PANIC DISORDER

 Basic information

description

Panic disorder is a type of anxiety disorder. It involves repeated and unexpected episodes of irrational fear and panic. It occurs with attack-like symptoms (even during sleep). Most attacks last 2 to 10 minutes, but some may extend as long as an hour or two. The attacks may begin in the late teen years or early adulthood.

FREQUENT SIGNS & SYMPTOMS

• Physical symptoms:
  • Pounding, racing, or skipping heartbeat, chest pains, and shortness of breath.
  • Choking feeling, lump in the throat feeling, weakness, faintness, dizziness, lightheaded, and sweating.
  • Trembling, numbness, tingling, flushes, or chills.
  • Muscle spasms or contractions in the hands and feet.
  • Feeling of "butterflies" in the stomach or nausea.
• Emotional symptoms:
  • Intense fear of losing one's mind (fear of going crazy), an urge to flee, fear of dying.
  • Sense of terror, doom, or dread. Sense of unreality, loss of contact with people and objects, and fear of losing control. Fear of having another panic attack.

causes

The brain's "alarm system" appears to be affected by a combination of biologic/genetic factors, illnesses, drugs, and one's personal history of traumatic events.

risk increases with

• Stress (emotional or physical); feelings of guilt, fatigue, or overwork; illness; alcohol or drug abuse.
• Personal history of emotional problems. Family history of panic disorder, alcoholism, or bipolar disorder.

PREVENTIVE MEASURES

No specific measures to prevent a first panic attack. Treatment helps prevent repeated attacks.

expected outcomes

Many people may have one panic attack and never have another. For others, this disorder gets better at times and worse at other times. Treatment can help reduce or completely prevent attacks. Sometimes it recurs after treatment, but repeated treatment can be successful.

possible complications

• Without treatment, it can negatively affect all aspects of life (work, family, friends, social, and recreational).
• Chronic anxiety or depression; phobias, including agoraphobia (fear of being alone or in public places).
• People with this disorder often feel there is a physical problem causing the symptoms and go from doctor to doctor for a diagnosis. Despite assurances of their good health, they continue to believe otherwise.
• Increased risk of drug or alcohol abuse.

 diagnosis & treatment

general measures

• Your health care provider will do a physical exam and ask questions about your symptoms and activities. Medical tests may be done to rule out other disorders. A variety of physical disorders can mimic panic attacks.
• Treatment may involve psychotherapy (treatment of emotional and mental problems), self-care, and drugs.
• Cognitive-behavioral therapy may help. Cognitive therapy teaches how to change thoughts, behaviors, or attitudes. Behavioral therapy teaches ways to reduce anxiety with deep breathing and muscle relaxation.
• Self-care steps may include:
  • Talking to a friend or family member about your feelings. This may sometimes defuse your anxiety.
  • Keep a journal about your anxious thoughts or emotions. Consider the causes and possible solutions.
  • Join a self-help group.
  • Learn relaxation techniques. For some people, meditation is effective.
  • Reduce stress in your life, where possible.
• To learn more: National Institute of Mental Health; 6001 Executive Blvd., Bethesda, MD 20892-9663; (866) 615-6464; website: www.nimh.nih.gov.

medications

Your health care provider may prescribe an antidepressant or benzodiazepine. The drug may be slowly reduced or stopped, after 6 months to a year, to determine if the panic attacks will return. If they do not return, the drug can be discontinued.

activity

Get regular physical exercise and adequate sleep.

diet

• Consider giving up caffeine (coffee, tea, soft drinks). You may have withdrawal symptoms of headache or tiredness, but they will stop in a few days.
• Don't use alcohol as a way to numb your feelings.

 notify our office if

• You or a family member has panic attacks.
• Symptoms return after treatment.

Special Notes: