Panic Disorder
Panic disorder is different from the normal fear and anxiety reactions to stressful events in our lives. Panic disorder is a serious condition that strikes without reason or warning. Symptoms of panic disorder include sudden attacks of fear and nervousness, as well as physical symptoms such as sweating and a racing heart. During a panic attack, the fear response is out of proportion for the situation, which often is not threatening. Over time, a person with panic disorder develops a constant fear of having another panic attack, which can affect daily functioning and general quality of life.
Panic disorder often occurs along with other serious conditions, such as depression, alcoholism, or drug abuse.
Panic disorder is different from the normal fear and anxiety reactions to stressful events in our lives. Panic disorder is a serious condition that strikes without reason or warning. Symptoms of panic disorder include sudden attacks of fear and nervousness, as well as physical symptoms such as sweating and a racing heart. During a panic attack, the fear response is out of proportion for the situation, which often is not threatening. Over time, a person with panic disorder develops a constant fear of having another panic attack, which can affect daily functioning and general quality of life.
Panic disorder often occurs along with other serious conditions, such as depression, alcoholism, or drug abuse.
Symptoms of a panic attack, which often last about 10 minutes, include:
- Difficulty breathing.
- Pounding heart or chest pain.
- Intense feeling of dread.
- Sensation of choking or smothering.
- Dizziness or feeling faint.
- Trembling or shaking.
- Sweating
- Nausea or stomachache.
- Tingling or numbness in the fingers and toes.
- Chills or hot flashes.
- A fear that you are losing control or are about to die.
Beyond the panic attacks themselves, a key symptom of panic disorder is the persistent fear of having future panic attacks. The fear of these attacks can cause the person to avoid places and situations where an attack has occurred or where they believe an attack may occur.
Symptoms of a panic attack, which often last about 10 minutes, include:
- Difficulty breathing.
- Pounding heart or chest pain.
- Intense feeling of dread.
- Sensation of choking or smothering.
- Dizziness or feeling faint.
- Trembling or shaking.
- Sweating
- Nausea or stomachache.
- Tingling or numbness in the fingers and toes.
- Chills or hot flashes.
- A fear that you are losing control or are about to die.
Beyond the panic attacks themselves, a key symptom of panic disorder is the persistent fear of having future panic attacks. The fear of these attacks can cause the person to avoid places and situations where an attack has occurred or where they believe an attack may occur.
What Causes Panic Disorder?
Although the exact cause of panic disorder is not fully understood, studies have shown that a combination of factors, including biological and environmental, may be involved. These factors include.
- Family history. Panic disorder has been shown to run in families. It may be passed on to some people by one or both parent(s) much like hair or eye color can.
- Abnormalities in the brain. Panic disorder may be caused by problems in parts of the brain.
- Substance abuse. Abuse of drugs and alcohol can contribute to panic disorder.
- Major life stress. Stressful events and major life transitions, such as the death of a loved one, can trigger panic disorder.
Although the exact cause of panic disorder is not fully understood, studies have shown that a combination of factors, including biological and environmental, may be involved. These factors include.
- Family history. Panic disorder has been shown to run in families. It may be passed on to some people by one or both parent(s) much like hair or eye color can.
- Abnormalities in the brain. Panic disorder may be caused by problems in parts of the brain.
- Substance abuse. Abuse of drugs and alcohol can contribute to panic disorder.
- Major life stress. Stressful events and major life transitions, such as the death of a loved one, can trigger panic disorder.
How Common Is Panic Disorder?
Panic disorder affects about 2.4 million adult Americans. Panic disorder most often begins during late adolescence and early adulthood. It is twice as common in women as in men.
Panic disorder affects about 2.4 million adult Americans. Panic disorder most often begins during late adolescence and early adulthood. It is twice as common in women as in men.
How Is Panic Disorder Diagnosed?
If symptoms of panic disorder are present, the doctor will begin an evaluation by performing a complete medical history and physical exam. Although there are no lab tests to specifically diagnose panic disorder, the doctor may use various tests to look for physical illness as the cause of symptoms.
