Dear Mike, thank you for your detailed letter. You refer to these incidents as panic attacks. It makes sense that you would label them that way because when they occur part of what you experience is panic and anxiety. But I am not sure these experiences are panic attacks. What you consider panic attacks might actually be bouts of paranoia. Panic attacks are often confused with paranoia.
Some of the symptoms of panic attacks include racing heart, palpitations, sweating, visibly shaking, shortness of breath, dizziness, feeling “unreal” or feeling like you are about to lose control. You did not mention any of these physical symptoms. During your episode you became very frightened of the idea that your friends were trying to kill you. You believed that you actually saw one of them holding a butcher knife. This naturally frightened you and you immediately left for the nearest bus station. There was anxiety and panic associated with the incident but it’s more likely that you were exhibiting signs of paranoia.
Paranoia is a persecutory delusion. It’s the belief that someone or a group of people are attempting to harm you in some manner, physically, emotionally or mentally.
Lately these paranoid thoughts and feelings have returned. This is due to a recent contact from the group of friends that you once feared may have tried to harm you. I would strongly recommend that you seek help from a mental health professional immediately. The fear that you describe is, according to you, out of control. You are beginning to fear that your parents are involved in the plot to harm you. This shows that the paranoia may be intensifying and it needs to be treated.
A mental health professional can help you gain control of this fear either by teaching you a way to ground yourself in reality or by prescribing you a low dose of medication. I believe you’re an excellent candidate for help at this time because of your keen awareness of this growing fear. You also seem open-minded and willing to seek help. If you meet with a qualified mental health professional there is a high likelihood that you could gain control of your fear but it requires that you seek help immediately.
In summary, you are probably experiencing paranoia and not panic attacks but I cannot know this for sure based on a short letter. I believe that if you sought help immediately there is a very good chance that you can effectively decrease or eliminate these episodes of paranoia. If you do not seek help the concern is that these incidents will become more frequent and significantly impair your ability to function.
I would advise against meeting with the friends you believe are attempting to harm you until you have sought treatment. That’s because you’ve already begun to experience paranoia associated with these friends and seeing them may only intensify these feelings. Lastly, please seek help immediately and do not put this off. I do not mean to alarm you but I know that if you go to treatment there is a good chance you can be helped. Please consider writing back and letting me know how you are doing.
This article has been updated from the original version, which was originally published here on February 23, 2009.