Panic Disorder affects more than 2.7% of the adult population
(6million) adults each year. Panic Disorder is a condition in which the patient
experiences repeated episodes of “Panic attacks”. Most people will
experience some degree of a panic attack at least once during their lifetime.
With Panic disorder the episodes are recurrent and can if untreated result in a
condition where the person begins to avoid going around certain things that
remind them of panic attacks, or have triggered these attacks in the past. This
condition eventually becomes generalized to geographical areas and can result in
the person becoming afraid to go outside at all. This condition is called
agoraphobia.
Panic attacks can occur anytime at anyplace, they can even occur
during sleep. One saving grace is that a true panic attack only last a few
minutes generally less than 6-16 minutes. Panic attacks are more common in women
often beginning in mid to late adolescents and tend to run in families though at
this time we cannot definitely say they are genetically inherited.
An attack usually peaks within 10 minutes, but some symptoms may
last much longer. Panic disorder affects about 6 million American adults1 and is
twice as common in women as men. Panic attacks often begin in late adolescence
or early adulthood, but not everyone who experiences panic attacks will develop
panic disorder. Many people have just one attack and never have another. The
tendency to develop panic attacks appears to be inherited. Untreated Panic
disorder will usually progress into a very difficult to treat condition called
agoraphobia. For this reason Panic disorder should ALWAYS be AGGRESSIVELY
Treated.
It is important to identify early on and
aggressively treat panic disorder in order to prevent the agoraphobia. Often
times patients will frequent emergency rooms often going in knowing that
something is killing them, but not sure what it is (maybe a heart attack, cannot
breath, feel as if they are drowning etc. The person will wait in the ER for the
doctor to FINALLY get around to seeing them and by then they feel “OK” and
somewhat embarrassed to be in the hospital ER.
Panic often occurs simultaneously with other
psychiatric conditions especially other panic disorders, and depression.
A combination of both Cognitive Behavioral
therapy (CBT) and medication therapy is almost always the BEST pathway to improved
health. CBT is important because without changing the underlying thinking
patterns which lead to panic, the medicines usually provide only a temporary
shelter from these horrifying experiences. Without medication it is very
difficult for the patient to experience enough of a reprieve from the panic
attacks to focus on the therapy, which facilitates the changing of thought
patterns.
Making Treatment More Effective
One of the most helpful things to know about panic is to get the locus of focus outside of the person. This means, that unlike dealing with a general sense of anxiety where focusing inside the person, on say breathing, when having a panic attack the person should focus OUTSIDE of themselves. Start counting things, leaves, blades of grass, stars in the night sky (ANYTHING TO KEEP THE FOCUS OUT SIDE OF THE BODY) Remember with a panic attack the person often feels certain they are dying from something going wrong inside of them., They feel as if they are dying from such things as: cannot breath, having a heart attack, or stroke. Putting your head between your knees in a seated position can also help.
Joining a self-help or support group
and sharing problems and accomplishments with others is often helpful. This
includes Internet chat rooms, however advice received over the Internet should
be taken with a double helping of caution; especially be leery of anyone who may
have a hidden agenda such as "this brand name medication is the answer
accept no substitute". Talking with trusted friends, family, or member of
the clergy can also provide support, but is no substitute for care from a mental
health professional.
Stress management techniques such as: meditation, progressive muscle relaxation,
autogenic relaxation, guided imagery, hypnosis, and biofeedback can be helpful
to calm and may enhance the effects of therapy. There is evidence that aerobic
exercise may have a calming effect.
The family unit can be very important in the recovery process of patients with
any anxiety disorder. Ideally, family should be supportive, but not help
perpetuate the symptoms. Family members should never trivialize the disorder, or
expect improvement without treatment.
About the Author:
Donald W. Ahrens Jr, PMH-NP, A.R.N.P. is a
psychiatric Nurse Practitioner who provides full spectrum psychiatric service
(both psychotherapy and medication therapy) to the people of Wichita and the
surrounding metropolitan area.