Panic Disorder:

Panic Disorder typically starts with the first panic "attack." I personally don't like to describe them as "attacks", although they certainly feel like "attacks." I prefer to call them "reactions" or "responses." It sounds less threatening and hopefully gets you to think of them as less "dangerous." As a "response" it also implies that it is more within your potential control than thinking of them as uncontrollable "attacks."

OK. Let's look at what happens.

1. The first "reaction" (or "attack" if you are stubborn) occurs.

                   It comes out of the blue.

                       You think you are going to die, go crazy, lose control, convulse, flip out ....

                                You feel the intense physiological symptoms.

                                       Your heart is racing.                                               

                                            Your breath is shallow. You feel like you can't get any air into your lungs.

                                                       Things seem unreal.

                                                               You feel like you are outside of yourself.

                                                                       You're scared. I mean, your SCARED!#*(&@(#&^#_$)#*@#^@^ ...

2. You start thinking that something is definitely wrong medically.

                           You interpret these physical sensations as dangerous. Really dangerous.

                                   You may not trust your doctor when he or she gives you a "clean bill of health."

                                           Many people actually hope that their MRI's, blood work, or other tests show that something is actually wrong.

3. You feel that the sensations are actually getting worse.

                    Now, you are more convinced that something is dreadfully wrong.
 

4. When the "response" finally stops, you sit and wait for the next one, terrified of it happening again.

                   You have no idea, other than some guesses, what caused it to happen.

                           You can actually work yourself into another "response" because of your fear of it recurring.

5. Now, you might find yourself avoiding things that might stimulate another "response."
          You don't like to leave the house for fear of having an "attack."

                            You make excuses so you don't have to accept invitations or do things.

                                    You start to feel that these "feelings" have taken over your life.

6. Welcome to Panic Disorder.
 
 

Panic Disorder:

Panic disorder is characterized by unexpected and repeated episodes of intense fear accompanied by very disturbing physical symptoms. 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.
 
 

People with panic disorder experience frequent, unprovoked panic responses that involve some or all of the following symptoms:

According to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM IV): a "panic attack" is comprised of 4 or more of the following sypmtoms. For your "reaction" to be considered a "panic attack", it must have developed abruptly and have reached its peak within 10 minutes. Fewer than 4 of these symptoms constitutes a LIMITED SYMPTOM ATTACK.
 
 

_____ accelerated heartbeat

_____ sweating

_____ trembling/shaking

_____ sensations of smothering or shortness of breath

_____ feeling that you are choking

_____ chest pain or discomfort

_____ nausea or abdominal distress

_____ dizziness, unsteadiness, lightheadedness or faintness

_____ feelings of unreality or detachment from oneself

_____ fear of losing control or going "crazy"

_____ fear of dying

_____ numbness or tingling

_____ chills or hot flashes
 
 

NOTE: to be considered a "panic attack," these symptoms must NOT have occured due to the direct physiological effects of a substance (eg. drug, medicine, etc.) or be the result of a general medical condition.

NOTE: to be considered a "panic attck," these symptoms must NOT be better accounted for by another mental or psychological disorder.

REMEMBER: DO NOT diagnose yourself. This website, as we indicated earlier, is just informational. If you think that you might be suffering from an anxiety disorder, like panic disorder, consult your doctor.

Demographics:Panic Disorder:

Incidence

Panic disorder exists in 3 to 6 million Americans

In a given year, 1 to 2% of the U.S. population has panic disorder.

Women are twice as likely as men to develop panic disorder.

Panic disorder typically strikes in young adulthood, but is evident in all age ranges, from children to the elderly.

Roughly half of all people who have panic disorder develop the condition before age 24.
 
 

Causes

The exact cause of panic disorder is unknown and is the subject of intense scientific investigation.

Possible causes include heredity, other biological factors, stressful life events, and overreacting to normal bodily sensations.

Some research suggests panic attacks occur when a suffocation alarm mechanism in the brain erroneously fires, falsely reporting that death is imminent.
 
 

Treatment

Treatment for panic disorder includes medications and a type of psychotherapy known as cognitive-behavioral

therapy, which teaches people how to view panic attacks differently and demonstrates ways to reduce anxiety.

Appropriate treatment by an experienced professional can reduce or prevent panic attacks in 70% to 90% of people with panic disorder. Most patients show significant progress after a few weeks of therapy. Relapses may occur, but they can often be effectively treated just like the initial episode.
   

Concurrent Problems

Panic disorder can coexist with other disorders, including depression and substance abuse.

About 30% of people with panic disorder use alcohol and 17% use drugs, such as cocaine and marijuana, in

unsuccessful attempts to manage the pain and discomfort associated with their condition. Appropriate diagnosis

and treatment of other disorders such as substance abuse or depression are important to successfully treat panic

disorder.

Panic sufferers may also develop phobias about places or situations where panic attacks have occurred, such as in restaurants, 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, which is an inability to go beyond perceived "safe" surroundings because of intense fear and anxiety.

People with panic disorder may also have irritable bowel syndrome, characterized by intermittent bouts of gastrointestinal cramps and diarrhea or constipation, or a relatively minor heart problem called mitral valve prolapse. In fact, panic disorder often coexists with unexplained medical problems such as chest pain not associated with a heart attack or chronic fatigue.
 
 

The Course of Panic Disorder

Not everyone who experiences a panic "response" will develop panic "disorder."
   

For those who do have panic disorder:

1. It's important to seek treatment. Untreated, the disorder can become very disabling.

2. Panic disorder is often accompanied by other conditions such as depression or alcoholism, and may lead to phobias, which can develop in places or situations where panic attacks have occurred.
   

Human being are constantly trying to figure out "why" things happen. We just tend to look for the causes of things, especially very good things, so that we might put ourselves in situations where we would be exposed to them again, and when it comes to bad things, since we can of course avoid them.

This is what happens with panic. The panic sufferer asks "why did this happen?" "What caused it?"

Since no answer is obviously available, they guess. Maybe it happened because I there were so many people around, or because it was hot and stuffy, or because the lights were so bright, or because ............

Then the person will start to feel safer avoiding these things, particularly if there is a CHANCE that they could cause another "attack."

Here's the tricky part. The panic sufferer is afraid of another "attack." Correct?

So, any time the person feels ANY symptom which reminds them of the "attack," they get frightened. This fear causes adrenalin to be released into the bloodstream which actually increased the symptoms of which they are afraid.

Now, the person not only wants to avoid situations that may provoke an attack, but also wants to avoid any feelings or sensations which they feel will lead to another attack. The person actually tries NOT TO FEEL.

Some people's lives become so affected by their panic that they start to avoid everyday activities such as driving, shopping, or even leaving the house. Some places and things are considered to "safe" and others to be "unsafe." Sometimes they can only do these activities if they are accompanied by a "safe person." They essentially avoid any situation where they would feel helpless if a panic attack occured. This is known as agoraphobia.

Agoraphobia occurs in about 33% of all panic sufferers. Early treatment of panic disorder, however, can prevent the development of agoraphobia.

A tendency toward panic disorder and agoraphobia runs in families.

Studies have shown that proper treatmenta type of psychotherapy called cognitive-behavioral therapy, often in combination with certain medications, help 70 to 90 percent of people with panic disorder. Significant improvement is usually seen within 6 to 8 weeks.