If no physical illness is found, you may be referred to a psychiatrist or psychologist, mental health professionals who are specially trained to diagnose and treat mental illnesses. Psychiatrists and psychologists use specially designed interview and assessment tools to evaluate a person for panic disorder.
The doctor bases his or her diagnosis on reported intensity and duration of symptoms, including the frequency of panic attacks, and the doctor's observation of the patient's attitude and behavior. The doctor then determines if the symptoms and degree of dysfunction suggest panic disorder.
If symptoms of panic disorder are present, the doctor will begin an evaluation by performing a complete medical history and physical exam. Although there are no lab tests to specifically diagnose panic disorder, the doctor may use various tests to look for physical illness as the cause of symptoms.
If no physical illness is found, you may be referred to a psychiatrist or psychologist, mental health professionals who are specially trained to diagnose and treat mental illnesses. Psychiatrists and psychologists use specially designed interview and assessment tools to evaluate a person for panic disorder.
The doctor bases his or her diagnosis on reported intensity and duration of symptoms, including the frequency of panic attacks, and the doctor's observation of the patient's attitude and behavior. The doctor then determines if the symptoms and degree of dysfunction suggest panic disorder.
How Is Panic Disorder Treated?
A combination of the following therapies is often used to treat panic disorder.
- Psychotherapy. Psychotherapy (a type of counseling) addresses the emotional response to mental illness. It is a process in which trained mental health professionals help people by talking through strategies for understanding and dealing with their disorder.
- Cognitive behavioral therapy. A type of psychotherapy that helps a person learn to recognize and change thought patterns and behaviors that lead to troublesome feelings. Therapy also aims to identify possibly triggers for panic attacks.
- Medication. The anti-depressant drugs Paxil and Zoloft and anti-anxiety medications such as Xanax, Ativan, or Klonopin are used to treat panic disorders. Sometimes, heart medications (such as beta blockers) are used to help with anxiety.
- Relaxation techniques.
Some people will respond well to treatment only to experience panic attacks later in life. When panic attacks continue after treatment has stopped, additional treatment may still help control and reduce panic attacks. In addition, relaxation techniques, such as breathing retraining and positive visualization, may help a person during an attack.
A combination of the following therapies is often used to treat panic disorder.
- Psychotherapy. Psychotherapy (a type of counseling) addresses the emotional response to mental illness. It is a process in which trained mental health professionals help people by talking through strategies for understanding and dealing with their disorder.
- Cognitive behavioral therapy. A type of psychotherapy that helps a person learn to recognize and change thought patterns and behaviors that lead to troublesome feelings. Therapy also aims to identify possibly triggers for panic attacks.
- Medication. The anti-depressant drugs Paxil and Zoloft and anti-anxiety medications such as Xanax, Ativan, or Klonopin are used to treat panic disorders. Sometimes, heart medications (such as beta blockers) are used to help with anxiety.
- Relaxation techniques.
Some people will respond well to treatment only to experience panic attacks later in life. When panic attacks continue after treatment has stopped, additional treatment may still help control and reduce panic attacks. In addition, relaxation techniques, such as breathing retraining and positive visualization, may help a person during an attack.
What Is the Outlook for People With Panic Disorder?
Panic disorder can be successfully treated, and sufferers can go on to lead full and satisfying lives. With appropriate treatment, nearly 90% of people with panic disorder can find relief. Unfortunately, many people with panic disorder do not seek treatment. Without treatment, panic disorder can have serious consequences and can severely impair quality of life. Complications of untreated panic disorder include.
- Avoidance. A person may discontinue any activities that seem to trigger a panic attack. This can make a normal work and home life nearly impossible.
- Anticipatory anxiety. This refers to anxiety that is triggered merely by thinking about the possibility of having an anxiety attack.
