What is Panic Disorder?
Simplified, internally generated chemicals greatly increase our pain threshold, give us a powerful boost of energy, sharpens our senses, and increases our blood and oxygen supply to vital organs and muscles. This is a real advantage to people when they are in dangerous situations, but panic disorder causes these symptoms at inappropriate times, which can lead to panic attacks.Examples of Panic Disorder
Think of a past heated verbal exchange or the time that other driver blindly cut into your lane in busy traffic. Everyone is familiar with this response and the physical sensations it brings. However, the individual with panic disorder is so sensitized to their thoughts, inner dialogue, and environment that they can trigger this defense mechanism and associated response virtually at will! The underlining message to the self is, “I’m losing control. I’m going to have a heart attack. Something terrible is going to happen right now and I need to get out of here immediately!”Imagine, you're safe at home, sitting in front of the TV in your favorite chair when out of nowhere, you feel your heart rate accelerate, your breathing becomes erratic, and you experience true terror for no reason whatsoever. This is the experience of someone suffering from panic disorder.
Symptoms of Panic Disorder
Like the Generalized Anxiety Disorder sufferer, people with panic disorder also experience habitual worry. But the individual suffering from panic disorder also experiences persistent periods of intense fear (panic attacks) that seemingly come out of nowhere.For DSM IV classification of panic disorder, the unexpected panic attack(s) is followed by one month (at least) of persistent concern about having another attack. Hence, the panic sufferer will exhibit significant behavioral changes related to the specific circumstances surrounding the attack.
Differences between Panic Disorder and Generalized Anxiety Disorder
Much is often made about the difference between a panic attack and an anxiety attack. Both have their origins in the physiological response associated with the ‘fight or flight’ response. An anxiety attack includes all the body symptoms associated with high anxiety. But the anxiety is long lasting and doesn't seem to be "out of the blue," more like a steady and constant build up of stress. For people with panic disorder, however, panic attacks strike abruptly, like a sudden wave at the beach, and take about 20 minutes to fully build, peak and ebb. One is left with continued anxiety but not panic. Intense fear and discomfort are characteristic of panic attacks, whereas an anxiety attack is often characterized as worry accompanied by an edgy restlessness and anxious symptoms.Symptoms of Panic Disorder
Quite often, a person suffering from panic disorder will believe they are suffering from a heart attack and dying when they are really having a panic attack. So it is not surprising that many people end up in the hospitals’ emergency room after experiencing their first panic attack. These intense physical sensations stem from the natural chemical response associated with the ‘fight or flight’ response.Typical physical symptoms of panic disorder include:
- Racing heart, chest discomfort
- Tightness of the throat/choking sensation, a feeling that you can’t get enough air
- Extreme fear; fear that you’re going to lose control and do something foolish, fear that you’re ‘losing your mind’, fear that death is imminent
- Dizziness, feelings of ‘unreality’
- Numbing or tingling in the extremities
- Hot flashes or chills
Some people suffering from panic disorder become so frightened of the prospect of experiencing another panic attack that they limit their comings, goings, and activities (avoidances) in an effort to stave off future attacks. They retreat to a “safe place” or “safe person” and will avoid leaving their perceived safety net at all costs. People with extreme cases of panic disorder can develop agoraphobia; the sufferer becomes so terrified of having another panic attack that he or she rarely leaves their own home.
Quick Facts about Panic Disorder
Panic disorder affects 2.4 million Americans, and not surprisingly, often coexists with depression. Women are affected by panic disorder at twice the rate of men. A panic attack can occur at any time – even during sleep.Panic disorder normally develops in late adolescence or early childhood. But like all anxiety disorders, panic disorders are commonly under-recognized in the primary from panic disorder are properly diagnosed and properly treated.
What Causes Panic Disorder
While the exact cause of panic disorder is unknown, research seems to suggest that the onset of panic disorder often occurs at a time major life transition such as leaving home for college, the loss of a loved one, or the birth of a child. Like all anxiety disorders however, panic disorder probably develops as a result of a combination of risk factors including personality characteristics, genetics/biology, and environmental factors.Getting Help for Panic Disorder
Exact treatment will vary from person-to-person based on severity and other distinctive factors; panic disorder is typically treated with medications, therapy, or a combination of the two.Many forms of therapy are used in the treatment of anxiety disorders including psychotherapy, relaxation therapy, and exposure therapy. Perhaps the most researched and clinically proven form of treatment therapy for panic disorder is cognitive-behavioral therapy (CBT). CBT is simply an integration of the cognitive (thought) restructuring approach of traditional cognitive therapy and the behavior modification techniques of traditional behavioral therapy.
CBT is a structured, short-term therapy that that is very goal oriented and conducive to change. It is an action-based form of therapy based on the premise that bad or faulty thinking patterns cause negative emotions and negative behaviors. This treatment teaches people with panic disorder to understand and change their thinking patterns so they can change their behavior and emotional state. CBT teaches the panic disorder sufferer to think and respond differently in situations that cause anxiety.
Among the many educational strategies and proven coping skills I teach in lesson two of the ATTACKING ANXIETY & DEPRESSION Program is my six-step approach to self control when dealing with panic attacks.
- ACCEPT - float with the body feelings, don’t fight them. It’s just anxiety, it will pass.
- PERMISSION – give yourself permission to feel anxious for a while – “I know what this is, it will pass.”
- BREATHE – focus on your breathing. Inhale through your nose slowly for two seconds, mentally counting, one-one thousand, two-one thousand. Then exhale through your mouth to a mental count of four seconds. Do this for about one minute.
- INNER DIALOGUE – use positive, comforting dialogue instead of scaring yourself further. “I’m OK, it won’t hurt me and it will go away. I can function perfectly well even if I’m feeling a bit spacey.”
- DISTRACT – get busy and do something active to burn off some of this self-induced stimulation. Go for a walk, clean out a closet – DO something and distract yourself from the way you are feeling.
- LET TIME PASS – again, there’s no emergency, it’s no big deal, and this discomfort WILL pass.
