression.

Several factors contribute to this connection:

1. Chronic Stress and Exhaustion

The constant anticipation of panic attacks can create a perpetual state of stress. This heightened state of anxiety over time wears down the body and mind, contributing to feelings of emotional and physical exhaustion. As a result, many individuals with panic disorder experience a loss of interest in activities they once enjoyed, a hallmark symptom of depression. Chronic stress is also known to alter the body’s neurochemistry, particularly in relation to serotonin and cortisol, both of which play a significant role in mood regulation (McEwen, 2006).

2. Social Isolation

Panic disorder can lead to avoidant behaviors, where individuals begin to limit their social interactions, work obligations, or even simple errands out of fear of triggering a panic attack.

This social withdrawal can contribute to feelings of loneliness, sadness, and disconnection, which are common in depression. A study published in Archives of General Psychiatry found that social isolation is a key predictor of depression, and it can amplify the effects of anxiety disorders (Hawkley et al., 2008).

3. Fear of Losing Control

Panic attacks can make you feel as though you’re losing control, which can lead to a sense of helplessness. This feeling of helplessness can gradually evolve into feelings of hopelessness and despair, which are core to depression. The sense of uncontrollability experienced during panic attacks may contribute to the development of depressive symptoms over time.

4. Biological and Chemical Factors

Research has shown that panic disorder and depression share some common biological pathways. Both conditions are linked to imbalances in neurotransmitters, such as serotonin, dopamine, and norepinephrine. These imbalances can impact mood regulation, making it easier for depression to take hold when anxiety is left unaddressed. 

A meta-analysis published in The Lancet Psychiatry indicated that both anxiety and depression share a dysregulation of the serotonin and dopamine systems, which can explain why the two disorders often co-occur (Cohen et al., 2017).

5. Shared Risk Factors

Genetics, trauma, and chronic stress are common risk factors for both panic disorder and depression. If you have a family history of mental health conditions, or if you’ve experienced trauma or ongoing stress, you may be more vulnerable to developing both conditions. A review in Psychological Medicine highlighted how early life trauma and genetic predispositions increase the likelihood of both anxiety and mood disorders (Kendler et al., 2002).

Recognizing The Symptoms of Panic Disorder and Depression

It’s important to understand that panic disorder and depression can coexist, making it harder to distinguish between the two. Sometimes, the symptoms of one condition can mask the other, or they may exacerbate each other. Here are some signs that you may be dealing with both:

• Frequent Panic Attacks: Recurrent, unexpected panic attacks accompanied by physical symptoms like shortness of breath, chest pain, or dizziness.
• Persistent Worry About Future Attacks: A constant fear of experiencing another panic attack, leading to avoidance of certain situations or places.
• Loss of Interest or Pleasure: A feeling of disinterest in activities you once enjoyed, which is a key symptom of depression.
• Fatigue or Low Energy: Chronic exhaustion, even when you’re not physically exerting yourself, which is common in both panic disorder and depression.
• Feelings of Hopelessness or Worthlessness: Over time, you may start to feel that nothing will ever get better, and that your situation is hopeless.
• Difficulty Concentrating: Both panic disorder and depression can impair your ability to focus, leading to challenges in completing daily tasks.

Therapy Can Help Break the Cycle

If you’re struggling with both panic disorder and depression, therapy can be a powerful tool to help you break the cycle and regain a sense of control and peace. Therapy  can be a valuable tool for helping you understand the connection between these two conditions and finding effective ways to manage them.

At Marsh Psychotherapy, we offer a variety of evidence-based therapies that can help address both conditions in an integrated way including Cognitive Behavioral Therapy (CBT), exposure therapy, mindfulness practices, Creative Arts Therapy, and Interpersonal Psychotherapy (IPT). We’re committed to walking with you on your journey toward emotional well-being, helping you build resilience and reclaim your life from anxiety and depression.

If you’re interested in learning more about therapy for depression or panic disorder, please contact us.

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References

Cohen, S., et al. (2017). The relationship between serotonin and dopamine in mental health disorders. The Lancet Psychiatry.

Hawkley, L. C., et al. (2008). Loneliness and depression: The influence of social isolation on depressive symptoms. Archives of General Psychiatry.

Kendler, K. S., et al. (2002). Shared genetic factors between major depression and anxiety disorders in a population-based sample. Psychological Medicine.

McEwen, B. S. (2006). Protective and damaging effects of stress mediators: Central role of the brain. Dialogues in Clinical Neuroscience.