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An Introduction to Panic Disorder
Panic Disorder
-- It started 10 years ago. I was sitting in a seminar in a
hotel and this thing came out of the clear blue. I felt like
I was dying."
"For me, a panic attack is almost a violent experience.
I feel like I'm going insane. It makes me feel like I'm losing
control in a very extreme way. My heart pounds really hard,
things seem unreal, and there's this very strong feeling of
impending doom."
"In between attacks there is this dread and anxiety that
it's going to happen again. It can be very debilitating, trying
to escape those feelings of panic."
People with panic disorder have feelings of terror
that strike suddenly and repeatedly with no warning.
They can't predict when an attack will occur, and many
develop intense anxiety between episodes, worrying when
and where the next one will strike. In between times
there is a persistent, lingering worry that another
attack could come any minute.
When a panic attack strikes, most likely your heart
pounds and you may feel sweaty, weak, faint, or dizzy.
Your hands may tingle or feel numb, and you might feel
flushed or chilled. You may have chest pain or smothering
sensations, a sense of unreality, or fear of impending
doom or loss of control. You may genuinely believe you're
having a heart attack or stroke, losing your mind, or
on the verge of death. Attacks can occur any time, even
during nondream sleep.
While most attacks average a couple of minutes, occasionally
they can go on for up to 10 minutes. In rare cases,
they may last an hour or more.
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You may genuinely believe you're having a heart attack,
losing your mind, or on the verge of death. Attacks
can occur any time, even during nondream sleep.
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Panic disorder strikes between 3 and 6 million Americans, and
is twice as common in women as in men. It can appear at any
age--in children or in the elderly--but most often it begins
in young adults. Not everyone who experiences panic attacks
will develop panic disorder-- for example, many people have
one attack but never have another. For those who do have panic
disorder, though, it's important to seek treatment. Untreated,
the disorder can become very disabling.
Panic disorder is often accompanied by other conditions such
as depression or alcoholism, and may spawn phobias, which can
develop in places or situations where panic attacks have occurred.
For example, if a panic attack strikes while you're riding an
elevator, you may develop a fear of elevators and perhaps start
avoiding them.
Some people's lives become greatly restricted--they avoid normal,
everyday activities such as grocery shopping, driving, or in
some cases even leaving the house. Or, they may be able to confront
a feared situation only if accompanied by a spouse or other
trusted person. Basically, they avoid any situation they fear
would make them feel helpless if a panic attack occurs.
When people's lives become so restricted by the disorder, as
happens in about one-third of all people with panic disorder,
the condition is called agoraphobia. A tendency toward panic
disorder and agoraphobia runs in families. Nevertheless, early
treatment of panic disorder can often stop the progression to
agoraphobia.
Studies have shown that proper treatment--a type of psychotherapy
called cognitive-behavioral therapy, medications, or possibly
a combination of the two--helps 70 to 90 percent of people with
panic disorder. Significant improvement is usually seen within
6 to 8 weeks.
Cognitive-behavioral approaches teach patients how to view
the panic situations differently and demonstrate ways to reduce
anxiety, using breathing exercises or techniques to refocus
attention, for example. Another technique used in cognitive-behavioral
therapy, called exposure therapy, can often help alleviate the
phobias that may result from panic disorder. In exposure therapy,
people are very slowly exposed to the fearful situation until
they become desensitized to it.
Some people find the greatest relief from panic
disorder symptoms when they take certain prescription medications.
Such medications, like cognitive-behavioral therapy, can help
to prevent panic attacks or reduce their frequency and severity.
Two types of medications that have been shown to be safe and effective
in the treatment of panic disorder are antidepressants and benzodiazepines.
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-excerpted from the National Institutes of Health, Publication
97-3879
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