How to Get Rid of Panic Disorder

Panic disorder represents anxiety in its most severe form. It's an anxiety disorder characterized by unexpected and recurrent episodes of intense apprehension, terror, and impending doom, usually accompanied by physical symptoms that mimic a heart attack or other serious medical condition.

Panic disorder typically has an onset in late adolescence or early adulthood, commonly in response to a sudden loss. It may also be triggered by severe separation anxiety experienced during early childhood. Panic disorder is twice as common in women as men and even higher for panic disorder with agoraphobia. In addition, women who experience more severe symptoms are more likely to have recurrences after wellness and experience the illness for a longer period. Without treatment, panic disorder can persist for years with alternating exacerbations and remissions.

As the attacks become more frequent, the person commonly develops agoraphobia, also known as phobic avoidance the avoidance of those situations, places, or tasks that trigger the attacks, rendering the person unable to leave a known safe surrounding such as her home because of intense fear and anxiety. Panic disorder may also coexist with other disorders, such as depression and substance abuse.

General anxiety and panic disorder occurs 4 or more times as commonly in first-degree relatives of affected patients, suggesting a genetic influence. Sympathetic nervous system overactivity, increased muscle tension and hyperventilation are the common pathophysiological mechanisms. Psychodynamic theory suggests that anxiety is the emotional response to the threat of a loss, whereas depression is the response to the loss itself. There is some evidence that being bullied, with the explicit threats involved, leads to anxiety disorders in young people.

Panic disorder is characterized by periodic attacks of anxiety or terror ( panic attacks ). They usually last 15 to 30 minutes, although residual effects can persist much longer. The frequency and severity of acute states of anxiety determine the diagnosis. (It should be noted that panic attacks can occur in nearly every anxiety disorder, not just panic disorder. In other anxiety disorders, however, there is always a cue or specific trigger for the attack.)

Panic Disorder is the recurrent experiencing of unexpected Panic Attacks, with either the continued concern about having more panic attacks, worry about the consequences (physical or psychological) or undergoing a change in behavior or routine due to the panic attacks. Those who have panic disorder may eventually not return to a baseline state, but develop a generalized anticipatory anxiety, waiting for the next panic attack to occur.

Panic disorder is characterized by unexpected and repeated episodes of intense fear accompanied by physical symptoms that may include chest pain, heart palpitations, shortness of breath, dizziness or abdominal distress. These sensations often mimic symptoms of a heart attack or other life-threatening medical conditions. As a result, the diagnosis of panic disorder is frequently not made until extensive and costly medical procedures fail to provide a correct diagnosis or relief.

Many people with panic disorder develop intense anxiety between episodes. It is not unusual for a person with panic disorder to develop phobias about places or situations where panic attacks have occurred, such as in supermarkets or other everyday situations. As the frequency of panic attacks increases, the person often begins to avoid situations where they fear another attack may occur or where help would not be immediately available. This avoidance may eventually develop into agoraphobia, an inability to go beyond known and safe surroundings because of intense fear and anxiety.

Also see Panic Disorder with Agoraphobia and Agoraphobia

Fortunately, through research supported by the National Institute of Mental Health (NIMH) and by industry, effective treatments have been developed to help people with panic disorder.

Signs and symptoms of Panic attacks

The patient with panic disorder typically complains of repeated episodes of unexpected apprehension, fear or, in rare cases, intense discomfort. These panic attacks may last for minutes or hours and leave the patient shaken, fearful, and exhausted. They may occur several times per week sometimes even daily. Because the attacks may initially occur spontaneously without exposure to a known anxiety-producing situation, place, or task, the patient generally worries between attacks about when the next episode will occur.

Physical examination of the patient during a panic attack may reveal signs of intense anxiety, such as hyperventilation, tachycardia, palpitations, dizziness, trembling and profuse sweating. She may also complain of difficulty breathing, digestive disturbances, and chest pain.

How common is panic disorder?

Panic disorder typically strikes in young adulthood. Roughly half of all people who have panic disorder develop the condition before age 24.
About 1.7 percent of the adult U.S. population ages 18 to 54-approximately 2.4 million Americans-has panic disorder in a given year.
Women are twice as likely as men to develop panic disorder.

What Causes Panic Attacks?

Although the exact cause of panic disorder isn't known, many investigators theorize that, as in other anxiety disorders, panic disorder may stem from a combination of physical. psychological and biological factors, including heredity. For example, some studies emphasize the role of stressful events or unconscious conflicts that occur early in childhood. Another study found that children of parents with panic disorder were (themselves) more likely to suffer from panic attacks.

