Nicotine Withdrawal Induces Panic Response

GoodTherapy | Nicotine Withdrawal Induces Panic Response Individuals addicted to nicotine can exhibit unique responses when they are deprived of a cigarette. Many people report being anxious, snappy, or moody when they try to quit smoking. All of these responses are common. But for people with panic disorder (PD), going without a cigarette may trigger a panic attack. According to a recent study conducted by Teresa M. Leyro of the Department of Psychiatry at the University of California in San Francisco, people with anxiety problems and a history of panic attacks in particular are more likely to smoke than people without a history of anxiety-related problems. However, few studies have looked at how nicotine cessation, an event that can cause tension and stress in individuals with no history of anxiety, affects those with a predisposition to panic.

Leyro enlisted 58 adult smokers and exposed them to bodily sensations designed to elicit fear or anxiety. The participants were comprised of individuals with and without a history of PD, and all reported smoking approximately 20 cigarettes a day. The experiment was conducted after they had gone without smoking for 12 hours to allow sufficient time for withdrawal symptoms to occur. Leyro discovered that the participants with severe PD and the most significant withdrawal had the highest rates of panic symptoms after the experiment.

These results suggest that individuals with PD may catastrophize their circumstances and be more sensitive to physical cues when in a heightened state of anxiety. Additionally, these same individuals took longer to recover from their panic than those with low withdrawal symptoms. However, Leyro also found that the participants without PD and with low levels of withdrawal had elevated panic symptoms, too. This could be due to the fact that in the absence of withdrawal symptoms, these individuals may have been overly stimulated by fearful or threatening emotions when they experienced the physical sensations. Leyro hopes that these findings open up avenues of further research. She added, “This line of inquiry can shed light on the etiology of panic psychopathology among smokers and ultimately inform the development of novel specialized interventions for this difficult-to-treat population.”

Leyro, T. M., Zvolensky, M. J. (2012). The interaction of nicotine withdrawal and panic disorder in the prediction of panic-relevant responding to a biological challenge. Psychology of Addictive Behaviors. Advance online publication. doi: 10.1037/a0029423

Related articles:
Three Steps for Dealing with Panic Attacks
Identifying and Treating Addiction and Substance Abuse Problems

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  • Nikki g

    August 15th, 2012 at 11:29 AM

    This feeling of panic could be one big reason why so many smokers have such ahard time cutting out the habit. They try to stop, and they really do want to end that addiction, but ending it cuts off that supply of nicotine that they are used to, and then they go into this self induced panic mode. Then the only way that they know to end the panic is to what? of course, fire up a cigarette and physically they feel better again. But inside many of them are so angry with themselves because they can’t seem to make it over that hump and give it up altogether. Perhaps what more smoking cessation programs should begin to look at then are ways to help these smokers who are trying to give up the habit come up with better ways for managing those feelings of panic and offering them ways to reduce those feelings when they arise.

  • Matthew b

    April 1st, 2019 at 6:52 PM

    My name is Matthew and I am a recovering alcoholic in progress the real quit smoking for the last 6 and 1/2 + years was the fact that I drowned myself in so much alcohol and I forgot about the withdrawal I knew it was a last ditch effort but it worked that just made my alcoholism worse although by over the years I’m done very well staying sober for extended periods of time farewell staying out the cigarettes without much effort but the only problem is I I’m dumped with all this crazy hypnotic drunk and hoopla I never really seems to go away and every time I forget the misery of the last binge it just gets worse every time and when I forget the pain I can’t recreate the Euphoria like I used to I’m 34 by the way

  • tru

    August 15th, 2012 at 1:32 PM

    So maybe instead of a nicotine patch they need to somehow come up with a patch with anti anxiety meds instead! Control release meds that will keep the panic at bay

  • Alli

    August 15th, 2012 at 3:48 PM

    Panic attacks, lung cancer, emphysema, stinky breath. .
    What on earth does any of this hold for me that says “hey maybe I should start smoking?”

    Duh!! Nothing!!

  • Matt

    June 21st, 2015 at 5:17 PM

    How is this comment relevant to the discussion at hand?

  • Jdub123

    October 28th, 2017 at 7:28 AM

    Your comment is the comment from a person who hasn’t had tobacco. It’s the buzz and relaxing euphoric feel people get when lighting up. Im sure most people wouldn’t do it if there was only negatives or pain associated with it.

  • lakisha spence

    August 16th, 2012 at 4:32 AM

    One thing that over the years I have noticed about heavy smokers is that not only is this a habit, but smoking has become their way of coping or dealing with anything remotely stressful that comes their way. They think that to deal, they have to have a cigarette! So no wonder they feel a sense of panic when they don’t have this security blanket of theirs anymore. They re expected to go without that one thing in their lives that has allowed them to cope with situations, even if it was not the healthiest way to go about handling that pressure. So to take that away without also providing them with different ways to manage that stress is very unreasonable. We all have to have something to fall back on. Many of us are lucky that ours is not a vice such as smoking or deinking, but let’s have a little compassion for those who do suffer from these addictions, and instead of laying out so much judgement, why not give some thoughts on ways that they could handle this a little more productively instead.

