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PTIMA
| Specialty Hospital |
| VISIT OUR RELAXATION THERAPY ROOM |
PANIC DISORDER
What is Panic Disorder?
Panic disorder is an anxiety disorder and is characterized by unexpected and repeated
episodes of intense fear accompanied by physical symptoms that may include chest pain,
heart palpitations, shortness of breath, dizziness, or abdominal distress.
A panic attack is a sudden surge of overwhelming fear that comes without warning and
without any obvious reason. It is far more intense than the feeling of being 'stressed out'
that most people experience. Symptoms of a panic attack include:
racing heartbeat
difficulty breathing, feeling as though you 'can't get enough air'
terror that is almost paralyzing
dizziness, lightheadedness or nausea
trembling, sweating, shaking
choking, chest pains
hot flashes, or sudden chills
tingling in fingers or toes ('pins and needles')
fear that you're going to go crazy or are about to die
You probably recognize this as the classic 'flight or fight' response that human beings
experience when we are in a situation of danger. But during a panic attack, these
symptoms seem to rise from out of nowhere. They occur in seemingly harmless
situations--they can even happen while you are asleep.
In addition to the above symptoms, a panic attack is marked by the following conditions:
it occurs suddenly, without any warning and without any way to stop it.
the level of fear is way out of proportion to the actual situation; often, in fact, it's completely
unrelated.
it passes in a few minutes; the body cannot sustain the 'fight or flight' response for longer
than that. However, repeated attacks can continue to recur for hours.
A panic attack is not dangerous, but it can be terrifying, largely because it feels 'crazy' and
'out of control.' Panic disorder is frightening because of the panic attacks associated with it,
and also because it often leads to other complications such as phobias, depression,
substance abuse, medical complications, even suicide. Its effects can range from mild
word or social impairment to a total inability to face the outside world.
In fact, the phobias that people with panic disorder develop do not come from fears of
actual objects or events, but rather from fear of having another attack. In these cases,
people will avoid certain objects or situations because they fear that these things will
trigger another attack.
How to Identify Panic Disorder
Please remember that only a licensed therapist can diagnose a panic disorder. There are
certain signs you may already be aware of, though.
One study found that people sometimes see 10 or more doctors before being properly
diagnosed, and that only one out of four people with the disorder receive the treatment they
need. That's why it's important to know what the symptoms are, and to make sure you get
the right help.
Many people experience occasional panic attacks, and if you have had one or two such
attacks, there probably isn't any reason to worry. The key symptom of panic disorder is the
persistent fear of having future panic attacks. If you suffer from repeated (four or more)
panic attacks, and especially if you have had a panic attack and are in continued fear of
having another, these are signs that you should consider finding a mental health
professional who specializes in panic or anxiety disorders.
What Causes Panic Disorder: Mind, Body, or Both?
Body: There may be a genetic predisposition to anxiety disorders; some sufferers report
that a family member has or had a panic disorder or some other emotional disorder such
as depression. Studies with twins have confirmed the possibility of 'genetic inheritance' of
the disorder.
Panic Disorder could also be due to a biological malfunction, although a specific biological
marker has yet to be identified.
All ethnic groups are vulnerable to panic disorder. For unknown reasons, women are twice
as likely to get the disorder as men.
Mind: Stressful life events can trigger panic disorders. One association that has been
noted is that of a recent loss or separation. Some researchers liken the 'life stressor' to a
thermostat; that is, when stresses lower your resistance, the underlying physical
predisposition kicks in and triggers an attack.
Both: Physical and psychological causes of panic disorder work together. Although initially
attacks may come out of the blue, eventually the sufferer may actually help bring them on
by responding to physical symptoms of an attack.
For example, if a person with panic disorder experiences a racing heartbeat caused by
drinking coffee, exercising, or taking a certain medication, they might interpret this as a
symptom of an attack and , because of their anxiety, actually bring on the attack. On the
other hand, coffee, exercise, and certain medications sometimes do, in fact, cause panic
attacks. One of the most frustrating things for the panic sufferer is never knowing how to
isolate the different triggers of an attack. That's why the right therapy for panic disorder
focuses on all aspects -- physical, psychological, and physiological -- of the disorder.
Can People with Panic Disorder lead normal lives?
The answer to this is a resounding YES -- if they receive treatment.
Panic disorder is highly treatable, with a variety of available therapies. These treatments
are extremely effective, and most people who have successfully completed treatment can
continue to experience situational avoidance or anxiety, and further treatment might be
necessary in those cases. Once treated, panic disorder doesn't lead to any permanent
complications.
Side Effects of Panic Disorder
Without treatment, panic disorder can have very serious consequences.
