Panic Disorder

Panic Disorder is an anxiety disorder characterized by recurrent and unpredictable bursts of terror known as panic attacks. A panic attack is accompanied by physical symptoms that may feel similar to a heart attack or other life-threatening condition. Intense anxiety often develops between episodes of panic. As panic attacks become more frequent, people begin avoiding situations that could trigger them. Panic attacks can lead to agoraphobia, which is the fear of unknown places.

Causes

Scientists continue to look for the exact cause or causes of panic disorder. It is believed to be related to:
  • Family history
  • Other biological factors
  • Stressful life events
  • Increased sensitivity to physical sensations

Risk Factors

A risk factor is something that increases your chance of getting a disease or condition.
  • Sex: Female
  • Age: Young adult
  • History of another anxiety disorder
  • Family history of panic disorders

Symptoms

Panic attacks usually occur unexpectedly and repeatedly. They include many of the following symptoms:
  • Sudden and intense episodes of fear
  • Racing, pounding, or skipping heartbeat
  • Chest pain, pressure, or discomfort
  • Difficulty catching breath
  • Choking sensation or lump in the throat
  • Excessive sweating
  • Lightheadedness or dizziness
  • Nausea
  • Tingling or numbness in parts of the body
  • Chills or hot flashes
  • Shaking or trembling
  • Feelings of unreality, or being detached from the body
  • An urge to flee
  • Fear of impending doom, such as death, a heart attack, suffocation, loss of control, or embarrassment

Diagnosis

The doctor will ask about your symptoms and medical history, and perform a physical exam. Since some Panic Disorder symptoms are similar to heart and digestive problems, a physical exam and tests can rule out physical causes of your symptoms. Tell your doctor about your physical symptoms and how the symptoms make you feel. Your doctor will want to know if your attacks keep you from your normal activities. You should also tell your doctor if you have been feeling sad or hopeless, or have been drinking or using drugs to control symptoms.

Treatment

The goal of treatment is to decrease the frequency and intensity of panic attacks. Your doctor or mental health care specialist will provide treatment. The following treatments may be provided:
Cognitive-behavioral therapy
This canprepare patients for situations that may trigger panic attacks. Therapy focuses on:
  • Learning how to recognize what causes your fears
  • Gradually changing distorted thinking patterns to more healthful ones
  • Breathing exercises that increase relaxation
  • Reducing fear and feelings of terror
Medications
Your doctor or mental health care specialist may prescribe one or more of the following:
Antidepressants
  • Selective serotonin reuptake inhibitors (SSRIs) such as fluoxetine (Prozac) and sertraline (Zoloft)
  • Tricyclics such as clomipramine (Anafranil) or imipramine (Tofranil)
  • Monoamine oxidase inhibitors (MAOs) such as phenelzine (Nardil) or tranylcypromine (Parnate)
Benzodiazepines (anti-anxiety medicines)
  • Alprazolam (Xanax)
  • Clonazepam (Klonopin)
  • Lorezepam (Ativan)
Dietary changes
Some people find thatavoiding caffeine (found in coffee, tea, chocolate, colas, diet sodas) may help reduce panic attacks.

Prevention

  • Avoid caffeine
  • Avoid alcohol
  • Avoid drug use, unless prescribed by your doctor
  • Get plenty of rest
  • Schedule a regular "quiet time" for yourself at home