Panic Disorders

Panic Disorders

Panic is acute and extreme anxiety with accompanying physiological symptoms. Panic attacks may occur in any anxiety disorder,usually in response to a specific situation tied to the main characteristic of the disorder. For example, a person with a phobia of snakes may panic when encountering a snake.However, these situational panics differ from the spontaneous, unprovoked ones that define a person’s problem as panic disorder.

Prevalence

Panic attacks are common, occurring in more than a third of adults each year.Women are two to three times more likely than men to have panic attacks. Panic disorder is uncommon and is diagnosed in slightly less than 1 percent of the population. Panic disorder usually begins in late adolescence and early adulthood.

Symptoms

A panic attack involves the sudden appearance of at least four of the following symptoms:

 Shortness of breath or sense of being smothered
 Dizziness, unsteadiness, or faintness

 Palpitations or accelerated heart rate
 Trembling or shaking
 Sweating
 Choking
 Nausea, stomach ache, or diarrhea
 Feelings of unreality, strangeness, or detachment from the environment
 Numbness or tingling sensations
 Flushing or chills
 Chest pain or discomfort
 Fear of dying
 Fear of “going crazy” or losing control

Symptoms will vary from person to person but the common ones are palpitations, shortness of breath, sweating, choking sensation, tremors, dizziness and fear that he is going to die.Attacks usually last from5 to 20minutes and rarely last as long as an hour. There may be feelings of depersonalization and de realisation.The patient often tries to escape from the scene in a bid to be relieved of the symptoms.

Panic disorder is characterized by intermittent severe anxiety unrelated to any particular situation. The occurrence of unexpected panic attacks is required for a diagnosis of panic disorder (with or with out agoraphobia). Although many people experience an occasional unexpected attack of panic, the diagnosis of panic disorder is only made when the attacks occur with some regularity and frequently. Patients with occasional unexpected panic attacks may be genetically similar to patients with panic disorder.

Treatment

People respond better to treatment when they understand that panic disorder involves both biological and psychological processes. Drugs and behavioural therapy can generally control the symptoms.When a drugis effective, it prevents or greatly reduces the number of panic attacks.A drug may have to be taken for long periods of time if panic attacks return once the drug is stopped. Exposure therapy, a type of behaviour therapy in which the person is exposed repeatedly to whatever triggers a panic attack, often helps to diminish the fear.Exposure therapy is practised until the person develops a high level of comfort with the anxiety-provoking situation.

In addition, people who are afraid they will faint during a panic attack can practice an exercise in which they spin in a chair or breathe quickly(hyperventilate) until they feel faint.This exercise teaches them that they would not actually faint during a panic attack. Practicing slow, shallow breathing (respiratory control) helps many people who tend to hyperventilate.

In addition, psycho therapy may help resolve any psychological conflicts that might underlie the anxious feelings and behaviour. Psychotherapy with a view to gaining insight and better understanding of any underlying psychological conflicts may also be useful. Less intensive, supportive psychotherapy is always appropriate because a therapist can provide general information about the disorder, its treatment, realistic hope for improvement, and the support that comes from a trusting relationship with a therapist.