What is Panic Disorder?
Feb 13, 2009 | Author: Bio Behavioral Institute
Imagine that you were just going about your business and suddenly you notice a snarling tiger, teeth bared crouched in front of you. How would you feel? What physical symptoms would you experience? What would you have the urge to do? Probably many of us would feel immediate terror and a sense of impending doom. Our hearts might start pounding and we might start to breathe very rapidly. We might have a sense of unreality or start to feel numb and disconnected. Likely, we would either feel paralyzed or have a severe urge to flee. If we were lucky enough to escape we might think about this experience for a long time. Some of us might worry about running into a tiger again. Others might become apprehensive about going back to where the tiger appeared or even avoid that place altogether.
For many, a panic attack is an experience as frightening as the above example, except there is no tiger. At the onset of panic disorder, sudden and intense fear, accompanied by a variety of uncomfortable and frightening physical symptoms is common. There is usually an intense urge to flee or avoid and these symptoms appear to come out of nowhere. Uncomfortable sensations and experiences may include palpitations, chest pain, lightheadedness, numbness and feelings of unreality. It is common for those having a panic attack to seek help at emergency rooms or undergo repeated medical testing for reassurance. Panic attacks are categorized as a disorder when they become frequent and intense, interfering with one's functioning and quality of life. Many suffer a first panic attack after they have been under a high degree of stress in the recent past.
Characteristics of Panic Disorder
According to the DSM-IV, the widely used psychiatric guide, panic disorder is characterized by:
A. Both (1) and (2): (1) recurrent unexpected panic attacks (2) at least one of the attacks has been followed by 1 month (or more) of the following: (a) persistent concern about having additional attacks (b) worry about the implications of the attack or its consequences (e.g., loosing control, having a heart attack, "going crazy") (c) a significant change in behavior related to the attacks.
An important thing to recognize is that symptoms experienced during a panic attack, while distressing and uncomfortable, are not dangerous. In fact, it is the exaggerated misinterpretation of normal, albeit unexpected physical changes which causes the most harm. This is why panic is often thought of as a False Alarm.
Of course, before a diagnosis is made certain medical conditions, such as hyperthyroidism or actual cardiac problems that can lead to similar symptoms must be ruled out.
Who suffers from panic disorder?
Many who have panic disorder feel ashamed or weak, as if this condition is a sign of poor character. There is no reason to feel this way. Millions suffer from this condition and there is no fault attached. Vulnerability to panic disorder may be genetic since it has been found to run in many families where people have had panic attacks themselves or tend to be worried or anxious people. People who develop panic disorder may have certain kinds of brain functioning or ways of reacting to stress that predisposes them. Men and women both can have panic disorder, although it is more common among women. An early history of separation anxiety may be noted in people who later develop panic disorder. The age of onset of panic disorder can vary, but typically occurs between teenage years and young adulthood.
What are the symptoms?
Many people with panic disorder feel depressed. Fatigue and feeling that life is too stressful is also common. Some of those with panic disorder may be prone to self-medicating with drugs or alcohol. This may provide temporary relief but in the long run will usually make the condition worse. It has also been found that for some using a substance, marijuana for instance, can trigger the onset of panic disorder.
One of the most debilitating problems associated with panic disorder occurs when sufferers begin to fear or avoid places where they have had panic attacks or where they are apprehensive that a panic attack will take place. This is called agoraphobia. Common places that become feared for those with panic disorder often include malls and supermarkets.
People with panic disorder also frequently develop "safety signals," such as sitting nearby an exit that similarly results in short-term anxiety reduction, but just leads to more anxiety over time.
What treatments are available?
Although panic disorder can be a serious and persistent condition, the good news is that most can be helped with the right treatment. Relief often can take place within a few months or, for some, within a period of weeks. Sometimes, just receiving an accurate diagnosis and an understanding of what is happening to you can help. Of course, sometimes the disorder has evolved to where long-term treatment is required. However, despite their distress and interference with functioning, many put off seeking help, some out of embarrassment and others because they hope it will just go away. Unfortunately, while symptoms of panic disorder often wax and wane, and even sometimes disappear for awhile, it is usual for symptoms to return.
One approach that many have found useful involves behavior and cognitive therapy. In this method, one is though to think about sudden, often unexpected physiological changes in a more accurate way. In addition, one learns to confront the feared situations rather than engage in avoidance, which only feeds into the condition. Working with a therapist who is trained in these techniques is essential.