|
MENTAL HEALTH FACT SHEETS
Call (800)227-3953
Panic Disorder
Each year, Panic Disorder strikes more people than either stroke, epilepsy, or AIDS.
What is Panic Disorder?
Panic disorder is a chronic, relapsing, and often debilitating condition that can have devastating effects on a person's work, family, and social interactions. Three million American adults -at least one in 63 have or will have a panic disorder. Most of them will develop it in their late teens or early to mid-twenties.
Because its symptoms may mimic a variety of medical conditions, panic disorder frequently goes undiagnosed. It is not uncommon for people with panic disorder to see as many as 10 different doctors, undergo many unnecessary tests, and suffer for years before obtaining a correct diagnosis.
The good news is that once diagnosed, panic disorder is highly treatable. In fact, appropriate treatment can reduce or completely prevent panic attacks in 70 to 90 percent of patients— particularly when panic disorder is recognized early. Even if patients relapse, recurrent attacks can be treated effectively. Tragically, today just one in three people with panic disorder receives appropriate treatment.
Panic Disorder Symptoms
Panic disorder is characterized by panic attacks — acute episodes of terror accompanied by a sudden barrage of symptoms, including at least four of the following:
| • |
Racing or pounding heartbeat |
• |
Sweating |
| • |
Chest pains |
• |
Tingling or numbness in the hands |
| • |
Dizziness |
• |
Dreamlike sensations |
| • |
Nausea |
• |
Fear of losing control |
| • |
Difficulty breathing |
• |
Fear of dying |
| • |
Flushes or chills |
• |
Sense of impending doom |
Panic attacks typically occur spontaneously, with no apparent trigger. In fact, they can even begin during sleep. Attacks usually last for a few minutes — rarely longer — yet they often feel like an eternity for the patient.
All too often, patients with panic disorder experience such extreme distress that they present repeatedly to hospitals. With each panic attack, they may fear they are dying from a heart attack, or suffering from a respiratory problem, neurological disorder, or gastrointestinal condition. They may also fear that they are losing control or becoming psychotic.
When a person has repeated panic attacks and feels severe anxiety about having another attack, he or she has panic disorder. Panic disorder tends to worsen over time if not effectively treated.
Proper Diagnosis Is Critical
The symptoms noted above should distinguish panic disorder from everyday anxiety and stress. To help confirm a panic disorder diagnosis, consider the following approach:
• To differentiate panic disorder from other medical conditions, the patient should, of course, have a thorough physical examination. Panic disorder symptoms mimic other conditions, such as myocardial infarction, cardiac arrhythmias, hyperthyroidism, and certain types of epilepsy.
• It is important to probe the emotional components of the patient's symptoms. Patients may focus on only one or two symptoms as they describe the attacks.
• It can be constructive to probe for environmental factors that trigger panic attacks in some people. For example, in susceptible persons, attacks may occur during or within six months of such stressful life events as the death of a loved one, divorce, geographic relocation, childbirth, or surgery. Panic attacks can also be triggered by large doses of caffeine, some cold medicines, cocaine and marijuana.
Panic Disorder Can Be Serious
Even though panic attacks do not represent an immediate danger to the life of the patient, panic disorder can have equally harmful consequences as compared with other serious medical conditions:
• Many people with panic disorder develop fears about situations they associate with panic attacks and begin to avoid them. Their lives become an ordeal of chronic fear, and they may become greatly restricted in their ability to carry out normal activities like grocery shopping, traveling, and even leaving home.
• Panic disorder can radically impair family, work, and social relationships. Panic disorder has caused people to lose their job and independence.
• People with panic disorder may also suffer from clinical depression, substance abuse, obsessive-compulsive disorder, or irritable bowel syndrome. According to one the National Institute of Mental Health (NIMH) research study, 20 percent of people with panic disorder attempt suicide.
• Apart from the suffering experienced by the patient, untreated panic disorder is costly to both the patient and the medical system as a whole—because of repeated visits to doctors and emergency departments and unnecessary medical tests.
Causes Of Panic Disorder
Research suggests that panic disorder has both biological and psychological components, which interact. Family and twin studies indicate that panic disorder involves some genetic vulnerability.
