Panic disorder refers to recurrent unexpected panic attacks. The individual is persistently concerned or worried about having more panic attacks or changes his or her behavior in maladaptive ways because of the panic attacks (e.g., avoidance of exercise or of unfamiliar locations).
What are Panic Attacks?
Panic attacks are abrupt surges of intense fear or intense discomfort that reach a peak within minutes, accompanied by physical and/or cognitive symptoms.
One type of unexpected panic attack is a nocturnal panic attack (i.e., waking from sleep in a state of panic, which differs from panicking after fully waking from sleep)
Symptoms of Panic Disorder
- Recurrent unexpected panic attacks. A panic attack is an abrupt surge of intense fear or intense discomfort that reaches a peak within minutes, and during which time four (or more) of the following symptoms occur:
Note: The abrupt surge can occur from a calm state or an anxious state.
- Palpitations, pounding heart, or accelerated heart rate.
- Sweating.
- Trembling or shaking.
- Sensations of shortness of breath or smothering.
- Feelings of choking.
- Chest pain or discomfort.
- Nausea or abdominal distress.
- Feeling dizzy, unsteady, light-headed, or faint.
- Chills or heat sensations.
- Paresthesias (numbness or tingling sensations).
- Derealization (feelings of unreality) or depersonalization (being detached from oneself).
- Fear of losing control or “going crazy.”
- Fear of dying.
- At least one of the attacks has been followed by 1 month (or more) of one or both of the following:
- Persistent concern or worry about additional panic attacks or their consequences (e.g., losing control, having a heart attack, “going crazy”).
- A significant maladaptive change in behavior related to the attacks (e.g., behaviors designed to avoid having panic attacks, such as avoidance of exercise or unfamiliar situations).
- The disturbance is not attributable to the physiological effects of a substance (e.g., a drug of abuse, a medication) or another medical condition (e.g., hyperthyroidism, cardiopulmonary disorders). D. The disturbance is not better explained by another mental disorder (e.g., the panic attacks do not occur only in response to feared social situations, as in social anxiety disorder; in response to circumscribed phobic objects or situations, as in specific phobia; in response to obsessions, as in obsessive-compulsive disorder; in response to reminders of traumatic events, as in posttraumatic stress disorder; or in response to separation from attachment figures, as in separation anxiety disorder).
Causes of Panic Disorder
- Biological factors: Research has found that panic attacks can be caused by imbalances in brain chemicals called neurotransmitters, particularly serotonin and norepinephrine. Other biological factors that may contribute to panic attacks include genetics, hormonal imbalances, and medical conditions such as thyroid disorders.
- Psychological factors: Panic attacks can also be triggered by psychological factors such as stress, anxiety, and negative thoughts or beliefs about oneself or the world. Some people with panic attacks may tend to catastrophize or overestimate the danger of certain circumstances, which can contribute to the onset of panic attacks.
- Environmental factors: Some environmental factors, such as exposure to upsetting or distressing events, social seclusion, or drug misuse, can cause panic attacks. Some people may experience a cycle of worry and panic brought on by the threat of having another panic attack.
- Medical conditions: heart disease, asthma, and chronic obstructive pulmonary disease (COPD) are a few examples of illnesses that can cause panic attacks. Similarly, withdrawal from certain medications or substances, such as benzodiazepines or alcohol, can also trigger panic attacks.
Treatment for Panic Disorder
- Cognitive-behavioral therapy (CBT): CBT is a kind of psychotherapy that aims at changing negative thought patterns and behaviors that contribute to panic attacks. CBT for panic attacks also involves exposure therapy, which gradually exposes the individual to their feared situations or sensations, and provides coping strategies to manage anxiety and panic.
- Medication: Medications such as selective serotonin reuptake inhibitors (SSRIs) and benzodiazepines can be used to bring in control the symptoms of panic attacks. SSRIs are typically used as a long-term treatment for panic disorder, while benzodiazepines are used on an as-needed basis for acute and less severe symptoms.
- Relaxation techniques: Gradual relaxation techniques such as deep breathing, meditation, and progressive muscle relaxation can help reduce feelings of anxiety and panic and calm the muscles.
- Lifestyle changes: Reducing caffeine and alcohol consumption, improving sleep habits, and regular exercise can help reduce the frequency and intensity of panic attacks.
- Support groups: Support groups can build a safe and supportive environment for patients to share their experiences and learn from others facing similar life challenges.
Understanding the causes of panic attacks is an important first step in developing an effective treatment strategy.
It’s crucial to remember that every patient responds to therapy for panic attacks differently and may benefit from a combination of the treatments. A person must consult with a healthcare expert to create a personalized therapy plan based on their particular requirements and preferences.
A mental health professional can help determine if someone is experiencing a panic disorder and create a treatment plan to manage symptoms according to the severity type of the patient in a safe and sound environment.
