Better Information Retention

 

 Panic Disorder

Panic disorder is a type of anxiety disorder characterized by recurrent unexpected panic attacks. Symptoms may include chest pain, an accelerated heart rate, hyperventilation, dizziness and a feeling of detachment from oneself. Panic disorder may be diagnosed by the presence of panic attacks and associated worry about having future episodes. It can occur with other mental health conditions including substance abuse and depression .

The World Health Organization estimated the number of people with panic disorder at 5% in 2010. This is lower than the estimates for other anxiety disorders. Panic disorder is diagnosed by a physician based on an interview and observation of symptoms for a minimum of two weeks. More severe cases require a review by a mental health specialist to ensure fit for diagnosis.

The term "panic attack" was introduced in 1870 by Jean-Martin Charcot, who called it "hysterical paroxysm". William Gull is credited with coining the term "panic disorder" in 1965. In the DSM-IV (Diagnostic and Statistical Manual of Mental Disorders), "panic disorder" was called "panic attacks", which refers to discrete periods of intense fear or anxiety not associated with an additional physical problem. Panic disorder has been divided into two subtypes, distinguished by whether the person has had five or more attacks that meet criteria for panic disorder. Six attacks are required for subthreshold panic disorder.

Usually panic disorders develop in late adolescence or early adulthood. The average age at onset is 21 years, although it can occur at any time of life. In rare cases, the disorder develops after age 60.

Panic attacks are significantly different from other types of anxiety, in that panic attacks are very brief and tend to strike suddenly and without warning. People suffering from depression, on the other hand, frequently have persistent anxiety lasting weeks or months. Panic attacks may be mistaken for a heart attack in patients with anxiety disorder, particularly in the first case of an unexpected panic attack. Panic disorder is no more likely to turn into depression than any other anxiety disorder.

Panic attacks may be accompanied by physical symptoms that include: rapid heartbeat, sweating, trembling or shaking, shortness of breath, nausea or stomach pain and feeling dizzy, lightheaded or faint. These physical symptoms are what people commonly refer to as 'the fear'. The physical symptoms associated with a panic attack, though, may be difficult to identify. Many people who suffer from panic attacks do not report experiencing the "fear" that others describe.

Panic disorder can be effectively treated with medication, psychotherapy or a combination of the two. Psychotherapy includes cognitive behavioral therapy and exposure desensitization response therapy. Exposure desensitization response therapy exposes people to neutral cues (e.g. a white square on a black background or a "safe" image such as an image of a window) while they are experiencing panic. This exposure helps to prevent fear from occurring in the first place, and also helps to identify which situations did trigger distress. Panic disorder is one of several anxiety disorders for which psychotherapy has been found to be effective. Psychotherapy can help people make changes in the way they think and act, which in turn can ease anxiety.

Panic disorder causes significant personal distress, reduced quality of life and work and school difficulties. Between 10% to 20% of panic-disorder subjects are victims of repeated panic attacks. Approximately 95 percent of panic disorder sufferers will also have depression at some point in their life. These two disorders together affect approximately 6 percent of the population, which is around 18 million people in the United States.

The term "panic attack" was introduced by Jean-Martin Charcot, who called it "hysterical paroxysm". Charcot was a French neurologist and psychiatrist most famous for his work in the study of hysteria. He coined the term "panic" from the Greek word "panikos", meaning "sudden".

The terms "panic attack" and "panic disorder" have been used interchangeably for decades. The use of the phrase 'panic attack' tends to imply that attacks are sudden and unexpected and therefore not 'objective' (i.e. they are not due to an external threat). 'Panic disorder', on the other hand, implies that panic attacks are a symptom of an underlying condition. This is the most common view among professionals in the field today.

In terms of physical symptoms, panic attacks may cause tachycardia (rapid heart rate), sweating, shaking, and hyperventilation (rapid breathing). People experiencing a panic attack may incorrectly attribute them to a heart attack and thus seek treatment in an emergency room. Because panic attacks can be extremely frightening, people experiencing one may believe they are dying or going crazy. The fear and terror that a person with panic disorder experiences during an attack can potentially lead to many harmful or dangerous behaviors. These behaviors may include but are not limited to:

The cognitive effects of anxiety may include thoughts about suspected dangers, such as fear of dying. "You may ... fear that the chest pains are a deadly heart attack or that the shooting pains in your head are the result of a tumor or an aneurysm.

Conclusion

The panic attacks tend to be recurrent, with periods of time (an hour or two) where symptoms are absent. Panic attacks during these periods of time often return at the same intensity and may repeat the same sequence of events as the original panic attack. If a panic attack occurs repeatedly in a relatively short space of time (e.g. five out of four days), this may be considered a panic disorder, or panic attacks may "echo" during an individual's next period of quiet sleep (e.g. between night waking).