- Agoraphobia. This is the fear of being in places or situations in which an attack may occur, or from which escape would be difficult or highly embarrassing. This fear can drive people to avoid public places and crowds, and may even progress to the point that the person will not leave his or her home. About one-third of people with panic disorder develop agoraphobia.
- Claustrophobia. The person fears enclosed spaces.
Panic disorder can be successfully treated, and sufferers can go on to lead full and satisfying lives. With appropriate treatment, nearly 90% of people with panic disorder can find relief. Unfortunately, many people with panic disorder do not seek treatment. Without treatment, panic disorder can have serious consequences and can severely impair quality of life. Complications of untreated panic disorder include.
- Avoidance. A person may discontinue any activities that seem to trigger a panic attack. This can make a normal work and home life nearly impossible.
- Anticipatory anxiety. This refers to anxiety that is triggered merely by thinking about the possibility of having an anxiety attack.
- Agoraphobia. This is the fear of being in places or situations in which an attack may occur, or from which escape would be difficult or highly embarrassing. This fear can drive people to avoid public places and crowds, and may even progress to the point that the person will not leave his or her home. About one-third of people with panic disorder develop agoraphobia.
- Claustrophobia. The person fears enclosed spaces.
Can Panic Disorder Be Prevented?
Panic disorder cannot be prevented; however, there are some things you can do to reduce stress and decrease symptoms, including:
- Stop or reduce consumption of products that contain caffeine, such as coffee, tea, cola, and chocolate.
- Ask your doctor or pharmacist before taking any over-the-counter drugs or herbal remedies. Many contain chemicals that can increaseanxiety symptoms.
- Exercise daily and eat a healthy, balanced diet.
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People with panic disorder have feelings of terror that strike suddenly and repeatedly, most often with no warning. They usually can’t predict when an attack will occur, and many develop intense anxiety between episodes, worrying when and where the next one will strike. Between attacks there is a persistent, lingering worry that another one could come any minute.
Panic attacks often consist of a pounding heart, sweatiness, a feeling of weakness, faintness or dizziness. The hands may tingle or feel numb, the person may feel flushed or chilled. There can be chest pain or smothering sensations, a sense of unreality, a fear of impending doom or loss of control. The person may genuinely believe they are having a heart attack or stroke, losing their mind, or on the verge of death.
Attacks can occur any time, even during non-dream sleep. In the U.S., this type of panic attack has been estimated to occur at least one time in roughly one-quarter to one-third of individuals with panic disorder, of whom the majority also have daytime panic attacks. While most attacks average a couple of minutes, occasionally they can go on for up to 10 minutes. In rare cases, they may last an hour or more.
Panic disorder strikes between 3 and 6 million Americans, and is twice as common in women as in men. It can appear at any age — in children or in the elderly — but most often it begins in young adults. Not everyone who experiences panic attacks will develop panic disorder– for example, many people have one attack and never experience another. For those who do have panic disorder, though, it’s important to seek treatment. Untreated, the disorder can become debilitating.
In the U.S. and Europe, approximately one-half of individuals with panic disorder have expected panic attacks as well as unexpected panic attacks. Thus, as a recent change made to the criteria in the DSM-5, the presence of expected panic attacks no longer prevents the diagnosis of panic disorder. This change acknowledges that oftentimes a panic attack arises out of an already-anxious state (e.g., the person is worried about having a panic attack in a store and low-and-behold has one).
Clinicians now make the decision whether a person’sexpected panic attacks will count towards their client’s panic disorder diagnosis. They will usually classify expected panic attacks under panic disorder as long as the person’s concerns accompanying their panic attacks are centered around the fear of the panic sensations themselves, their consequences (e.g., “I could have died or gone crazy”), and of having them again in the future (e.g., the person makes special efforts to avoid returning to the place where that attack occurred).
Panic disorder is often accompanied by other conditions such as depression or alcohol/drug use to cope with or prevent symptoms. It may spawn phobias, which can develop in places or situations where panic attacks have occurred. For example, if a panic attack strikes while you’re riding an elevator, you may develop a fear of elevators and perhaps start avoiding them.