The immediate danger with panic disorder is that it can often lead to a phobia. That's
because once you've suffered a panic attack, you may start to avoid situations like the one
you were in when the attack occurred.
Many people with panic disorder show 'situational avoidance' associated with their panic
attacks. For example, you might have an attack while driving, and start to avoid driving until
you develop an actual phobia towards it. In worst case scenarios, people with panic
disorder develop agoraphobia -- fear of going outdoors -- because they believe that by
staying inside, they can avoid all situations that might provoke an attack, or where they
might not be able to get help. The fear of an attack is so debilitating, they prefer to spend
their lives locked inside their homes.
Even if you don't develop these extreme phobias, your quality of life can be severely
damaged by untreated panic disorder. A recent study showed that people who suffer from
panic disorder:
are more prone to alcohol and other drug abuse
have greater risk of attempting suicide
spend more time in hospital emergency rooms
spend less time on hobbies, sports and other satisfying activities
tend to be financially dependent on others
report feeling emotionally and physically less healthy than non-sufferers.
are afraid of driving more than a few miles away from home
Panic disorders can also have economic effects. For example, a recent study cited the
case of a woman who gave up a $40,000 a year job that required travel for one close to
home that only paid $14,000 a year. Other sufferers have reported losing their jobs and
having to rely on public assistance or family members.
None of this needs to happen. Panic disorder can be treated successfully, and sufferers
can go on to lead full and satisfying lives.
How Can Panic Disorder Be Treated?
Most specialists agree that a combination of cognitive and behavioral therapies are the
best treatment for panic disorder. Medication might also be appropriate in some cases.
The first part of therapy is largely informational; many people are greatly helped by simply
understanding exactly what panic disorder is, and how many others suffer from it. Many
people who suffer from panic disorder are worried that their panic attacks mean they're
'going crazy' or that the panic might induce a heart attack. 'Cognitive restructuring'
(changing one's way of thinking) helps people replace those thoughts with more realistic,
positive ways of viewing the attacks.
Cognitive therapy can help the patient identify possible triggers for the attacks. The trigger
in an individual case could be something like a thought, a situation, or something as
subtle as a slight change in heartbeat. Once the patient understands that the panic attack
is separate and independent of the trigger, that trigger begins to lose some of its power to
induce an attack.
The behavioral components of the therapy can consist of what one group of clinicians has
termed 'interoceptive exposure.' This is similar to the systematic desensitization used to
cure phobias, but what it focuses on is exposure to he actual physical sensations that
someone experiences during a panic attack.
People with panic disorder are more afraid of the actual attack than they are of specific
objects or events; for instance, their 'fear of flying' is not that the planes will crash but that
they will have a panic attack in a place, like a plane, where they can't get to help. Others
won't drink coffee or go to an overheated room because they're afraid that these might
trigger the physical symptoms of a panic attack.
Interoceptive exposure can help them go through the symptoms of an attack (elevated
heart rate, hot flashes, sweating, and so on) in a controlled setting, and teach them that
these symptoms need not develop into a full-blown attack. Behavioral therapy is also used
to deal with the situational avoidance associated with panic attacks. One very effective
treatment for phobias is in vivo exposure, which is in its simplest terms means breaking a
fearful situation down into small manageable steps and doing them one at a time until the
most difficult level is mastered.
Relaxation techniques can further help someone 'flow through' an attack. These
techniques include breathing retraining and positive visualization. Some experts have
found that people with panic disorder tend to have slightly higher than average breathing
rates, learning to slow this can help someone deal with a panic attack and can also
prevent future attacks.
In some cases, medications may also be needed. Anti-anxiety medications may be
prescribed, as well as antidepressants, and sometimes even heart medications (such as
beta blockers) that are used to control irregular heartbeats.
Finally, a support group with others who suffer from panic disorder can be very helpful to
some people. It can't take the place of therapy, but it can be a useful adjunct.
If you suffer from panic disorder, these therapies can help you. But you can't do them on
your own; all of these treatments must be outlined and prescribed by a psychologist or
psychiatrist.
Signs & Symptoms
People with panic disorder have feelings of terror that strike suddenly and repeatedly with
no warning. During a panic attack, most likely your heart will pound 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 nausea, chest pain or smothering sensations, a sense of
unreality, or fear of impending doom or loss of control. more>>
Treatment
Effective treatments for panic disorder are available, and research is yielding new,
improved therapies that can help most people with panic disorder and other anxiety
disorders lead productive, fulfilling lives.
Getting Help: Optima Specialty Hospital has specialist available for consultation or
Locate mental health services in your area, affordable healthcare, NIMH clinical trials, and
listings of professionals and organizations.
What is Panic Disorder?
