Panic Disorder

Panic disorder is an anxiety disorder in which patients suffer from sudden and unexplained attacks of extreme fear and loss of physical and psychological control. They may feel in terrible danger of overwhelming embarrassment or death. Panic attacks are sometimes precipitated by an anxiety-producing event, but often seem to occur without any provocation and are all the more terrifying for that reason.

Patients who experience panic disorder may attribute the attacks to circumstances and develop fears of certain situations in which panic attacks have previously occurred. When an individual first comes for treatment the precise causes of panic attacks are typically unknown. Overtime, when the treatment goes accordingly, we slowly begin to understand that which causes intense panic.

Symptoms of Panic Disorder

Apart from intense, disabling fear or dread, people having a panic attack may experience a variety of physical symptoms,including:

  • Tachycardia
  • Chest pain
  • Gastrointestinal distress
  • Dizziness of lightheadedness
  • Hot flashes or chills
  • Shortness of breath
  • Tingling or numbness
  • Fear of dying

Panic attacks usually last several minutes to an hour and since their symptoms mimic those of heart attacks, patients may end up in hospital emergency rooms. Once physical causes of the patient‘s distress have been ruled out by medical testing, patients may be diagnosed as having had a panic attack. If such attacks happen repeatedly, patients are diagnosed as having panic disorder. Unfortunately, panic attacks may be self-perpetuating. The distress experienced during a panic attack is so all-encompassing that the fear of having another attack may restrict a patient‘s activities. Desperately fearing a reoccurrence of symptoms, particularly in public, patients may restrict their activities and even become housebound.

Treatment of Panic Disorder

In my practice Panic disorder is typically treated with a combination of psychotherapy, and at times, medication. While several forms of psychotherapy can be helpful in relieving everyday anxieties, insight oriented psychotherapy has been found to be particularly effective in treating panic disorder.

Tranquilizers are prescribed to relieve the intense feeling of panic during an attack, while antidepressants, after they have reached an appropriate blood level in the patient, may assist in diminishing the frequency of attacks, mitigate their severity, or forestall them all together. It may take a month or more for antidepressants to be effective and such medications have to be carefully monitored since they can produce suicidal thoughts in children, adolescents or young adults.

It should be noted that treatment with an experienced psychotherapist, at the correct frequency, is oftentimes enough to manage and reduce the frequency and intensity of these debilitating symptoms. In my practice, it is rare, but sometimes it is necessary, to use medication management as an adjunct to the psychotherapy treatment process.

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