Some people’s lives become greatly restricted — they avoid normal, everyday activities such as grocery shopping, driving, or in some cases even leaving the house. On the other hand, they may be able to confront a feared situation only if accompanied by a spouse or another trusted person. Basically, they avoid any situation they fear would make them feel helpless if a panic attack occurs.
When people’s lives become so restricted by the disorder, as happens in about one-third of all people with panic disorder, the condition is called agoraphobia. A tendency toward panic disorder and agoraphobia runs in families. Nevertheless, early treatment of panic disorder can often stop the progression to agoraphobia.
Panic disorder cannot be prevented; however, there are some things you can do to reduce stress and decrease symptoms, including:
- Stop or reduce consumption of products that contain caffeine, such as coffee, tea, cola, and chocolate.
- Ask your doctor or pharmacist before taking any over-the-counter drugs or herbal remedies. Many contain chemicals that can increaseanxiety symptoms.
- Exercise daily and eat a healthy, balanced diet.
-----------------------------------------------------------------------------------------------------------------------
People with panic disorder have feelings of terror that strike suddenly and repeatedly, most often with no warning. They usually can’t predict when an attack will occur, and many develop intense anxiety between episodes, worrying when and where the next one will strike. Between attacks there is a persistent, lingering worry that another one could come any minute.
Panic attacks often consist of a pounding heart, sweatiness, a feeling of weakness, faintness or dizziness. The hands may tingle or feel numb, the person may feel flushed or chilled. There can be chest pain or smothering sensations, a sense of unreality, a fear of impending doom or loss of control. The person may genuinely believe they are having a heart attack or stroke, losing their mind, or on the verge of death.
Attacks can occur any time, even during non-dream sleep. In the U.S., this type of panic attack has been estimated to occur at least one time in roughly one-quarter to one-third of individuals with panic disorder, of whom the majority also have daytime panic attacks. While most attacks average a couple of minutes, occasionally they can go on for up to 10 minutes. In rare cases, they may last an hour or more.
Panic disorder strikes between 3 and 6 million Americans, and is twice as common in women as in men. It can appear at any age — in children or in the elderly — but most often it begins in young adults. Not everyone who experiences panic attacks will develop panic disorder– for example, many people have one attack and never experience another. For those who do have panic disorder, though, it’s important to seek treatment. Untreated, the disorder can become debilitating.
In the U.S. and Europe, approximately one-half of individuals with panic disorder have expected panic attacks as well as unexpected panic attacks. Thus, as a recent change made to the criteria in the DSM-5, the presence of expected panic attacks no longer prevents the diagnosis of panic disorder. This change acknowledges that oftentimes a panic attack arises out of an already-anxious state (e.g., the person is worried about having a panic attack in a store and low-and-behold has one).
Clinicians now make the decision whether a person’sexpected panic attacks will count towards their client’s panic disorder diagnosis. They will usually classify expected panic attacks under panic disorder as long as the person’s concerns accompanying their panic attacks are centered around the fear of the panic sensations themselves, their consequences (e.g., “I could have died or gone crazy”), and of having them again in the future (e.g., the person makes special efforts to avoid returning to the place where that attack occurred).
Panic disorder is often accompanied by other conditions such as depression or alcohol/drug use to cope with or prevent symptoms. It may spawn phobias, which can develop in places or situations where panic attacks have occurred. For example, if a panic attack strikes while you’re riding an elevator, you may develop a fear of elevators and perhaps start avoiding them.
Some people’s lives become greatly restricted — they avoid normal, everyday activities such as grocery shopping, driving, or in some cases even leaving the house. On the other hand, they may be able to confront a feared situation only if accompanied by a spouse or another trusted person. Basically, they avoid any situation they fear would make them feel helpless if a panic attack occurs.
