Your Guide to Panic Disorder

— Dr. M A Katzman, Dr. Jean Goulet —

What is Panic Disorder?

Panic attacks can occur at any time, anywhere: sitting in a movie theater, shopping, or driving.

A panic attack is a sudden and unexpected episode of intense and overwhelming fear that has a distinct beginning and end point. The fear is accompanied by other physical symptoms that often mimic heart attacks or suffocation. In a panic attack, the physical symptoms come to a peak within 10 minutes from start. Often with panic attacks, you feel as if something terrible is about to happen. You feel like you must flee or escape.

Roughly one person in seven will experience at least one panic attack during his or her lifetime. This does not mean the person is suffering from Panic Disorder, nor does it mean the person will develop Panic Disorder. A true diagnosis of Panic Disorder is made when a person has experienced more than one panic attack, and the panic attack was unexpected.

Panic Disorder is a medical illness. A person with Panic Disorder will experience repeated panic attacks that are accompanied by several of the following symptoms:

• Chest pain, pressure or discomfort.

• Heart palpitations or rapid heart beat.

• Difficulty breathing or catching your breath.

• A choking sensation or lump in the throat.

• Excessive sweating; light-headedness or dizziness.

• Tingling or numbness in parts of the body.

• Chills or hot flashes; shaking or trembling or feelings of unreality or of being detached from the body.

After having a panic attack, it is not unusual for a person to feel as if they are going crazy or having a "nervous breakdown". In fact, many people will continue to feel this way long after the initial panic attack. Many people begin to feel intense anxiety about the possibility of having more attacks. If untreated, many sufferers begin to avoid situations or places where they fear panic attacks might strike. The avoidance of situations where escape might be difficult or in which help may not be available can develop into a serious anxiety disorder of its own called agoraphobia. Agoraphobia develops when the person learns to fear having another attack in the same place or in a location where it would be difficult to get help. If agoraphobia becomes severe enough, the person may become housebound and unable to perform normal daily activities.

Panic Disorder is often misunderstood. People with the disorder may spend months or years trying to find an explanation for what they feel are mysterious physical symptoms. Others won't seek treatment because they are embarrassed, think their condition is just due to stress, or they are afraid of what the doctor will diagnose.

The truth about Panic Disorder

• Panic Disorder is a medical illness.

• 4% of the population will experience at least one panic attack in their lifetime.

• Symptoms of Panic Disorder usually appear in late adolescence or early adulthood.

• Women are more likely to develop Panic Disorder.

• Panic Disorder is treatable.

What causes Panic Disorder?

The exact cause of Panic Disorder remains a mystery. However, research suggests that it may be caused by a chemical imbalance in the area of the brain responsible for our ability to respond to perceived dangers, often described as the "fight or flight" response.

When faced with a dangerous situation our brain makes a decision on whether we should stay put and "fight" or if it is better to run away, "flight". Researchers believe that in people with Panic Disorder this response mechanism is being turned "on" when in fact there is no sign of danger.

Panic Disorder is not due to stress. It is not due to family situations. But these factors can worsen the symptoms. Panic Disorder is a medical illness, without proper treatment it can result in an inability to perform on the job, go to social functions or pass up opportunities due to the fear of being placed in situations associated with panic attacks.

Panic Disorder is often associated with Depression. Some people try to control their symptoms with alcohol or other drugs, but it is important to understand that drugs and alcohol often make the problem worse.

How can I tell if I have Panic Disorder?

Only your doctor can make the actual diagnosis of Panic Disorder. However, if you find that the descriptions given in this article apply to you and think you might have Panic Disorder, complete the next questionnaire.