panic disorder
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What is panic disorder?
Panic disorder is an anxiety disorder marked by recurring panic attacks, which trigger persistent worry and avoidance to prevent situations that might cause an attack. These attacks bring intense fear that appears suddenly and unexpectedly.
During these attacks, a person may experience terror, heart palpitations, and sweating. They may also fear that the symptoms indicate a heart attack, stroke, or other medical issue. Cognitive therapy and medications can help affected individuals cope with and prevent panic attacks.
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What are the common symptoms of panic disorder?
Panic disorder involves sudden panic attacks, which bring intense fear for no clear reason. Experiencing at least four physical or psychological symptoms is needed for diagnosis.
Common symptoms include:
* accelerated heart rate
* sweating
* trembling
* shortness of breath
* chest pain
* dizziness
* fear of losing control or dyingPeople with panic disorder often worry about attacks and avoid situations that might trigger them, which can limit their lives. Cognitive therapy and medication can help manage the disorder.
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How do panic attacks feel to someone experiencing them?
A panic attack involves a sudden surge of intense fear or terror without an obvious cause. People may experience terror, heart palpitations, and sweating. Physical symptoms can include shortness of breath, chest pain, dizziness, shaking, nausea, and numbness. Psychological symptoms may include a feeling of unreality, fear of dying, losing control, or "going crazy".
Panic attack intensity varies, but most last 10–15 minutes. Those experiencing a panic attack may believe they are having a heart attack or other illness. The attacks can create avoidance patterns that limit a person’s life.
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What causes panic disorder to develop in some people?
Panic disorder, an anxiety disorder, is characterized by recurring panic attacks that trigger continuous anxiety and avoidance behaviors to prevent situations that might cause an attack. These attacks involve a sudden onset of intense fear or terror, often without an obvious cause.
The development of panic disorder appears to stem from a combination of genetic and environmental variables. A significant genetic variation associated with panic disorder is mutation of the HTR2A gene, which affects serotonin receptors in the brain. Environmental and genetic factors also support the suffocation false alarm theory, where individuals with panic disorder show increased sensitivity to signals like rising carbon dioxide levels, leading to misinterpretation of nonthreatening situations as terrifying.
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How is panic disorder diagnosed by doctors or psychologists?
Panic disorder is diagnosed based on repeated panic attacks that lead to persistent worry and avoidance behavior in an attempt to prevent situations that could precipitate an attack. A panic attack is diagnosed based on the occurrence of at least four physical (somatic) or psychological symptoms.
Physical symptoms may include shortness of breath, palpitations or accelerated heart rate, chest pain or discomfort, choking, dizziness or faintness, trembling or shaking, sweating, nausea, abdominal distress, numbness or tingling, and hot flashes or chills. Psychological symptoms may consist of a smothering sensation, a feeling of unreality, a fear of dying, and a fear of “going crazy” or losing control.
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What treatments are available to help people with panic disorder?
Panic disorder is an anxiety disorder marked by recurring panic attacks that provoke continuous worry and avoidance to prevent triggers.
Effective treatments include cognitive therapy, teaching coping skills to prevent attacks, and exposure therapy, which desensitizes patients to their fears, especially useful for those with agoraphobia.
Pharmacotherapy addresses chemical imbalances with antidepressants like tricyclics (imipramine, desipramine), which boost neurotransmitter levels. Other options include benzodiazepines (diazepam, alprazolam), monoamine oxidase inhibitors (MAOIs), and serotonin reuptake inhibitors (SRIs) for anxiety and depression symptoms.
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panic disorder, anxiety disorder characterized by repeated panic attacks that leads to persistent worry and avoidance behavior in an attempt to prevent situations that could precipitate an attack. Panic attacks are characterized by the unexpected, sudden onset of intense apprehension, fear, or terror and occur without apparent cause.
Panic attacks often occur in people with breathing disorders such as asthma and in people experiencing bereavement or separation anxiety. While about 10 percent of people experience a single panic attack in their lifetimes, repeated attacks constituting panic disorder are less common; the disorder occurs in about 1–3 percent of people in developed countries. (The incidence in developing countries is unclear due to a lack of diagnostic resources and patient reporting.) Panic disorder typically occurs in adults, though it can affect children. It is more common in women than men, and it tends to run in families.
The underlying cause of panic disorder appears to arise from a combination of genetic and environmental factors. One of the most significant genetic variations that has been identified in association with panic disorder is mutation of a gene designated HTR2A (5-hydroxytryptamine receptor 2A). This gene encodes a receptor protein in the brain that binds serotonin, a neurotransmitter that plays an important role in regulating mood. People who possess this genetic variant may be susceptible to irrational fears or thoughts that have the potential to induce a panic attack. Environmental and genetic factors also form the basis of the suffocation false alarm theory. This theory postulates that signals about potential suffocation arise from physiological and psychological centres involved in sensing factors associated with suffocation, such as increasing carbon dioxide and lactate levels in the brain. People affected by panic disorder appear to have an increased sensitivity to these alarm signals, which produce a heightened sense of anxiety. This increased sensitivity results in the misinterpretation of nonthreatening situations as terrifying events.
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Altered activity of neurotransmitters such as serotonin can give rise to depression. Thus, there exists a close association between panic disorder and depression, and a large percentage of persons suffering from panic disorder go on to experience major depression within the next few years. In addition, about 50 percent of people with panic disorder develop agoraphobia, an abnormal fear of open or public places that are associated with anxiety-inducing situations or events. Panic disorder also may coincide with another anxiety disorder, such as obsessive-compulsive disorder, generalized anxiety disorder, or social phobia.
Because persistent worry and avoidance behavior are major characteristics of panic disorder, many patients benefit from cognitive therapy. This form of therapy typically consists of developing skills and behaviors that enable a patient to cope with and to prevent panic attacks. Exposure therapy, a type of cognitive therapy in which patients repeatedly confront their fears, becoming desensitized to their fears in the process, can be effective in panic disorder patients who are also affected by agoraphobia.
Pharmacotherapy can be used to correct for chemical imbalances in the brain. For example, tricyclic antidepressants, such as imipramine and desipramine, are effective treatments for panic disorder because they increase the concentrations of neurotransmitters at nerve terminals, where the chemicals exert their actions. These agents may also provide effective relief of associated depressive symptoms. Other antidepressants, including benzodiazepines such as diazepam (Valium) and alprazolam (Xanax), monoamine oxidase inhibitors (MAOIs), and serotonin reuptake inhibitors (SRIs), also can be effective in treating both anxiety- and depression-related symptoms.