Panic Disorder

maftab92 By maftab92, 28th Jul 2010 | Follow this author | RSS Feed
Posted in Wikinut>Health>Mind & Spirit>Anxiety

Panic attack usually occurs out of the blue even when apparently the person is in a relaxed state of mind or while sleeping. After that it becomes a vicious cycle. The person will develop a fear or a sense of apprehension of having another panic attack and because of the fear he will start having more frequent and intense panic attacks.

Panic Attacks

There is a difference between a panic attack and panic disorder. Panic attacks vary in their frequency and intensity, often waxing and waning over time and in response to psychosocial stressors. It is not uncommon for an individual to experience numerous moderate attacks for months at a time or to experience frequent attacks daily for a short period (e.g., a week), with months separating subsequent periods of attacks.

The essential features of panic disorder identified in DSM-IV-TR are “recurrent unexpected panic attacks” that are followed by 1 month or more of “persistent concern about having additional attacks,” “worry about the implications of the attack or its consequences,” or “a significant change in behavior related to the attacks”.

A panic attack that counts toward a diagnosis of panic disorder is defined as a “discrete period of intense fear or discomfort” in which at least four of the following symptoms are present:
• Palpitations
• pounding heart or increased heart rate
• sweating
• trembling or shaking
• sensations of shortness of breath
• feelings of choking
• chest pain or discomfort
• nausea
• feeling dizzy, unsteady, light-headed, or faint
• derealization or depersonalization
• fear of losing control or “going crazy”
• fear of dying
• numbness or tingling sensations
• chills or hot flushes.

Individuals with panic disorder commonly have anxiety about the recurrence of panic attacks or symptoms or about the implications (e.g., “Am I having a heart attack? Am I going crazy?”) or consequences (e.g., “Will I be able to drive my children to school?”). Panic disorder, especially with agoraphobia, may lead to the loss or disruption of interpersonal relationships, especially as individuals struggle with the impairment or loss of social role functioning and the issue of responsibility for symptoms. Examples of the disrupting nature of panic disorder include the fear that an attack is the indicator of a life-threatening illness despite medical evaluation indicating otherwise or the fear that an attack is a sign of emotional weakness. Some individuals experience the attacks as so severe that they take such actions as quitting a job to avoid a possible attack. Others may become so anxious that they avoid most activities outside their homes (i.e., severe agoraphobia).

Associated Problems

Epidemiologic studies have clearly documented the morbidity associated with panic disorder. Patients with panic disorder may also experience:
• Depression
• High risk of suicide attempts
• Impaired social and marital functioning
• Work impairment
• Use of psychoactive medication and substance abuse
• Agoraphobia
• Obsessive Thinking or Compulsive Rituals
• Poor Sexual Interest or Ability
• Overly Dependent Behavior


Causes
• Stress is one of the commonly reported causes of panic disorder.
• Family studies using direct interviews of relatives and family history studies have shown that panic disorder runs in families. The median risk of panic disorder is eight times as high in the first-degree relatives with panic disorder as in the relatives of control subjects.
• Panic attacks can also occur in response to some physical health condition i.e. Mitral Valve Prolapse, which is a minor cardiac problem that occurs when one of the heart’s valves doesn't close correctly, Hyperthyroidism and Hypoglycemia. It may also occur because of Stimulant use (amphetamines, cocaine, and caffeine) or Medication withdrawal. In such cases, there is a probability of panic attacks going away followed by medical treatment.

Treatment of Panic Disorder

Panic Disorder is usually treated by a combination of antidepressants and benzodiazepine. Keeping in view the side effects of these medicines one should go for psychological treatment.

1- Cognitive-behavioral therapy (CBT)

CBT focuses on the thinking patterns and behaviors that are responsible for sustaining or triggering the panic attacks. Different techniques are used to change the contributing thoughts like deep breathing, imagination and affirmative cards. CBT is the treatment of choice in panic disorder.

2- Exposure Therapy

In exposure therapy for panic disorder, the patient is exposed to the physical sensations of panic in a safe and controlled environment, giving him the opportunity to learn healthier ways of coping.

3- Mindfulness-based Therapies

Stress reduction, which includes training in meditation and relaxation strategies are said to be helpful in the management of panic disorder.

4- Paradoxical Intervention

Paradoxical Intervention is a technique in which the patient is asked to consciously trigger a panic attack, interestingly the more he tries, the more difficult it becomes. As a result the patient develops confidence and learns to manage panic attacks.

5- Psycho Educational

Patients with panic attacks need to learn the following under supervision of an experienced therapist.
• Learn about panic attacks: It is important to learn about the theory behind panic attacks. Simply knowing more about panic attacks can go a long way towards relieving the distress.
• Avoid smoking tea and caffeine: Smoking, tea and caffeine can provoke panic attacks. So it’s better to avoid cigarettes, coffee, and other medicines, which have stimulants, such as diet pills.
• Deep Breathing: Hyperventilation brings on many sensations, which occur during a panic attack. Deep breathing, on the other hand, can relieve the symptoms.
• Practice relaxation techniques: Activities such as yoga, meditation, and progressive muscular relaxation strengthen the body’s relaxation response, which is the opposite to the stress response involved in panic attacks.

Tags

Anxiety, Panic Attack, Panic Disorder, Treatment

Meet the author

author avatar maftab92
I am a clinical psychologist from Pakistan. I am running my own clinic to help people overcome psychological problems.

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Comments

author avatar smoothoperator
1st Aug 2010 (#)

Solid for a person with my reading skills. Good for others.

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author avatar Michelle
3rd Sep 2010 (#)

I am so glad I chose to read what you wrote on Panic Disorder I have a friend that has it as well as myself and i am passing this information on. Thank you and I will continue to read!

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