When people’s lives become so restricted by the disorder, as happens in about one-third of all people with panic disorder, the condition is called agoraphobia. A tendency toward panic disorder and agoraphobia runs in families. Nevertheless, early treatment of panic disorder can often stop the progression to agoraphobia.
Specific Symptoms of Panic Disorder:
A person with panic disorder experiences recurrent either expected or unexpected Panic Attacks and at least one of the attacks has been followed by one month (or more) of one or more of the following:
- Persistent concern about about the implications of the attack, such as its consequences (e.g., losing control, having a heart attack, “going crazy”) or fears of having additional attacks
- A significant change in behavior related to the attacks (e.g., avoid exercise or unfamiliar situations)
The Panic Attacks may not be due to the direct physiological effects of use or abuse of a substance (alcohol, drugs, medications) or a general medical condition (e.g., hyperthyroidism).
Though panic attacks can occur in other mental disorders (most often anxiety-related disorders), the panic attacks in Panic Disorder itself cannot occur exclusive to symptoms in another disorder. In other words, attacks in Panic Disorder cannot be better accounted for by another mental disorder, such as Social Phobia (e.g., occurring on exposure to feared social situations),Specific Phobia (e.g., on exposure to a specific phobic situation), Obsessive-Compulsive Disorder (e.g., on exposure to dirt in someone with an obsession about contamination),Posttraumatic Stress Disorder (e.g., in response to stimuli associated with a severe stressor), or Separation Anxiety Disorder (e.g., in response to being away from home or close relatives).
Panic disorder is associated with high levels of social, occupational, and physical disability; considerable economic costs; and the highest number of medical visits among the anxiety disorders, although the effects are strongest with the presence of agoraphobia. Though Agoraphobia may also be present, it isn’t required in order to diagnose panic disorder.
A person with panic disorder experiences recurrent either expected or unexpected Panic Attacks and at least one of the attacks has been followed by one month (or more) of one or more of the following:
- Persistent concern about about the implications of the attack, such as its consequences (e.g., losing control, having a heart attack, “going crazy”) or fears of having additional attacks
- A significant change in behavior related to the attacks (e.g., avoid exercise or unfamiliar situations)
The Panic Attacks may not be due to the direct physiological effects of use or abuse of a substance (alcohol, drugs, medications) or a general medical condition (e.g., hyperthyroidism).
Though panic attacks can occur in other mental disorders (most often anxiety-related disorders), the panic attacks in Panic Disorder itself cannot occur exclusive to symptoms in another disorder. In other words, attacks in Panic Disorder cannot be better accounted for by another mental disorder, such as Social Phobia (e.g., occurring on exposure to feared social situations),Specific Phobia (e.g., on exposure to a specific phobic situation), Obsessive-Compulsive Disorder (e.g., on exposure to dirt in someone with an obsession about contamination),Posttraumatic Stress Disorder (e.g., in response to stimuli associated with a severe stressor), or Separation Anxiety Disorder (e.g., in response to being away from home or close relatives).
Panic disorder is associated with high levels of social, occupational, and physical disability; considerable economic costs; and the highest number of medical visits among the anxiety disorders, although the effects are strongest with the presence of agoraphobia. Though Agoraphobia may also be present, it isn’t required in order to diagnose panic disorder.
Panic Disorder
(continued)
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How Is Panic Disorder Treated?
A combination of the following therapies is often used to treat panic disorder.
- Psychotherapy. Psychotherapy (a type of counseling) addresses the emotional response to mental illness. It is a process in which trained mental health professionals help people by talking through strategies for understanding and dealing with their disorder.
- Cognitive behavioral therapy. A type of psychotherapy that helps a person learn to recognize and change thought patterns and behaviors that lead to troublesome feelings. Therapy also aims to identify possibly triggers for panic attacks.
- Medication. The anti-depressant drugs Paxil and Zoloft and anti-anxiety medications such as Xanax, Ativan, or Klonopin are used to treat panic disorders. Sometimes, heart medications (such as beta blockers) are used to help with anxiety.
