Causes
The cause is unknown, although
genes may play a role. If one identical twin has the disorder, the other twin
will also present the condition 40% of the time. However, panic disorder often
occurs when there is no family history.
Panic disorder is twice as common
in women than in men. Symptoms usually begin before age 25, but can occur at
age 35. Although panic disorder may occur in children, is usually not diagnosed
until they are older.
Symptoms
A crisis or panic attack starts
suddenly and often peaks within 10 to 20 minutes. Some symptoms may continue
for one hour or more. A panic attack can be confused with one heart.
Panic attacks may include anxiety
about being in a situation where escape might be difficult (like being in a
crowd or traveling in a car or bus).
A person with panic disorder often
lives in fear of another attack and may be afraid of being alone or far from
medical help.
People with panic disorder have at
least four of the following symptoms during an attack:
Chest pain or discomfort
Dizziness or fainting
Fear of dying
Fear of losing control or
impending doom
Feeling of choking
Feelings of separation
Feelings of unreality
Nausea or upset stomach
Numbness or tingling in hands, feet
or face
Palpitations, rapid heart rate or
pounding heartbeat
Sensation of shortness of breath
or smothering
Sweating, chills or hot flashes
Trembling or shaking
Panic attacks can change the
behavior and performance at home, work or school. People with this disorder
often worry about the effects of your panic attacks.
People with panic disorder may
have symptoms of:
Alcoholism
Depression
Drug
Panic attacks can not be predicted.
At least in the early stages of the condition, trigger no attack begins. The
memory of a past attack may trigger panic attacks.
Exams and Tests
Many people with panic disorder
first seek treatment in the emergency room, because the panic attack feels like
a heart attack.
The doctor will perform a physical
exam, including a psychiatric evaluation.
Blood tests will be done. It must
rule out other medical conditions before a diagnosis of panic disorder. Also
must be considered drug-related disorders, because the symptoms can mimic panic
attacks.
Treatment
The goal of therapy is to help you
function well during everyday life. A combination of cognitive behavioral
therapy (CBT) and medication works best.
Antidepressants called SSRIs (selective
serotonin reuptake inhibitors) are the most commonly prescribed medications for
panic disorder and include:
Fluoxetine (Prozac)
Sertraline (Zoloft)
Paroxetine (Paxil)
Other SSRIs
Other drugs that may be used
include:
Other types of antidepressants, as
inhibitors of norepinephrine reuptake inhibitors (SNRIs).
Anticonvulsants for severe cases.
Benzodiazepines, including
diazepam (Valium), alprazolam (Xanax), clonazepam (Klonopin) and lorazepam (Ativan)
can be used for a short time.
Monoamine oxidase inhibitors (MAOIs)
are used only when other drugs do not work, because they can have serious side
effects.
Your symptoms should improve
slowly over a few weeks. Talk with your doctor if this does not happen. Do not
stop taking your medication without telling your doctor.
Cognitive behavioral therapy helps
you understand their behavior and how to change them. You should have 10 to 20 visits
over many weeks. During therapy, you will learn how to:
Understanding and Managing
distorted views of life stressors, such as the behavior of others or the facts
of life.
Recognize and replace panic-causing
thoughts and decrease the sense of helplessness.
Managing stress and relax when
symptoms occur.
Imagine the things that cause
anxiety, starting with the least feared. Practicing in a real life situation to
help you overcome your fears.
The following may also help reduce
the number or severity of panic attacks:
Eat at regular times.
Exercise regularly.
Get enough sleep.
Reduce or avoid caffeine, certain
medications for colds and stimulants.
Expectations (prognosis)
Panic disorders can be long
lasting and difficult to treat. It is possible that some people with this
disorder is not cured with treatment, but most improvement with a combination
of medication and behavioral therapy.
Complications
Substance abuse can occur when
people who have panic attacks is to face your fear consume alcohol or illicit
drugs.
People with panic disorder are
more likely to live unemployed, to be less productive at work and have
difficult personal relationships, including marital problems.
Agoraphobia is when fear of future
panic attacks leads someone to avoid situations or places that are thought to
cause the attacks. This can lead a person to put extreme restrictions on places
where it goes or who is around. See: Panic disorder with agoraphobia
Anxiolytics dependence is a
possible complication of treatment. Dependence involves needing a medication to
function and to avoid withdrawal symptoms. It is not the same as addiction.
When to Contact a Medical
Professional
Make an appointment with your
doctor if panic attacks are interfering with your work, relationships or self-esteem.
Prevention
If you have panic attacks, avoid
the following:
Alcohol
Stimulants such as caffeine and
cocaine
These substances may trigger or
worsen symptoms.