Panic disorder is an anxiety disorder and is characterized by unexpected and repeated
episodes of intense fear accompanied by physical symptoms that may include chest pain,
heart palpitations, shortness of breath, dizziness, or abdominal distress.
A panic attack is a sudden surge of overwhelming fear that comes without warning and
without any obvious reason. It is far more intense than the feeling of being 'stressed out'
that most people experience. Symptoms of a panic attack include:
racing heartbeat
difficulty breathing, feeling as though you 'can't get enough air'
terror that is almost paralyzing
dizziness, lightheadedness or nausea
trembling, sweating, shaking
choking, chest pains
hot flashes, or sudden chills
tingling in fingers or toes ('pins and needles')
fear that you're going to go crazy or are about to die
You probably recognize this as the classic 'flight or fight' response that human beings
experience when we are in a situation of danger. But during a panic attack, these
symptoms seem to rise from out of nowhere. They occur in seemingly harmless
situations--they can even happen while you are asleep.
In addition to the above symptoms, a panic attack is marked by the following conditions:
it occurs suddenly, without any warning and without any way to stop it.
the level of fear is way out of proportion to the actual situation; often, in fact, it's completely
unrelated.
it passes in a few minutes; the body cannot sustain the 'fight or flight' response for longer
than that. However, repeated attacks can continue to recur for hours.
A panic attack is not dangerous, but it can be terrifying, largely because it feels 'crazy' and
'out of control.' Panic disorder is frightening because of the panic attacks associated with it,
and also because it often leads to other complications such as phobias, depression,
substance abuse, medical complications, even suicide. Its effects can range from mild
word or social impairment to a total inability to face the outside world.
In fact, the phobias that people with panic disorder develop do not come from fears of
actual objects or events, but rather from fear of having another attack. In these cases,
people will avoid certain objects or situations because they fear that these things will
trigger another attack.
How to Identify Panic Disorder
Please remember that only a licensed therapist can diagnose a panic disorder. There are
certain signs you may already be aware of, though.
One study found that people sometimes see 10 or more doctors before being properly
diagnosed, and that only one out of four people with the disorder receive the treatment they
need. That's why it's important to know what the symptoms are, and to make sure you get
the right help.
Many people experience occasional panic attacks, and if you have had one or two such
attacks, there probably isn't any reason to worry. The key symptom of panic disorder is the
persistent fear of having future panic attacks. If you suffer from repeated (four or more)
panic attacks, and especially if you have had a panic attack and are in continued fear of
having another, these are signs that you should consider finding a mental health
professional who specializes in panic or anxiety disorders.
What Causes Panic Disorder: Mind, Body, or Both?
Body: There may be a genetic predisposition to anxiety disorders; some sufferers report
that a family member has or had a panic disorder or some other emotional disorder such
as depression. Studies with twins have confirmed the possibility of 'genetic inheritance' of
the disorder.
Panic Disorder could also be due to a biological malfunction, although a specific biological
marker has yet to be identified.
All ethnic groups are vulnerable to panic disorder. For unknown reasons, women are twice
as likely to get the disorder as men.
Mind: Stressful life events can trigger panic disorders. One association that has been
noted is that of a recent loss or separation. Some researchers liken the 'life stressor' to a
thermostat; that is, when stresses lower your resistance, the underlying physical
predisposition kicks in and triggers an attack.
Both: Physical and psychological causes of panic disorder work together. Although initially
attacks may come out of the blue, eventually the sufferer may actually help bring them on
by responding to physical symptoms of an attack.
For example, if a person with panic disorder experiences a racing heartbeat caused by
drinking coffee, exercising, or taking a certain medication, they might interpret this as a
symptom of an attack and , because of their anxiety, actually bring on the attack. On the
other hand, coffee, exercise, and certain medications sometimes do, in fact, cause panic
attacks. One of the most frustrating things for the panic sufferer is never knowing how to
isolate the different triggers of an attack. That's why the right therapy for panic disorder
focuses on all aspects -- physical, psychological, and physiological -- of the disorder.
Can People with Panic Disorder lead normal lives?
The answer to this is a resounding YES -- if they receive treatment.
Panic disorder is highly treatable, with a variety of available therapies. These treatments
are extremely effective, and most people who have successfully completed treatment can
continue to experience situational avoidance or anxiety, and further treatment might be
necessary in those cases. Once treated, panic disorder doesn't lead to any permanent
complications.
Side Effects of Panic Disorder
Without treatment, panic disorder can have very serious consequences.
The immediate danger with panic disorder is that it can often lead to a phobia. That's
because once you've suffered a panic attack, you may start to avoid situations like the one
you were in when the attack occurred.
