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Panic Disorder and Panic Attacks: A Way of Life?

panic attackSome people use the term panic disorder and panic attacks interchangeably.  However, while they are similar terms describing similar manifestations of anxiety symptoms, panic disorder is made up of a series of panic attacks and may be experienced with the experience of avoidance of certain places and experiences which is referred to as agoraphobia.  This series will thoroughly explained panic disorder and panic attacks as well as the related psychological treatments and medications. 

Panic attacks: 

Panic attacks consist of a very frightening array of anxiety-related symptoms which may include shortness of breath, shakiness or trembling, sweating, feelings of choking, chest pain, nausea, dizziness, feelings of detachment or unreality, fear of dying, numbness or tingling, hot or cold flashes, and a fear of losing control or going insane.  They usually arise suddenly or “out of the blue” and usually do not last more than 30 minutes.  The peak level of symptoms is usually reached in about 10 minutes.  When an individual has recurrent attacks and is fearful about having future attacks, and is fearful of the possible  impact upon their life, and as a result change their behaviors or life, they are said to have a panic disorder. 


Panic disorder: 

The DSM IV, which is the diagnostic manual used by mental health clinicians, states that many individuals have panic disorder and also show evidence of agoraphobia, which may be anywhere from mild to severe.  Agoraphobias is usually characterized by a fear of being in open places, public places, traveling on trains or planes, or of being in situations in which escape may be blocked, or in which it may be difficult to get help when necessary.  Individuals who experience agoraphobia may avoid these situations entirely, may endure them with great discomfort, or may require a companion in order to enter into these circumstances. 

Some experts believe that after an individual has their first panic attack, they may become hypersensitive to any physical sensations of anxiety and may develop anticipatory anxiety for any situations that may arouse panic.  Although some individuals may not have had a recent attack, they may continue to be fearful and avoid possible panic provoking situations (agoraphobia) and may continue to think about them frequently.  Some of the more distressing situations avoided by many individuals with agoraphobia include riding in planes, cars or elevators; walking down the street, and even shopping in stores.  Their fear is that a panic attack will occur and may either endanger their life or cause them to be embarrassed in public.  Because of the unpredictability and generality in which panic attacks may occur, many individuals constrict their life severely in an effort to avoid a variety of situations which may precipitate the panic attack.  Ultimately, the consequence of panic disorder and the avoidance related to it sometimes results in depression. 

People with panic disorder also frequently have panic attacks at home and it has been noted that many attacks actually occur shortly after 1:30 a.m.  Nocturnal panics usually occur between one and four hours after the onset of sleep, and many people have actually said that nocturnal panic is even more severe than daytime attacks.  These nocturnal panic attacks are very different from daytime attacks in that there is no physical activity causing the arousal and that the person is actually in a relaxed state with lowered blood pressure, reduced respiration and reduced heart rate. 

People with panic disorder and agoraphobia usually seek ways to adapt to their fears.  Some may work or live in a first-floor apartment in an effort to not be trapped on an elevator. Others may have someone accompany them to stores or may use the telephone to shop or shop online.  Some of these individuals self-medicate with alcohol and sedative drugs in order to deal with their panic symptoms and fears, and may actually develop substance abuse or dependence as their primary diagnosis. Many clinicians have found that the panic disorder sometimes does not even present itself until after detoxification has began. 

Information adapted from Treatment Plans and Interventions for Depression and Anxiety Disorders by Robert L. Leahy and Stephen J. Holland

Webpage and additional information By Paul Susic MA Licensed Psychologist Ph.D Candidate 

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