Question:
What Causes Panic Disorder: Mind, Body, or Both?
Answer:
Panic Disorder is a serious condition that around one out of every 75
people might experience. It usually appears during the teens or early
adulthood, and while the exact causes are unclear, there does seem to
be a connection with major life transitions that are potentially
stressful: graduating from college, getting married, having a first
child, and so on. There is also some evidence for a genetic
predisposition; if a family member has suffered from panic disorder,
you have an increased risk of suffering from it yourself, especially
during a time in your life that is particularly stressful.
Panic Attacks: The Hallmark of Panic Disorder
A panic attack is a sudden surge of overwhelming fear that comes
without warning and without any obvious reason. It is far more intense
than the feeling of being 'stressed out' that most people experience.
Symptoms of a panic attack include:
racing heartbeat
difficulty breathing, feeling as though you 'can't get enough air'
terror that is almost paralyzing
dizziness, lightheadedness or nausea
trembling, sweating, shaking
choking, chest pains
hot flashes, or sudden chills
tingling in fingers or toes ('pins and needles')
fear that you're going to go crazy or are about to die
You probably recognize this as the classic 'flight or fight' response
that human beings experience when we are in a situation of danger. But
during a panic attack, these symptoms seem to rise from out of nowhere.
They occur in seemingly harmless situations--they can even happen while
you are asleep.
In addition to the above symptoms, a panic attack is marked by the
following conditions:
it occurs suddenly, without any warning and without any way to stop it.
the level of fear is way out of proportion to the actual situation;
often, in fact, it's completely unrelated.
it passes in a few minutes; the body cannot sustain the 'fight or
flight' response for longer than that. However, repeated attacks can
continue to recur for hours.
A panic attack is not dangerous, but it can be terrifying, largely
because it feels 'crazy' and 'out of control.' Panic disorder is
frightening because of the panic attacks associated with it, and also
because it often leads to other complications such as phobias,
depression, substance abuse, medical complications, even suicide. Its
effects can range from mild word or social impairment to a total
inability to face the outside world.
In fact, the phobias that people with panic disorder develop do not
come from fears of actual objects or events, but rather from fear of
having another attack. In these cases, people will avoid certain
objects or situations because they fear that these things will trigger
another attack.
How to Identify Panic Disorder
Please remember that only a licensed therapist can diagnose a panic
disorder. There are certain signs you may already be aware of, though.
One study found that people sometimes see 10 or more doctors before
being properly diagnosed, and that only one out of four people with the
disorder receive the treatment they need. That's why it's important to
know what the symptoms are, and to make sure you get the right help.
Many people experience occasional panic attacks, and if you have had
one or two such attacks, there probably isn't any reason to worry. The
key symptom of panic disorder is the persistent fear of having future
panic attacks. If you suffer from repeated (four or more) panic
attacks, and especially if you have had a panic attack and are in
continued fear of having another, these are signs that you should
consider finding a mental health professional who specializes in panic
or anxiety disorders.
What Causes Panic Disorder: Mind, Body, or Both?
Body: There may be a genetic predisposition to anxiety disorders; some
sufferers report that a family member has or had a panic disorder or
some other emotional disorder such as depression. Studies with twins
have confirmed the possibility of 'genetic inheritance' of the
disorder.
Panic Disorder could also be due to a biological malfunction, although
a specific biological marker has yet to be identified.
All ethnic groups are vulnerable to panic disorder. For unknown
reasons, women are twice as likely to get the disorder as men.
Mind: Stressful life events can trigger panic disorders. One
association that has been noted is that of a recent loss or separation.
Some researchers liken the 'life stressor' to a thermostat; that is,
when stresses lower your resistance, the underlying physical
predisposition kicks in and triggers an attack.
Both: Physical and psychological causes of panic disorder work
together. Although initially attacks may come out of the blue,
eventually the sufferer may actually help bring them on by responding
to physical symptoms of an attack.