Many people with panic disorder show 'situational avoidance' associated with their panic
attacks. For example, you might have an attack while driving, and start to avoid driving until
you develop an actual phobia towards it. In worst case scenarios, people with panic
disorder develop agoraphobia -- fear of going outdoors -- because they believe that by
staying inside, they can avoid all situations that might provoke an attack, or where they
might not be able to get help. The fear of an attack is so debilitating, they prefer to spend
their lives locked inside their homes.
Even if you don't develop these extreme phobias, your quality of life can be severely
damaged by untreated panic disorder. A recent study showed that people who suffer from
panic disorder:
are more prone to alcohol and other drug abuse
have greater risk of attempting suicide
spend more time in hospital emergency rooms
spend less time on hobbies, sports and other satisfying activities
tend to be financially dependent on others
report feeling emotionally and physically less healthy than non-sufferers.
are afraid of driving more than a few miles away from home
Panic disorders can also have economic effects. For example, a recent study cited the
case of a woman who gave up a $40,000 a year job that required travel for one close to
home that only paid $14,000 a year. Other sufferers have reported losing their jobs and
having to rely on public assistance or family members.
None of this needs to happen. Panic disorder can be treated successfully, and sufferers
can go on to lead full and satisfying lives.
How Can Panic Disorder Be Treated?
Most specialists agree that a combination of cognitive and behavioral therapies are the
best treatment for panic disorder. Medication might also be appropriate in some cases.
The first part of therapy is largely informational; many people are greatly helped by simply
understanding exactly what panic disorder is, and how many others suffer from it. Many
people who suffer from panic disorder are worried that their panic attacks mean they're
'going crazy' or that the panic might induce a heart attack. 'Cognitive restructuring'
(changing one's way of thinking) helps people replace those thoughts with more realistic,
positive ways of viewing the attacks.
Cognitive therapy can help the patient identify possible triggers for the attacks. The trigger
in an individual case could be something like a thought, a situation, or something as
subtle as a slight change in heartbeat. Once the patient understands that the panic attack
is separate and independent of the trigger, that trigger begins to lose some of its power to
induce an attack.
The behavioral components of the therapy can consist of what one group of clinicians has
termed 'interoceptive exposure.' This is similar to the systematic desensitization used to
cure phobias, but what it focuses on is exposure to he actual physical sensations that
someone experiences during a panic attack.
People with panic disorder are more afraid of the actual attack than they are of specific
objects or events; for instance, their 'fear of flying' is not that the planes will crash but that
they will have a panic attack in a place, like a plane, where they can't get to help. Others
won't drink coffee or go to an overheated room because they're afraid that these might
trigger the physical symptoms of a panic attack.
Interoceptive exposure can help them go through the symptoms of an attack (elevated
heart rate, hot flashes, sweating, and so on) in a controlled setting, and teach them that
these symptoms need not develop into a full-blown attack. Behavioral therapy is also used
to deal with the situational avoidance associated with panic attacks. One very effective
treatment for phobias is in vivo exposure, which is in its simplest terms means breaking a
fearful situation down into small manageable steps and doing them one at a time until the
most difficult level is mastered.
Relaxation techniques can further help someone 'flow through' an attack. These
techniques include breathing retraining and positive visualization. Some experts have
found that people with panic disorder tend to have slightly higher than average breathing
rates, learning to slow this can help someone deal with a panic attack and can also
prevent future attacks.
In some cases, medications may also be needed. Anti-anxiety medications may be
prescribed, as well as antidepressants, and sometimes even heart medications (such as
beta blockers) that are used to control irregular heartbeats.
Finally, a support group with others who suffer from panic disorder can be very helpful to
some people. It can't take the place of therapy, but it can be a useful adjunct.
If you suffer from panic disorder, these therapies can help you. But you can't do them on
your own; all of these treatments must be outlined and prescribed by a psychologist or
psychiatrist.
Signs & Symptoms
People with panic disorder have feelings of terror that strike suddenly and repeatedly with
no warning. During a panic attack, most likely your heart will pound 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 nausea, chest pain or smothering sensations, a sense of
unreality, or fear of impending doom or loss of control. more>>
Treatment
Effective treatments for panic disorder are available, and research is yielding new,
improved therapies that can help most people with panic disorder and other anxiety
disorders lead productive, fulfilling lives.
Getting Help: Optima Specialty Hospital has specialist available for consultation or
Locate mental health services in your area, affordable healthcare, NIMH clinical trials, and
listings of professionals and organizations.
| THE MOST COMMON MENTAL AND EMOTIONAL DISORDERS |
| The information provided on these pages are intended as a educational public service. New studies often change our understanding of how to diagnose and treat these illnesses and direct contact with the appropriate, licensed mental health professional prior to treatment is always reccomended. |