Plain Talk about Panic Disorder
Timothy Schneider, M.D.

In panic disorder, brief episodes of intense fear are accompanied by multiple physical symptoms (such as heart palpitations and dizziness) that occur repeatedly and unexpectedly in the absence of any external threat. These "panic attacks," which are the hallmark of panic disorder, are believed to occur when the brain’s normal mechanisms for reacting to a threat ­ the so-called "fight or flight" response ­ becomes inappropriately aroused. Most people with panic disorder also feel anxious about the possibility of having another panic attack and avoid situations in which they believe these attacks are likely to occur. Anxiety about another attack, and the avoidance it causes, can lead to serious disabilities.

In the United States, between 3 and 6 million people have panic disorder at some time in their lives. The disorder typically begins in young adulthood, but older people and children can be affected. Women are affected twice as frequently as men.

In panic disorder, panic attacks recur and the person develops an intense apprehension of having another attack. This fear ­ called anticipatory anxiety or fear of fear ­ can be present most of the time and seriously interfere with the person’s life even when a panic attack is not in progress. In addition, the person may develop irrational fears called phobias about situations where a panic attack has occurred. For example, someone who has had a panic attack while driving may be afraid to get behind the wheel again, even to drive to the grocery store.

People who develop these panic-induced phobias will tend to avoid situations that they fear will trigger a panic attack, and their lives may be increasingly limited as a result. Their work may suffer because they can’t travel or get to work on time. Relationships may be strained or marred by conflict as panic attacks, the fear of them, rule the affected person and those close to them.

Panic disorder may progress to a more advanced stage in which the person becomes afraid of being in any place or situation where escape might be difficult or help unavailable in the event of a panic attack. This condition is called agoraphobia. It affects about a third of all people with panic disorder.

Treatment can bring significant relief to 70-90 percent of people with panic disorder. Before undergoing any treatment for panic disorder, a person should receive a thorough medical examination to rule out other possible causes of the distressing symptoms.

Prescription medication such as Zoloft is often used with good results to prevent panic attacks or reduce their frequency and severity, and to decrease the associated anticipatory anxiety. However, a combination of medication and psychotherapy represents the best approach to treating panic disorder. It is extremely important for the person who has panic attacks to learn about the problem and the availability of effective treatments and to seek help at the earliest onset of panic attack symptoms.

Panic Attack Symptoms
During a panic attack, some or all of the following symptoms occur:

• Terror ­ a sense that something unimaginably horrible is about to happen.


• Racing or pounding heartbeat


• Chest pains o Dizziness, lightheadedness, nausea


• Difficulty breathing


• Tingling or numbness in the hands


• Flushes or chills


• Sense of unreality


• Fear of losing control


• Fear of dying

For more information on this topic, go to our website at www.humanservicescenter.net

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