- Relaxation techniques.
Some people will respond well to treatment only to experience panic attacks later in life. When panic attacks continue after treatment has stopped, additional treatment may still help control and reduce panic attacks. In addition, relaxation techniques, such as breathing retraining and positive visualization, may help a person during an attack.
A combination of the following therapies is often used to treat panic disorder.
- Psychotherapy. Psychotherapy (a type of counseling) addresses the emotional response to mental illness. It is a process in which trained mental health professionals help people by talking through strategies for understanding and dealing with their disorder.
- Cognitive behavioral therapy. A type of psychotherapy that helps a person learn to recognize and change thought patterns and behaviors that lead to troublesome feelings. Therapy also aims to identify possibly triggers for panic attacks.
- Medication. The anti-depressant drugs Paxil and Zoloft and anti-anxiety medications such as Xanax, Ativan, or Klonopin are used to treat panic disorders. Sometimes, heart medications (such as beta blockers) are used to help with anxiety.
- Relaxation techniques.
Some people will respond well to treatment only to experience panic attacks later in life. When panic attacks continue after treatment has stopped, additional treatment may still help control and reduce panic attacks. In addition, relaxation techniques, such as breathing retraining and positive visualization, may help a person during an attack.
What Is the Outlook for People With Panic Disorder?
Panic disorder can be successfully treated, and sufferers can go on to lead full and satisfying lives. With appropriate treatment, nearly 90% of people with panic disorder can find relief. Unfortunately, many people with panic disorder do not seek treatment. Without treatment, panic disorder can have serious consequences and can severely impair quality of life. Complications of untreated panic disorder include.
- Avoidance. A person may discontinue any activities that seem to trigger a panic attack. This can make a normal work and home life nearly impossible.
- Anticipatory anxiety. This refers to anxiety that is triggered merely by thinking about the possibility of having an anxiety attack.
- Agoraphobia. This is the fear of being in places or situations in which an attack may occur, or from which escape would be difficult or highly embarrassing. This fear can drive people to avoid public places and crowds, and may even progress to the point that the person will not leave his or her home. About one-third of people with panic disorder develop agoraphobia.
- Claustrophobia. The person fears enclosed spaces.
Panic disorder can be successfully treated, and sufferers can go on to lead full and satisfying lives. With appropriate treatment, nearly 90% of people with panic disorder can find relief. Unfortunately, many people with panic disorder do not seek treatment. Without treatment, panic disorder can have serious consequences and can severely impair quality of life. Complications of untreated panic disorder include.
- Avoidance. A person may discontinue any activities that seem to trigger a panic attack. This can make a normal work and home life nearly impossible.
- Anticipatory anxiety. This refers to anxiety that is triggered merely by thinking about the possibility of having an anxiety attack.
- Agoraphobia. This is the fear of being in places or situations in which an attack may occur, or from which escape would be difficult or highly embarrassing. This fear can drive people to avoid public places and crowds, and may even progress to the point that the person will not leave his or her home. About one-third of people with panic disorder develop agoraphobia.
- Claustrophobia. The person fears enclosed spaces.
Can Panic Disorder Be Prevented?
Panic disorder cannot be prevented; however, there are some things you can do to reduce stress and decrease symptoms, including:
- Stop or reduce consumption of products that contain caffeine, such as coffee, tea, cola, and chocolate.
- Ask your doctor or pharmacist before taking any over-the-counter drugs or herbal remedies. Many contain chemicals that can increaseanxiety symptoms.
- Exercise daily and eat a healthy, balanced diet.
Panic disorder cannot be prevented; however, there are some things you can do to reduce stress and decrease symptoms, including:
- Stop or reduce consumption of products that contain caffeine, such as coffee, tea, cola, and chocolate.
- Ask your doctor or pharmacist before taking any over-the-counter drugs or herbal remedies. Many contain chemicals that can increaseanxiety symptoms.
- Exercise daily and eat a healthy, balanced diet.
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