For example, if a person with panic disorder experiences a racing
heartbeat caused by drinking coffee, exercising, or taking a certain
medication, they might interpret this as a symptom of an attack and ,
because of their anxiety, actually bring on the attack. On the other
hand, coffee, exercise, and certain medications sometimes do, in fact,
cause panic attacks. One of the most frustrating things for the panic
sufferer is never knowing how to isolate the different triggers of an
attack. That's why the right therapy for panic disorder focuses on all
aspects -- physical, psychological, and physiological -- of the
disorder.
Can People with Panic Disorder lead normal lives?
The answer to this is a resounding YES -- if they receive treatment.
Panic disorder is highly treatable, with a variety of available
therapies. These treatments are extremely effective, and most people
who have successfully completed treatment can continue to experience
situational avoidance or anxiety, and further treatment might be
necessary in those cases. Once treated, panic disorder doesn't lead to
any permanent complications.
Side Effects of Panic Disorder
Without treatment, panic disorder can have very serious consequences.
The immediate danger with panic disorder is that it can often lead to a
phobia. That's because once you've suffered a panic attack, you may
start to avoid situations like the one you were in when the attack
occurred.
Many people with panic disorder show 'situational avoidance' associated
with their panic attacks. For example, you might have an attack while
driving, and start to avoid driving until you develop an actual phobia
towards it. In worst case scenarios, people with panic disorder develop
agoraphobia -- fear of going outdoors -- because they believe that by
staying inside, they can avoid all situations that might provoke an
attack, or where they might not be able to get help. The fear of an
attack is so debilitating, they prefer to spend their lives locked
inside their homes.
Even if you don't develop these extreme phobias, your quality of life
can be severely damaged by untreated panic disorder. A recent study
showed that people who suffer from panic disorder:
are more prone to alcohol and other drug abuse
have greater risk of attempting suicide
spend more time in hospital emergency rooms
spend less time on hobbies, sports and other satisfying activities
tend to be financially dependent on others
report feeling emotionally and physically less healthy than
non-sufferers.
are afraid of driving more than a few miles away from home
Panic disorders can also have economic effects. For example, a recent
study cited the case of a woman who gave up a $40,000 a year job that
required travel for one close to home that only paid $14,000 a year.
Other sufferers have reported losing their jobs and having to rely on
public assistance or family members.
None of this needs to happen. Panic disorder can be treated
successfully, and sufferers can go on to lead full and satisfying
lives.
How Can Panic Disorder Be Treated?
Most specialists agree that a combination of cognitive and behavioral
therapies are the best treatment for panic disorder. Medication might
also be appropriate in some cases.
The first part of therapy is largely informational; many people are
greatly helped by simply understanding exactly what panic disorder is,
and how many others suffer from it. Many people who suffer from panic
disorder are worried that their panic attacks mean they're 'going
crazy' or that the panic might induce a heart attack. 'Cognitive
restructuring' (changing one's way of thinking) helps people replace
those thoughts with more realistic, positive ways of viewing the
attacks.
Cognitive therapy can help the patient identify possible triggers for
the attacks. The trigger in an individual case could be something like
a thought, a situation, or something as subtle as a slight change in
heartbeat. Once the patient understands that the panic attack is
separate and independent of the trigger, that trigger begins to lose
some of its power to induce an attack.
The behavioral components of the therapy can consist of what one group
of clinicians has termed 'interoceptive exposure.' This is similar to
the systematic desensitization used to cure phobias, but what it
focuses on is exposure to he actual physical sensations that someone
experiences during a panic attack.
People with panic disorder are more afraid of the actual attack than
they are of specific objects or events; for instance, their 'fear of
flying' is not that the planes will crash but that they will have a
panic attack in a place, like a plane, where they can't get to help.
Others won't drink coffee or go to an overheated room because they're
afraid that these might trigger the physical symptoms of a panic
attack.
Interoceptive exposure can help them go through the symptoms of an
attack (elevated heart rate, hot flashes, sweating, and so on) in a
controlled setting, and teach them that these symptoms need not develop
into a full-blown attack. Behavioral therapy is also used to deal with
the situational avoidance associated with panic attacks. One very
effective treatment for ...
