What is Panic Disorder?
Starting with the dry stuff: The Diagnostic and Statistical Manual, 4th edition [DSM-IV], published by the American Psychiatric Association, defines Panic Disorder with or without Agoraphobia. In Panic Disorder the key identifying features are:
- 1. One or more episodes of abrupt, intense fear or discomfort, i.e., a panic attack. and
- 2. Persistent apprehension about the recurrence of the episodes of intense fear of discomfort.
At least one of the panic episodes must be unexpected and not caused by a situation in which one is the focus of attention. Fear of death or losing control or losing sanity generally accompanies these attacks.
It's important to distinguish between general feelings of anxiety and panic. In a panic attack anxiety and fear rapidly surge to a very uncomfortable point, then subside after 10 to 30 minutes with some symptoms possibly lasting for several hours. Anxiety tends to be more generalized and stable in nature.
A panic attack can be understood as the body reacting naturally to a panic situation when there is no real danger present. You might be browsing the local bookstore for a new cookbook when suddenly your body goes into a fight or flight reaction for no apparent reason. To those who've not experienced it, it almost sounds comical, but it's no laughing matter when it happens to you!
Since there is no logical explanation for why you are feeling these sensations, the mind goes to work rationalizing, am I having a heart attack, am I going insane, am I dying? Even after the surge of panic and emotion subsides the mind keeps working, what was that, why did it happen, will it happen again? Hence the apprehension component of the disorder. If another attack occurs the apprehension intensifies. It can become an endless cycle, apprehension triggering panic, panic triggering increased apprehension.
Often Panic Disorder is accompanied by, or can be the cause of, Agoraphobia. The tendency to avoid places or situations in which escape may be difficult should a panic attack occur, such as a large crowded shopping mall, airplanes, busses, etc., is called Agoraphobia. Agora being Greek for the ancient marketplace Agoraphobia literally meaning fear of the marketplace.
Debate rages over whether there is a physical or chemical cause for panic disorder and, so far, there is no proof one way or the other. It is evident that there are neurochemical differences in people experiencing Panic Disorder but it seems likely that the imbalance is caused by the disorder rather than the reverse (likely, at least to those of us who are inclined to agree with that assessment). The irrefutable fact is that people are overcoming the disorder and living normal lives without the benefit of drugs. To me this implies that the cause is not chemical imbalance. Even if it is, proper treatment can effect a lasting recovery from Panic Disorder.
How Do I Know If Panic Disorder Is What I've Got?
- Do you experience surges of anxiety or fear, sometimes fearing that you are dying or losing control?
- Do you feel like you are having a heart attack?
- Do you feel dizzy, shaky and weak?
- Do you feel short of breath or feel like it is difficult to get a word out?
- Do these experiences seem to come out of the blue, such as when you are otherwise enjoying yourself?
- Do you find yourself worrying about these events, trying to anticipate or stave off the next one?
- Do you find yourself avoiding experiences you used to enjoy such as shopping, driving, going to church, etc.?
- Do you find your self focusing on your pulse, breathing or blood pressure, trying to monitor them?
- When in public do you often think of possible ways to escape should an attack occur?
- Do you worry that you might collapse, loose control, or be embarrassed in public?
If you can relate to items on this list, the likelihood is that you are having panic attacks and associated anxiety.
Following are two actual case histories. Read them and see if you can relate to some of Bill and Ann's experiences:
Bill was a 24 year old married man who worked in a metal processing plant as inventory manager. He began suffering repeatedly from episodes of dizziness, feelings of suffocation, blurred vision, racing heart, loss of concentration and feelings of impending doom. The first episode happened at home while visiting with a friend. He began to feel light headed and disoriented. He couldn't focus on the conversation and soon began to feel he was suffocating. He finally asked his friend to drive him to the emergency room. He felt like he might faint or lose control and he had no doubt something was wrong with him.
After a thorough exam the doctor in ER told him he was in perfect health and was just hyperventilating. Bill continued to have episodes like this and by the time he finally discovered this program he had suffered heart palpitations, chills, sweating, racing heart, numbness, but the worst was the feelings of losing control or feeling he was dying. Bill would sometimes awake from sleep in a panic, thinking his heart had stopped, or that he had stopped breathing. Between the panic episodes Bill was plagued with feelings of anxiety, jittery nerves, difficulty relaxing, he would often check his pulse, he had feelings of pressure in his chest.
He had lost much of his self esteem. He had lost his job at the metal processing plant because he feared it was the environment there that was causing his problems. He had a hard time holding any job because his symptoms were so severe. Once a great outdoorsman, he now avoided leaving the city for fear of being too far away from a hospital. He also avoided situations like crowded stores, theaters, waiting in lines, barbers' chairs, and wouldn't even consider a situation like flying in an airliner where he felt he would be trapped if he panicked.
Bill's friends and family didn't understand what he was going through, nor did he for that matter. "It's just in your head." "Get over it." "That's crazy, Bill." He heard the advice, the ribbing, the anger at his bizarre behavior. He saw the rolling eyes, the shrugs, the shaking heads. He felt like they were right and It broke his heart.
Ann completely overcame her panics by following this program. She was 24 years old. She was having repeated attacks of dizziness, breathlessness, palpitations, chest pain, blurred vision, a lump in her throat and a feeling of unreality, accompanied by feelings of impending doom. She was afraid that she was going to have a heart attack or just lose control.
The problem began with a "bad trip", an unpleasant drug experience. The experience had been horrifying and she began to experience the symptoms described above. When she went to the doctor he told her that her symptoms were due to hyperventilating because of anxiety. Ann completely stopped all drug use. She even became nervous about and eventually avoided prescription drugs such as antibiotics.
The attacks varied over the years in both intensity and frequency. She worried about having another attack most of the time. She felt uneasy in situations where she thought she would be trapped if an attack occurred, but did not actually avoid many places. She took alprazolam (Xanax) to help her cope with her panics and it helped a great deal, but she wanted a cure, not a Band-Aid.
Bill's and Ann's stories are typical of those experiencing panic disorder. If you are having similar experiences it is very likely you too are experiencing Panic Disorder. Please keep in mind that panic disorder mimics other, very serious physical ailments. Before embarking upon this, or any other treatment plan, please see a doctor to make sure you are in good health. Please do not
rely only on the info you find here to make a self diagnosis.
