Talk to Psychiatry on Severe Panic Attacks With Loss Of Control And Self-injury
Asking for Self, Female, 23 years old, Sarai Alamgir
I have been experiencing very intense panic episodes, especially when I feel emotionally overwhelmed or when I need reassurance/support from my partner. During these episodes, I feel like I am dying and feel extremely desperate and unable to control myself. At the peak of the episodes, I sometimes hit myself repeatedly, especially my face, to the point that my face becomes bruised/blue, my skin gets scratched/cut and bleeds. I feel like I cannot control my actions during these episodes. I want to see a psychiatrist and would like to know whether medication for panic attacks/anxiety could help reduce the intensity of these episodes. I also feel very emotionally dependent on my partner, and when I cannot reach him or feel unsupported, my anxiety can become extremely intense. I would like advice on what treatment would be appropriate, including whether I need medication, therapy, or both. I also want to learn how to prevent myself from hurting myself during these episodes.
Dr. Usman Ahmad - Psychiatrist
MBBS, FCPS Psychiatrist | Islamabad
Help is available. Contact for detailed assessment. Meanwhile , please make a safety plan: when you notice an episode escalating, do not isolate yourself; stay with a trusted person, move away from anything you could use to hurt yourself, and tell someone clearly that you are struggling. Grounding, slow breathing and temporarily stepping away from the triggering situation can also help reduce the intensity. Because you have already been hitting yourself hard enough to cause bruising, cuts and bleeding, please arrange a psychiatric appointment as soon as possible. If you feel you cannot control yourself or believe you may seriously hurt yourself, go to the nearest emergency department immediately and have someone accompany you.
Asst. Prof. Dr. Muhammad Ayub Baloch | Consultant Psychiatrist | Fcps (Gold Medalist) - Psychiatrist
MBBS, FCPS Psychiatry ( Gold-Medalist ), Fellow, College of Physicians & Surgeons, Pakistan, Certificated Child & Adolescent Psychiatry. Consultant Psychiatrist & Expert in the treatment of Psychiatric, Neuropsychiatric, Drug addiction & Sexual disorders | Karachi
581 Positive Reviews
I’m really sorry you’re going through episodes this intense. The fact that you are hitting yourself hard enough to cause bruising, cuts and bleeding means this needs more than routine anxiety advice—it deserves prompt, compassionate psychiatric assessment. The episodes may include panic attacks, but the severe emotional overwhelm, loss of control, self-injury and strong dependence on reassurance from your partner suggest that we should look more broadly as well. Anxiety, depression, trauma-related difficulties, problems regulating intense emotions, relationship/attachment difficulties and other mental health conditions can sometimes produce a similar pattern. A proper assessment is needed before attaching any diagnosis. Yes, both therapy and medication can help, depending on what is driving the episodes. Psychological therapy can help you understand triggers, tolerate overwhelming emotions, reduce reassurance-seeking and develop safer ways of responding when distress peaks. Medication can be useful for significant anxiety or associated mood symptoms in some people, but should be chosen after assessment rather than simply treating each attack. Effective psychological and medication treatments are available for panic disorder. Most importantly, because you are already injuring yourself, please make a safety plan now: tell someone you trust what is happening, try not to remain alone when an episode is escalating, move away from objects or situations you could use to hurt yourself, and seek urgent mental-health/emergency assessment if you feel unable to stop yourself or fear you may seriously injure yourself. Severe anxiety or a mental-health crisis warrants urgent help. Because these episodes are affecting both your safety and your relationship, a detailed psychiatric consultation would be very worthwhile. If you feel comfortable, you can book an online or clinic appointment through Marham so we can explore the panic, emotional triggers, self-harm and relationship pattern carefully and develop an individual treatment and safety plan. There is a realistic path forward here—these patterns can become much more manageable with the right treatment and support. Disclaimer: This online response provides general guidance and cannot replace a full individual assessment. If you are currently unable to keep yourself safe, please seek urgent in-person help now.
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