Recent studies suggest that people with panic disorder have a low tolerance for the body's normal physiological and psychological response to stress; their body's alarm response goes off with little or no provocation. The hypothesis that panic disorder patients may have learned to perceive essentially normal physiological events as being dangerous may help in understanding the lowered stress response threshold, giving rise to a "false alarm."
Some researchers theorize that the disturbance in coping mechanisms is a product of repeated life stresses in predisposed individuals, leading eventually to panic disorder. Research also suggests that people with this disorder may not be able to utilize the body's own naturally produced anxiety-reducing substances.
Treatment Methods
According to a panel of experts convened in 1991 by the National Institutes of Health and the National Institute of Mental Health, panic disorder can be treated effectively with cognitive-behavioral therapy, pharmacological therapy, and possibly best with a combination of therapy and medication. Most patients generally begin to respond quickly to appropriate treatment. However, it is important to monitor the response to treatment closely and reassess the treatment strategies after 6 to 8 weeks.
Cognitive-behavioral therapy
Cognitive-behavioral therapy teaches patients to anticipate the situations and bodily sensations that are associated with their panic attacks. This awareness sets the stage for helping the patient to control the attacks. Rimrock's specially trained therapists tailor this therapy to the specific needs of our patients. They help patients identify and change patterns of thinking that cause them to misperceive commonplace events or situations as dangerous and to "think the worst." Patients often are unaware of how deeply these anxiety-raising thoughts have become ingrained in their daily activities. Activity exercises should include:
• Teaching patients exercises to prevent the hyperventilation that often triggers a panic attack. The exercises also help the patient to replace alarmist thoughts such as, "I'm dying," with more appropriate ones, such as, "I'm just hyperventilating—I can handle this."
• Helping patients become less fearful by safely and gradually exposing them to situations and physical sensations they avoid or find frightening.
Usually this type of outpatient therapy is a short-term treatment, typically lasting 12 to 15 sessions over several months. Patients with panic disorder who go through short-term treatment have very few adverse effects and a relatively low relapse rate of panic attacks.
Medications
Several classes of medications can reduce or prevent panic attacks and therefore substantially decrease patients' anticipatory anxiety about having attacks. The medications most often used are antidepressants, including serotonin reuptake inhibitors, tricyclics, monoamine oxidase inhibitors and certain high-potency benzodiazepines.
Each of these classes of medications works differently and has different side effects. The latest information about the pharmacotherapy of panic and related disorders is available in clinical handbooks of psychotherapeutic medications. For most of these medications, treatment lasts 6 months to a year. With all of them, proper dosing and monitoring by a qualified psychiatrist is essential.
The Path To Healing
Many panic disorder patients are reluctant to seek treatment or have been frustrated by previous encounters with healthcare professionals. Therapists can playa crucial role in motivating these people to get treatment. Here are some suggestions for communicating with anyone who has panic disorder.
It helps to acknowledge the seriousness of panic disorder. Often, people trivialize this condition. Recognition by professionals that it is real and serious can persuade patients to seek treatment and begin returning their lives to normalcy.
In offering comfort to patients, it is important to avoid statements that may be interpreted as dismissive, such as, "it's nothing to worry about" or "it's just stress". Many professionals who have treated panic disorder have found patients receptive to the following explanation: "You have a condition that can be treated — panic disorder. You need professional help to overcome it, just as you would for any serious medical illness."
Knowing more about panic disorder can help people overcome their fear, embarrassment, or skepticism about treatment. Pointing out that treatment can make a significant difference in their lives in just weeks or months and explaining the various treatment options is important. Making the patient an active, fully informed participant in the treatment planning process is essential.
Rimrock Foundation has four licensed Crisis Stabilization beds available for patients who may need a short-term stay for the purpose of stabilizing them on medications or who may need a safe place with medical monitoring and evaluation but who do not require the full services of an acute psychiatric facility. These beds serve as an alternative to hospitalization and may be accessed by referral from the patient's physician, case manager or therapist.
For further information on Rimrock Foundation's treatment of Panic Disorder or other mental health issues, call Barbara Hansen, Admissions Supervisor at 1-800-227-3953 or 1-406-248-3175, or visit our website at rimrock.org. For more educational information on Panic Disorder, contact the Rimrock Foundation Library at 1-800-227-3953 or 1-406-248-3175.
|
Printer Friendly
Send To A Friend
