Brief Answer: Panic disorder is a psychological illness Detailed Answer: Hello, Thanks for your query. I appreciate your efforts for medical consultation in so much distress. Important aspects of your query are: • 34 year old female • Complaints of: chronic racing thoughts, severe panic attacks and depersonalization • Concern related to presence of neurological problem. Chronic racing thoughts occurs due to excessive worry. Racing thoughts, severe panic attacks and depersonalization all can occur in panic disorder. Panic disorder is a type of ANXIETY DISORDER. It is not a neurological illness if there is no apparent structural problem in brain. This disorder can start at any age. Common causes of panic symptoms (in hierarchy) are: -Psychological causes: most common cause. It may occur with or without stressor in life. Most common biological explanation of such problem is impaired serotonin transmission in brain. Diagnosis is based on the history of patient, mental status examination (MSE) by psychiatrist and exclusion of medical causes (mentioned below) of anxiety. -Vitamin deficiency: specially b1, b6 and b12. Healthy balance diet is beneficial in such cases. -Thyroid imbalance: Specially in female. You can get your thyroid profile (T3/T4/TSH) to rule it out. -Excessive use of stimulants (amphetamines, cocaine, caffeine), so stop use if present. Reduce tea, coffee and cola drinks use as these contain caffeine. -Side effect of substance use: Stop smoking and alcohol use (if present). -Anemia -Neurological problem: If suspected after examination, imaging study of brain is required. -Combination of above causes (2nd most common cause after psychological cause). In treatment both drug and non drug treatment like cognitive behavior therapy (form of psychotherapy) are used. Choice of treatment depends on severity of symptoms, personal preference and availability of treatment. I hope this information has been both informative and helpful for you. In case of any doubt, I will be available for follow ups. Wish you good health. Regards,

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