Recent evidence indicates that alterations in brain biochemistry, especially in norepinephrine, serotonin and gamma-aminobutyric acid activity, may also contribute to panic disorder. Another area of research for the treatment of panic disorder focuses on the amygdala, a very small and complicated structure inside the brain that controls the body's response to fear. Recent research suggests that the abnormal activation of the amygdala is associated with anxiety disorders.

Diagnosis of panic disorder

Panic disorder is diagnosed when the patient has repeated sudden attacks of overwhelming anxiety, accompanied by severe physical symptoms, usually related to both hyperventilation and sympathetic nervous system activity. The prevalence is 1%. Patients with panic disorder often have catastrophic illness beliefs during the panic attack, such as convictions that they are about to die from a stroke or heart attack, or that they suffer from multiple sclerosis (MS). The fear of a stroke is related to dizziness and headache. Fear of a heart attack accompanies chest pain (atypical chest pain), and the fear of MS follows paraesthesiae.

A diagnosis of panic disorder is made under the following conditions:

A person experiences at least two recurrent, unexpected panic attacks.
For at least a month following the attacks, the person fears that another will occur.

What are the treatments available for Panic Disorder?

Panic disorder may respond to behavioral-cognitive therapy, supportive psychotherapy, or drug therapy, or a combination of these treatments. Behavioral-cognitive therapy works best when agoraphobia accompanies panic disorder because identifying the anxiety-inducing situation is easier.

Supportive psychotherapy commonly uses cognitive techniques to enable the patient to view anxiety provoking situations more realistically and to recognize panic symptoms as a misinterpretation of essentially harmless physical sensations.

Drug therapy includes anti anxiety drugs, such as diazepam, alprazolam, and clonazepam, and beta-adrenergic blockers such as propranolol to provide symptomatic relief. Antidepressants, including tricyclic antidepressants, selective serotonin reuptake inhibitors (specifically paroxetine and sertraline) and monoamine oxidase (MAD) inhibitors, are also effective.

Complications:

Possible complications of this condition include avoidance of situations or places that might bring on an attack, and an increased likelihood for other anxiety and mood disorders.

Dependence on anti-anxiety medications is a possible complication of treatment. Dependence involves needing a medication to be able to function and to avoid withdrawal symptoms. It is not the same as addiction, which involves the compulsive use of a substance despite negative consequences. Dependence and addiction often occur together, but dependence itself is not always a problem.

Special considerations and Prevention

If the patient is experiencing an acute panic attack, stay with the patient until the attack subsides. If left alone, she may become even more anxious.
Maintain a calm, serene approach. Statements such as, "I won't let anything here hurt you," and, ''I'll stay with you," can assure the patient that you're in control of the immediate situation. Avoid giving her insincere expressions of reassurance.
The patient's perceptual field may be narrowed; excessive stimuli may cause her to feel overwhelmed. Dim or brighten lights as necessary.
The combination of both counseling and medicine seems to be an effective treatment for panic disorder.
If the patient loses control, move her to a smaller, quieter space.
The patient may be so overwhelmed that she can't follow lengthy or complicated instructions. Speak in short, simple sentences and slowly give one direction at a time. Avoid giving lengthy explanations and asking too many questions.
Allow the patient to pace around the room (if she isn't in danger of hurting herself or anyone else) to help expend energy. Show her how to take slow, deep breaths if she's hyperventilating.
Avoid touching the patient until you've established rapport. Unless she trusts you, she may be too stimulated or frightened to find touch reassuring.

Facts and Tips about Panic Disorder

Panic disorder is a condition in which panic attack occurs repetitively.
Panic attacks are without any warning and without any specific reason and this attack may last for few minutes to hours.
Along with panic disorder individuals may have agoraphobia or limited symptom attacks.
Occurrence of panic disorder is more frequent in women and begins in early adulthood.
Panic disorder may arise because of genetics, defect in the brain, stress, drugs and alcohol abuse, and smoking but exact cause is still unfamiliar.
Symptoms of panic attack are rapid heartbeat, choking, dyspnea, trembling, perspiration, lightheadedness, hyperventilation etc. along with fear and nervousness.
Combination of medication and psychotherapy, cognitive behavioral therapy, relaxation techniques, exposure therapy are used to cure disorder.