Basic Psychology, Psychopathology

Panic disorder

Panic disorder is a type of anxiety disorder. It causes panic attacks, which are sudden feelings of terror when there is no real danger. Panic attacks are characterized by a fear of disaster or of losing control even when there is no real danger. A person may also have a strong physical reaction during a panic attack. It may feel like having a heart attack. Panic attacks can happen anytime, anywhere, and without warning. You may live in fear of another attack and may avoid places where you have had an attack. For some people, fear takes over their lives and they cannot leave their homes.A person with panic disorder may become discouraged and feel ashamed because he or she cannot carry out normal routines like going to school or work, going to the grocery store, or driving.

Most panic attacks last for between 5 and 20 minutes. Some panic attacks have been reported to last up to an hour.The number of attacks you have will depend on how severe your condition is. Some people have attacks once or twice a month, while others have them several times a week.Although panic attacks are frightening, they’re not dangerous. An attack won’t cause you any physical harm, and it’s unlikely that you’ll be admitted to hospital if you have one.

Panic disorder often begins in the late teens or early adulthood. More women than men have panic disorder. But not everyone who experiences panic attacks will develop panic disorder.Even though the symptoms of this disorder can be quite overwhelming and frightening, they can be managed and improved with treatment. Seeking treatment is the most important part of reducing symptoms and improving your quality of life.

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Symptoms 

  • Pounding or fast heartbeat
  • Sweating
  • Trembling or shaking
  • Shortness of breath or a feeling of being smothered
  • A choking feeling
  • Chest pain
  • Nausea or stomach pains
  • Feeling dizzy or faint
  • Chills or hot flashes
  • Numbness or tingling in the body
  • Feeling unreal or detached
  • A fear of losing control or going crazy
  • A fear of dying

Be aware that most of these symptoms can also be symptoms of other conditions or problems, so you may not always be experiencing a panic attack.For example, you may have a racing heartbeat if you have very low blood pressure.

Panic Cycle

It is Misinterpretation and Catastrophization that cause us to panic and become locked in the cycle.

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Causes

It’s not known what causes panic attacks or panic disorder, but these factors may play a role:

  • Genetics
  • Major stress
  • Temperament that is more sensitive to stress or prone to negative emotions
  • Certain changes in the way parts of your brain function

Panic attacks may come on suddenly and without warning at first, but over time, they’re usually triggered by certain situations.Some research suggests that your body’s natural fight-or-flight response to danger is involved in panic attacks. For example, if a grizzly bear came after you, your body would react instinctively. Your heart rate and breathing would speed up as your body prepared for a life-threatening situation. Many of the same reactions occur in a panic attack. But it’s unknown why a panic attack occurs when there’s no obvious danger present.

Treatment

Psychological treatments

  • Education about the disorder : Following assessment, a therapist will teach you about anxiety in general, and panic disorder specifically. This will involve talking about the ‘fight or flight’ response and details of how this affects the body. Education will involve dispelling fears that people commonly have about this disorder such as that they are going crazy or will die as a result of the symptoms.
  • Relaxation and breathing techniques : Panic can be made worse by overbreathing. Slowing one’s breathing rate can be effective for some people to help deal with a panic attack and also to prevent a full-blown attack from occurring. Relaxation is probably more useful as a general strategy for dealing with anxiety but has been shown to be helpful for some people with panic disorder. Relaxation and slow-breathing alone have not generally been shown to effectively treat panic disorder, although there is some evidence that a form of relaxation called ‘applied relaxation’ can be helpful.
  • Cognitive Behavioural Therapy:CBT for panic disorder involves treatments that change the behaviour (exposure and anxiety management such as slow-breathing) and those that change anxiety-provoking and worrying thoughts (i.e. cognitive therapy). The goal is to help you develop a less upsetting understanding of physical changes that occur when you are anxious.There is evidence that CBT is more effective than medication in both the short and long term. One advantage of CBT over medication is that it has been shown to be helpful in the long-term, i.e. several months to several years after short-term treatment has finished.
  • Cognitive therapy : This part of treatment involves identifying triggers for panic attacks and understanding the fears you have about the symptoms of panic. Triggers might be a thought or situation or a slight physical change such as faster heartbeat. People are taught to be more realistic in their interpretation of panic symptoms and feared situations.
  • Interoceptive exposure and In vivo exposure(graded exposure) : Interoceptive exposure involves becoming less frightened of the symptoms of panic in a controlled manner. For instance, it might involve jogging on the spot in the therapist’s office to become more familiar with the meaning of certain symptoms such as rapid heartbeat and shortness of breath. Alternatively, it may involve drinking cups of coffee or sitting in a hot room.For those who avoid situations for fear of having a panic attack it will be important to face feared places. In vivo exposure involves breaking a fearful situation down into achievable steps and doing them one at a time until the most difficult step is achieved. For example, if a person is fearful of train journeys, the treatment may include going on trains, then going on trains with an increasing number of stops and with increasingly large crowds and so on.

Medications

WARNING :Please do consult a doctor as I am only a psychology student who is not much aware on medicines and the given data is just for an information.

Medications can help reduce symptoms associated with panic attacks as well as depression if that’s an issue for you. Several types of medication have been shown to be effective in managing symptoms of panic attacks, including:

  • Selective serotonin reuptake inhibitors (SSRIs). Generally safe with a low risk of serious side effects, SSRI antidepressants are typically recommended as the first choice of medications to treat panic attacks. SSRIs approved by the Food and Drug Administration (FDA) for the treatment of panic disorder include fluoxetine (Prozac), paroxetine (Paxil, Pexeva) and sertraline (Zoloft).
  • Serotonin and norepinephrine reuptake inhibitors (SNRIs). These medications are another class of antidepressants. The SNRI venlafaxine (Effexor XR) is FDA approved for the treatment of panic disorder.
  • Benzodiazepines. These sedatives are central nervous system depressants. Benzodiazepines approved by the FDA for the treatment of panic disorder include alprazolam (Xanax) and clonazepam (Klonopin). Benzodiazepines are generally used only on a short-term basis because they can be habit-forming, causing mental or physical dependence. These medications are not a good choice if you’ve had problems with alcohol or drug use. They can also interact with other drugs, causing dangerous side effects.

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