Panic Disorder
What is "panic disorder"?
Panic disorder is a recurrent and persistent occurrence of panic attacks that's accompanied by the worry or fear that you're going to have another panic attack in the future. Panic disorder creates a lot of anxiety and can set up a whole host of avoidance behavior patterns as you struggle to figure out ways to prevent panic attacks from happening.
What is a "panic attack"?
A panic attack develops unexpectedly and peaks over the course of approximately ten minutes. The symptoms of panic attacks can be broken into physical symptoms and cognitive symptoms. The physical symptoms can include cardiac symptoms such as palpitations, increased heart rate; you can have shortness of breath and symptoms of choking. There can be abdominal discomfort or nausea and some people experience flushing or dizziness. The cognitive symptoms include the fear of losing control, that you're going out of your mind. If you're having a lot of those cardiac symptoms you might actually fear that you're dying, that you're having a heart attack. Sometimes this results in going to the emergency room and in some cases people experience periods of derealization, where they feel disconnected from their surroundings.
What is "agoraphobia"?
Agoraphobia is the anxiety that you would be trapped in a place that would be difficult to escape from or where help, if needed, would be unavailable. This sometimes occurs in patients with panic disorder. Agoraphobia often develops a pattern of avoidance, because you want to actually stay away of places that you fear. Agoraphobia literally, in the Latin translation, means fear of the common place or fear of the market place.
What causes a person to be susceptible to panic attacks?
Like other mental disorders, such as post traumatic stress, we don't know exactly what's happening in the brain when people have a panic attack. We do know that involves structures that involve the neuroepinephrine or neuroadrenaline pathways. This is the neurotransmitter pathways that is important in fight or flight in getting a person ready for action if they're in danger or and service survival function. There have been a lot of studies trying to elucidate the specific circuitry that's involve in panic attack but that to this point has not been clearly elaborated.
What are the most common dangers associated with a panic disorder?
Panic disorder can be associated with a number of important dangers. First of all, and most importantly, people with panic disorder are at increased risk of suicide. They're also at risk of having their disorder interfere with their functioning. This would occur in the job workplace, or impair a panic disorder sufferer's ability to have relationships and function at a high level in social situations. Before panic disorder is diagnosed, often patients go to the emergency room with complaints of these physical symptoms. Sometimes, this can result in unnecessary laboratory or diagnostic tests that sometimes have some risk in and of themselves. Panic disorder is also associated with development of major depression which can cause further impairment. Panic disorder is also associated with substance abuse as patients try to self-medicate some of their anxiety symptoms.
What are the common treatments for panic disorder?
The primary treatment for panic disorder is pharmacotherapy - treatment with medications. These medications usually include antidepressants, such as the serotonin re-uptake inhibitors. Examples of those medications would be fluoxetine, peroxitine or satalapram. Other medications can sometimes be used as co-treatment for panic disorder. This would include drugs like xanax or other benzodiazepines. Because these are sedative medications, we tend to use them only at the beginning of panic disorder treatment, while we're waiting for the antidepressant to take affect. In mild cases, certain psychotherapies, such as cognitive behavioral therapy, is effective for treating panic disorder.
Who is most at risk for having a panic disorder?
Panic disorder is known to occur more prominently in women compared to men. There's also an eight fold in the incidents if you have a first degree relative with panic disorder. Beyond some of these gender and genetic factors there's not really a way to predict who's going to develop panic disorder.
Is there anything I can do to avoid developing panic disorder?
Beyond screening your parents for anxiety disorders, there's not really a lot we can do to prevent panic disorder developing. What we can do is ensure that we seek treatment if we think we have panic disorder or any other mental illness. Panic disorder is very treatable and it's possible to live a normal life with the proper treatment.
