Definition

Panic Disorder is classified in the DSM-IV as an Anxiety Disorder. Its central features are repeated, unexpected episodes of intense fear or discomfort that are accompanied by multiple physical symptoms in the absence of any life-threatening danger. These episodes are commonly referred to as Panic Attacks and they may or may not be brought on by specific situational triggers. Key criteria for diagnosis are that the attacks are unexpected, and cannot be better explained by a pre-existing medical or psychological condition.

Individuals experiencing a panic attack may feel as though they are suddenly losing control, going crazy, or even dying. They may be simultaneously overcome with dizziness, feelings of nausea, shortness of breath, a racing or pounding heartbeat, and other seemingly distressing physical symptoms that only serve to exacerbate their distress. Further, it is not uncommon for such episodes to occur several times in a day. Individuals may also come to associate Panic Attacks with particular events or situations such that they will try to avoid placing themselves in such circumstances for fear of experiencing an attack. If left unchecked, these avoidant tendencies may eventually lead to Agoraphobia, a fear of being in places or situations from which escape might be difficult (or embarrassing) or in which help might not be forthcoming.

Research is indicating that Panic Disorder is evident in countries around the world. Current estimates suggest that it is prevalent in approximately 1.5%-3.5% of the population. Women are twice as likely to suffer from the disorder than men; however, when Agoraphobia is also present, women are three times as likely to suffer from the condition.

For information and treatment of Panic Disorder or Panic Attacks, please visit www.CrossCreekCounseling.com

Symptoms

Several physical and psychological symptoms are associated with Panic Disorder:

• sudden, unexpected feeling of intense anxiety, fear, or even terror
• a racing and/or pounding heartbeat
• chest pain or discomfort
• lightheadedness, dizziness, feeling faint
• feelings of nausea, tingling or numbness in the extremities, sweating
• trembling or shaking
• difficulty breathing or feeling of choking
• chills or hot flushes
• feelings of unreality, e.g., dreamlike sensations or perceptual distortions
• feelings of being detached from oneself or one's environment
• fear of losing control, "going crazy," or dying
• typically last for several minutes to an hour

Cause(s)

The cause of Panic Disorder is presently unknown. At the moment, the research literature tends to be divided into two camps: biological explanations and cognitive-behavioral explanations. The former consider whether neurochemical defects in the brain give rise to such behaviors and whether the manifestation of the disorder is rooted in a genetic predisposition, while the latter suggests that a misinterpretation of bodily sensations (such as those that are associated with anxiety) triggers more intense levels of anxiety, which in turn create more disturbing sensations until panic ensues and phobic avoidance may develop.

Course

The age of onset typically occurs in the late twenties. In rare cases, panic disorders may develop in childhood or in the late forties. Panic Attacks may occur several times a week or even several times in a day. The disorder may persist for a single, relatively brief period (several weeks or months) or recur intermittently several times. It can also persist off-and-on for years, and, in some cases, can give rise to Agoraphobia .

Treatment

A combination of medication and cognitive-behavioral therapy has proved efficacious in treating panic disorder. Antianxiety medications such as clonazepam (Klonopin), diazepam (Valium), and alprazolam (Xanax) are often prescribed to reduce feelings of panic and anxiety. Antidepressants including fluoxetine (Prozac), paroxetine (Paxil), sertraline (Zoloft), and imipramine (Tofranil) can also be prescribed to allay any associated depressive symptoms that may arise as a consequence of worrying about future panic attacks. In many cases, the right combination of medication and dosage has been able to eliminate symptoms entirely.

Cognitive-behavioral therapy can involve educating individuals about the nature of anxiety and stress responses and challenging fearful cognitions that are tied to particular events or situations. Behavioral treatment methods can include exposure techniques such as systematic desensitization, a method involving gradual exposure to a source of anxiety, and flooding, direct exposure to the source of anxiety if the individual is capable of tolerating it.

Dealing with Relapse

During a period of stability and wellness, individuals should devise a relapse management plan with their mental health professional and family members or friends that will outline what steps may need to be taken should a relapse occur. The plan will need to identify symptoms that may constitute warning signs and, if they are evident, an agreement should be made by the individual and members of his or her immediate support network to contact the family physician, counselor, or other mental health professional. In addition, methods to reduce stress and stimulation should be established with a counselor so that they can be put into effect pending any relapse.

Emergencies

In the case of an emergency, individuals should call their physician, therapist, or the emergency ward of their local hospital. Additional assistance may also be obtained by clicking on the Further Information and Support link below.

Further Information and Support (Coming Soon)

References (Coming Soon)

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