Question:
Being a very curious person who researches and needs to understand
everything I possibly can about things, I was justcurious about the
underlying causes of PD. I developed Panic Disorder 2 years ago at the
age of 45. It was completely out of the blue while going out for dinner
with my husband and hit me like a ton of bricks. I figured it must have
been a one time thing, but unfortunately it didn't turn out that way. So
here is my question: I always wondered if the first attack was just some
chemical/seritonin thing that at that particular moment in time just
"snapped" and went out of whack. Or, is it something that happens on a
gradual basis and then reaches its breaking point. And you are unaware
of it building until the moment of the first attack. Sort of like a
heart attack that has been building for years clogging your arteries and
all of a sudden you have this heart attack "out of the blue" which
actually has been building up for years. Any ideas?
Answer:
an anxiety attack can happen to anyone seemingly out of the blue and indeed if
it is an isolated manifestation then the ultimate primary etiology may not be
known or discovered however it takes more then just an isolated attack to
forment a disorder-the person who has an anxiety disorder has been brewing this
for a while from multidimensional arenas mostly triggered by a stress diathesis
dynamic and perpetuated by both a nuerochemical anomoly and a cognitive one
Little is really understood except that there can be many causes from
traumatic experiences, stress, chemical, and other causes including
inner ear dysfunction. If you have attacks this might help you and your
doctor come to some conclusions. I had a doctor that told me to keep a
diary of when I had attacks, what I was doing a few minutes before the
attack, the symptoms I had, how long it lasted, and what was going on
around me. This in some cases can determine if it is phobic, chemical,
or neurological in nature.
If you discover noises, perhaps tv, or being in a room with persons
talking with many conversations going on, or if visual events such as
certain tv shows especially ones with quickly changing scenes set you
off, or even being in a car in traffic with fast moving vehicles nearby
set you off I can give you a good place to look.
I'd try the diary and see if the attacks have a common denominator. If
you have a history of any inner ear trouble or hey fever ect. You need
to see an audiologist for Vestibular Dysfunction or auditory processing
disorders as these disturbances have been linked to anxiety disorders.
It's a fairly common problem and a lot of times missed.
The truth is nobody knows. Also there may well be different kinds of panic
disorders which cannot yet be identified as the etiology is not very well
understood at this point. Obviously it is a matter of an oversensitive
Cenbtral Nervous System which sort of goes out of whack and can be managed
by intervening in the behaviour of several neurotransmitters by way of meds
and therapy (Cognitive Behavioural Therapy, that is. There are studies which
show that CBT can have the same effect on our brain chemistry as treatment
with medications; a combination seems your best bet at this point). I
believe many of us have a genetic predisposition for PD and research
regarding this aspect is exciting but, like much in the *nature-nurture*
discussion, this is not all of the truth. Environmental, psychological
matters and whatnots will play a part as well, not in the first PA which
came "Out of the Blue" maybe, but a proper *disorder* includes not only
PA's but also living with PA's and the anticipatory anxiety and situational
phobias we develop and which are surely learned behaviour which can be
unlearned which is what CBT is for. It is probable that there Panic
Disorders with a biological origin waiting for a trigger or just manifesting
themselves at some unexpected point without any trigger and there is also
*acquired* PD like PTSD, substance induced PD etc. There is a lot to sort
out here and I believe that in ten-fifteen years we will know a lot more
just as we know a lot more now than we did way back when I developed PD in
1968. It is remarkable to develop PD after 40 but it does occur. The good
news is that these days is *can* be managed even if it won't be *cured*.
