PANIC DISORDER


"It started 10 years ago. I was sitting in a seminar in a hotel and this thing came
out of the clear blue. I felt like I was dying."

"For me, a panic attack is almost a violent experience. I feel like I’m going
insane. It makes me feel like I’m losing control in a very extreme way. My heart pounds
really hard, things seem unreal, and there’s this very strong feeling of impending
doom."

"In between attacks there is this dread and anxiety that it’s going to happen
again. It can be very debilitating, trying to escape those feelings of panic."

People with panic disorder have feelings of terror that strike suddenly and repeatedly with no warning. They can’t predict when an attack will occur, and many develop intense anxiety between episodes, worrying when and where the next one will strike. In between times there is a persistent, lingering worry that another attack could come any minute.

When a panic attack strikes, most likely your heart pounds and you may feel sweaty, weak, faint, or dizzy. Your hands may tingle or feel numb, and you might feel flushed or chilled. You may have chest pain or smothering sensations, a sense of unreality, or fear of impending doom or loss of control.
You may genuinely believe you’re having a heart attack or stroke, losing your mind, or on
the verge of death. Attacks can occur any time, even during nondream sleep. 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 Attack Symptoms

  • — Pounding heart
  • — Chest pains
  • — Lightheadedness or dizziness
  • — Nausea or stomach problems
  • — Flushes or chills
  • — Shortness of breath or a feeling of smothering or choking
  • — Tingling or numbness
  • — Shaking or trembling
  • — Feelings of unreality
  • — Terror
  • — A feeling of being out of control or going crazy
  • — Fear of dying
  • — Sweating

Panic disorder strikes at least 1.6 percent of the population 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 but never have another. For those who
do have panic disorder, though, it’s important to seek treatment. Untreated, the disorder
can become very disabling.

Panic disorder is often accompanied by other conditions such as depression or
alcoholism, and 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. Or, they may
be able to confront a feared situation only if accompanied by a spouse or other 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.

Studies have shown that proper treatment–a type of psychotherapy called
cognitive-behavioral therapy, medications, or possibly a combination of the two–helps 70
to 90 percent of people with panic disorder. Significant improvement is usually seen
within 6 to 8 weeks.

Cognitive-behavioral approaches teach patients how to view the panic situations
differently and demonstrate ways to reduce anxiety, using breathing exercises or
techniques to refocus attention, for example. Another technique used in
cognitive-behavioral therapy, called exposure therapy, can often help alleviate the
phobias that may result from panic disorder. In exposure therapy, people are very slowly
exposed to the fearful situation until they become desensitized to it.

Some people find the greatest relief from panic disorder symptoms when they take
certain prescription medications. Such medications, like cognitive-behavioral therapy, can
help to prevent panic attacks or reduce their frequency and severity. Two types of
medications that have been shown to be safe and effective in the treatment of panic
disorder are antidepressants and benzodiazepines.

text taken from ANXIETY DISORDERS: DECADE OF THE BRAIN
(NIMH).