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What
is panic disorder?
A person who experiences recurrent panic attacks, at least
one of which leads to at least a month of increased anxiety
or avoidant behavior, is said to have panic disorder. Panic
disorder may also be indicated if a person experiences fewer
than four panic episodes but has recurrent or constant fears
of having another panic attack.
Doctors
often try to rule out every other possible alternative before
diagnosing panic disorder. To be diagnosed as having panic
disorder, a person must experience at least four of the following
symptoms during a panic attack: sweating; hot or cold flashes;
choking or smothering sensations; racing heart; labored breathing;
trembling; chest pains; faintness; numbness; nausea; disorientation;
or feelings of dying, losing control, or losing one's mind.
Panic attacks typically last about 10 minutes, but may be
a few minutes shorter or longer. During the attack, the physical
and emotional symptoms increase quickly in a crescendo-like
way and then subside. A person may feel anxious and jittery
for many hours after experiencing a panic attack.
Panic attacks can occur in anyone. Chemical or hormonal imbalances,
drugs or alcohol, stress, or other situational events can
cause panic attacks, which are often mistaken for heart attacks,
heart disease, or respiratory problems.
What
are phobias?
Phobias are irrational, involuntary, and inappropriate fears
of (or responses to) ordinary situations or things. People
who have phobias can experience panic attacks when confronted
with the situation or object about which they feel phobic.
A category of symptoms called phobic disorder falls within
the broader field of anxiety disorders.
Phobias
are divided into three types:
-
Specific (simple) phobia:
an unreasonable fear of specific circumstances or objects,
such as traffic jams or snakes.
-
Social phobia: extreme fear of
looking foolish or stupid or unacceptable in public that
causes people to avoid public occasions or areas.
-
Agoraphobia: an intense fear of
feeling trapped in a situation, especially in public places,
combined with an overwhelming fear of having a panic attack
in unfamiliar surroundings. This word means, literally (in
Greek), "fear of the marketplace."
Phobias
are usually chronic (long-term), distressing disorders that
keep people from ordinary activities and places. They can
lead to other serious problems, such as depression. In fact,
at least half of those who suffer with phobias and panic disorders
also have depression. Alcoholism, loss of productivity, secretiveness,
and feelings of shame and low self-esteem also occur wit this
illness. Some people are unable to go anywhere or do anything
outside their homes without the help of others they trust.
What
does it mean to "fear the fear"?
Many people with phobias or panic disorder "fear the
fear," or worry about when the next attack is coming.
The fear of more panic attacks can lead to a very limited
life. People who have panic attacks often begin to avoid the
things they think triggered the panic attack and then stop
doing the things they used to do or the places they used to
go.
Am
I the only one?
It is estimated that 2 percent to 5 percent of Americans have
panic disorder, so you are not alone if you, too have these
symptoms. Usually panic disorder first strikes people in their
early twenties. Severe stress, such as the death of a loved
one, can bring on panic attacks.
A 1986 study by the National Institute of Mental Health showed
that 5.1 percent to 12.5 percent of people surveyed had experienced
phobias in the past six months. The study estimated that 24
million Americans will experience some phobias in their lifetimes.
Phobias are the leading psychiatric disorders among women
of all ages. One survey showed that 4.9 percent of women and
1.8 percent of men have panic disorder, agoraphobia, or any
other phobias.
What
causes panic disorder?
No one really knows what causes panic disorder, but several
ideas are being researched. Panic disorder seems to run in
families, which suggests that it has at least some genetic
basis. Some theories suggest that panic disorder is part of
a more generalized anxiety in the people who have panic attacks
or that severe separation anxiety can develop into panic disorder
or phobias, most often agoraphobia.
Biological
theories point to possible physical defects in a person's
autonomic (or automatic) nervous system. General hypersensitivity
in the nervous system, increased arousal, or a sudden chemical
imbalance can trigger panic attacks. Caffeine, alcohol, and
several other agents can also trigger these symptoms.
Is
panic disorder treatable?
Recovery from panic disorder can be achieved either by taking
medication or by cognitive behavioral therapy that is specific
for panic disorder. Studies suggest that medication and cognitive
behavioral therapy are about equally effective and the decision
about which to take depends largely on the preference of the
person with the panic disorder. Medication probably works
a bit faster, but has more adverse side effects than cognitive
behavioral therapy. Also, when successful treatment is finished,
people who have had cognitive behavioral therapy tend to remain
well longer than people who have taken medication. There is
some evidence that the combination of cognitive behavioral
therapy and medication may offer some benefits over either
one alone.
-
Cognitive therapy is used to help
people think and behave appropriately. Patients learn to
make the feared object or situation less threatening as
they are exposed to, and slowly get used to, whatever is
so frightening to them. Family members and friends help
a great deal in this process when they are supportive and
encouraging
-
Medication
is most effective when it is used as part of an overall
treatment plan that includes supportive therapy. Antidepressants
and antianxiety medications are the most successful medications
for this disorder. Ask your doctor about these medications
or others that may help you.
-
Healthy living habits may
also help people overcome panic disorder. Exercise, a proper
and balanced diet, moderate use of caffeine and alcohol,
and learning how to reduce stress are all important.
-
Peer support is a vital part of
overcoming panic disorder. Family and friends can play a
significant role in the treatment process and should be
informed of the treatment plan and of the ways they can
be most helpful.
For
more in-depth information about mental illness, treatments
and supports, and medications;
please choose from the following topics:
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