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 panic disorder
ABOUT/DESCRIPTION
In dangerous, life-threatening situations, the body's defense mechanisms kick in to prepare us for confrontation or flight from the perceived threat. In these situations, the body's nervous system gets us physically and mentally prepared to 'fight or flee' through the release of hormones such as adrenaline, noradrenaline, cortisol, and more. Simplified, these internally generated chemicals GREATLY increase our pain threshold; give us a powerful boost of energy, sharpens our senses, and increases our blood and oxygen supply to vital organs and muscles. Think of a past heated verbal exchange or the time that other driver blindly cut into your lane in busy traffic and recall the physical sensations that occur. Individuals with Panic Disorder are so sensitized to their thoughts, inner dialogue, and environment that they can trigger this defense mechanism and associated response virtually at will! The underlying message to the self is, "I'm losing control. I'm going to have a heart attack. Something terrible is going to happen right now and I need to get out of here immediately!" Imagine, you're safe at home, sitting in front of the TV in your favorite chair when out of nowhere, you feel your heart rate accelerate, your breathing becomes erratic, and you experience TRUE TERROR for no reason what so ever. This is the experience of the panic sufferer. Like the Generalized Anxiety Disorder sufferer, they too experience habitual worry, but the individual suffering from panic disorder also experiences persistent periods of intense fear (panic attacks) that seemingly come out of nowhere. pAccording to the DSM IV classification of panic disorder, the unexpected panic attack(s) is followed by one month (at least) of persistent concern about having another attack. Hence, the panic sufferer exhibits significant behavioral changes related to the specific circumstances surrounding the attack. Much is often made about the difference between a panic attack and an anxiety attack. Both have their origins in the physiologic responses associated with the 'fight or flight' response. An anxiety attack includes all the body symptoms associated with HIGH anxiety. But the anxiety is long lasting and doesn't seem to be "out of the blue," more like a steady and constant build up of stress. A panic attack on the other hand strikes abruptly, like a sudden wave at the beach and takes about 20 minutes to fully build, peak and ebb. One is left with continued anxiety but not panic. INTENSE FEAR and discomfort are characteristics of panic attacks, whereas an anxiety attack is often characterized as worry accompanied by an edgy restlessness and anxious symptoms that are longer lasting. Panic disorder also differs from GAD in that the individual suffering from panic disorder is more likely to experience obsessive, scary thoughts and physical symptoms. Quite often, a person suffering from a panic attack will believe they are suffering from a heart attack and dying. These intense physical sensations stem from the natural chemical response associated with the 'fight or flight' response. Typical physical symptoms of Panic Disorder include;
Some people suffering from Panic Disorder become so frightened of the prospect of experiencing another panic attack that they limit their activities in an effort to stave off future attacks. They retreat to a "safe place" or "safe person" and will avoid leaving their perceived safety net at all costs. Agoraphobia is just such an example; the sufferer becomes so terrified of having another panic attack that he or she rarely leaves home. Lorraine's case history serves as a good example of the typical experience of the Panic Disorder sufferer. "I couldn't sleep so I was up late one night watching TV on the couch. I don't remember what I was watching or anything, it all just happened so fast. I remember sitting there, when all of a sudden my heart started beating really fast. My throat tightened, like there was a giant lump lodged in my breathing airway. I thought, "This is it, I'm having a heart attack." As I stood up to get my husband, I almost fell over. I was dizzy and had this strange, surreal feeling of impending doom. I just knew I was going to die. My husband raced me the two-blocks to the emergency room. My heart was still racing, and I was sure I would pass out before we even got to the emergency room doors. When the administrating nurse saw us walk in, she immediately took us to a room in the back. As my husband answered the nurse's questions and explained what happened, I was administered a tranquilizer to calm me down. It worked almost instantly. After I was calm, the ER doctor conducted a few tests. They determined I did not suffer from a heart attack and indeed, everything seemed to be normal, but did suggest I see my family physician the next morning just to be sure. I arrived home trembling and scared, but I was so exhausted sleep stole me quickly, thankfully. My family doctor too found nothing wrong with me. He said I was likely just stressed out and prescribed a mild dose of medication he said would help me. After reading the possible side effects I was too scared to take the medication and kept the pills hidden in my purse, only taking them when I felt I had to. I hated living this way, and I was afraid of what might happen if I had an episode and my husband wasn't around to take care of me. I felt I would probably end up locked up in an institution some place and never let out..." Panic Disorder affects 2.4 million Americans, and not surprisingly, often coexists with depression. Women are affected by Panic Disorder at twice the rate of men. Like all Anxiety Disorders, Panic Disorders are commonly under-diagnosed in the primary care setting. Some studies suggest that less than a third of those who suffer are properly diagnosed and properly treated. While the exact cause of Panic Disorder is unknown, research suggests that the onset of Panic Disorder often occurs at a time of major life transition such as leaving home for college, the loss of a loved one, or the birth of a child. Like all Anxiety Disorders however, Panic Disorder probably develops as a result of a combination of risk factors including personality characteristics, genetics/biology, and environmental factors. Exact treatment will of course vary from person to person based on severity, and other individual factors. Panic Disorder is typically treated with medications, therapy, or a combination of the two. Many forms of therapy are used to treat Panic Disorder including psychotherapy, relaxation therapy, and exposure therapy. Perhaps the most researched and clinically proven form of treatment therapy for Panic Disorder is cognitive-behavioral therapy (CBT). CBT is simply an integration of the cognitive (thought) restructuring approach of traditional cognitive therapy and the behavior modification techniques of traditional behavioral therapy. CBT is a structured, short-term therapy that is very goal oriented and conducive to change. It is an action oriented form of therapy based on the premise that bad or faulty thinking patterns cause negative emotions and negative behaviors. This treatment teaches people to understand and change their thinking patterns so that they can change their behavior and emotional state. CBT teaches the individual to think and respond differently in situations that cause anxiety. While medication and CBT are both effective in reducing the symptoms of Panic Disorder, for many people CBT creates a greater sense of personal satisfaction and is clinically better than medications at preventing relapse. One of the many educational strategies and proven coping skills taught in lesson two of the ATTACKING ANXIETY & DEPRESSION Program is a six-step approach to self control when dealing with panic attacks.
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