  • Ginny hunt

    August 17th, 2012 at 10:49 AM

    Just thinking about throwing away the cigarettes for good makes me panic!

    I know I would be healthier and probably happier too, but. . . there you go. Not ready.

  • Amanda

    September 13th, 2019 at 2:12 PM

    I’m on day 6 and the anxiety and panic has just started. Praying it doesnt last long, because like it is stated to relieve it is to get some nicotine.

  • euni

    December 29th, 2020 at 9:07 AM

    im 3months without nicotine and im still having panic attacks.ant1 whose experiencing the same thing or am i alone.

  • Raquel

    July 31st, 2023 at 8:00 PM

    No you are not alone!
    I’m on my 1st week and I have a 3 month old baby and the panics are severe even when driving it’s such a scary feeling 🥺

  • Seth

    January 8th, 2021 at 7:05 AM

    I am 1 month and 5 days off and am still having panic attacks and really bad anxiety. You’re not alone.

  • Joshua

    January 8th, 2021 at 9:11 AM

    Have you been diagnosed with a panic disorder? Im on day 7 and its been really rough.

  • Sai

    June 19th, 2021 at 11:33 PM

    It’s horrible iam still having the fear of panic attack it’s my 14th dayhow long it takes for the risk to go down.

  • tim

    July 6th, 2021 at 9:34 AM

    5 months into quitting and my anxiety is stronger than ever

  • tim

    September 20th, 2021 at 3:59 AM

    7 months into quittiing and anxiety still very strong. does it ever get better?

  • Kate

    September 22nd, 2021 at 3:11 AM

    I’m in the same boat. Almost 7 months quit after 17 years as a smoker, and anxiety is worse than ever! My alcohol intake has increased, as has appetite which has put 5kgs on me! The worst anxiety attack I suffered was 3 months in. It was like a brick sitting on my chest and I couldn’t breath properly. I couldn’t control my words nor my emotion. It was terrifying.
    I will persist. But when international boarders open and I find myself on a beach somewhere tropical.. well ain’t no one gonna stop me from having a cigarette with my cold beer.. mind you, this could be years from now so maybe I won’t even want one by then.

  • Bernard

    November 9th, 2021 at 4:13 PM

    Holy cow ! I quit October 1 2021. And my panic attacks have sent me to the hospital 7 times ! I was dealing with stomach issue so it made it even worse. I quit cold turkey so it has been a mess. Reading these comments has made me feel a lot better cause I know I am not alone( don’t mean it in a bad way ) . They prescribe me xanax but I didn’t take it cause I heard that stuff is addicting.

  • Jen P

    January 26th, 2022 at 12:38 AM

    Bernard: my withdrawals and panic atracks as well as depression were still there 8 months down the line and I became completely non functio al. Tried Zyban but I’m badly allergic. I’ve noticed men find it easier to stop than women….maybe something to do with hormones. I started smoking to cope with overwhelming stress and no support system and I sugfer from PTSD. Can’t stop now after 54 years of a 30 a day habit, hope you have better luck. Try nicotine chewing gum as it may take the edge off and take up a sport or something. It took my late husband 6 months to stop and ge took up running. Unfortunately for me nothing worked so I decided that a sane smoker was better than being a permanent basket case.

  • Bella

    April 9th, 2022 at 11:29 PM

    I quit 7 months ago. I had panic attacks most days for the first three months. Then it got better and now panic attacks come and go once a week or less, but I’m still not like before… my motivation, focus, mental function… it’s all gone and I’m supposed to live and handle everything like this… It is getting better but very slowly. I took anti-depressants and it really helped me with anxiety and feeling better in general and also being more focused, but they didn’t stop the panic attacks. I guess the panic attacks are gonna eventually go away but very slowly… I think a less stressful life or a good support system helps a lot. I won’t give up. I made it 7 months, I’ll seek help and repair this broken brain…

  • Bella

    April 15th, 2022 at 5:24 PM

    UPDATE: I started taking Wellbutrin 100 one daily and all my anxiety and panic symptoms are gone. I’m also focused and I’m back to my normal self! My mental capacity is back! I’m so happy about taking this pill. it’s only a week but it worked from the very first pill! I wish I took this from the very first day of quitting. I wouldn’t have to go through so much in the last 7 months.

  • Laura

    June 25th, 2022 at 8:09 PM

    I quit 38vdays ago cold turkey…dr. Gave me busiprone and xanax as i was having the worst panic attacks an anxiety. Im getting better but its a slow process…this too shall pass…im determined

  • Erika

    April 3rd, 2023 at 12:21 PM

    My God I cannot do this much longer. I’m only on day 10 and the panic is almost non-stop. I am reading all these months people have in and I feel like I can’t go another day. It’s nice to know that I’m not alone, but did anyone find a solution?

  • Erika

    April 3rd, 2023 at 12:25 PM

    Thank you so much for posting a solution!!! I am so happy that you found something. I was thinking about going on a medication that worked for me in the past but it was reacting with another med, so, I had to stop it. That isn’t a problem any longer. You have given me much hope. I know you know what that means to someone with panic disorder. Thank you!

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