What is a Panic Disorder?
Panic disorder is one of several anxiety disorders in which the patient experiences repeating bouts of severe anxiety or fear. During panic attacks, people experience intense fear and anxiety which may include the fear of losing one’s mind or the fear of having a heart attack. More common in women than in men, panic disorder typically first emerges in the patient’s twenties or thirties, though adolescents also develop this syndrome.In the United States alone, 2.4 million adults are suspected to have panic disorder.
Panic disorder can be distinguished from generalized anxiety disorder, or GAD, primarily through the level of intensity. GAD, which is characterized by an excessive and irrational worry, is more common than panic disorder and its symptoms are more long-lasting. By contrast, the panic attacks which occur during panic disorder are acute and short-lived and displays definite beginning and endpoints.
Symptoms of Panic Disorder
Panic disorder is associated with both physical and psychological symptoms. Common physical symptoms of panic attacks include:
- Elevated heart rate
- Chest pain or chest discomfort
- Feeling faint
- Shortness of breath and hyperventilation
- Trembling or shaking
- Tingling or numbness
- Body temperature changes, including both chills for some people and hot flashes for others
- The sensation of choking
Common psychological symptoms of panic disorder include:
- Fear of death
- Fear of losing control
- Fear of going mad
- A surreal experience of an altered reality or detachment
- Claustrophobia or agoraphobia
Causes of a Panic Disorder
There is no single cause of panic disorder. Recent studies suggest that panic disorders tend to run in families – for example, if one identical twin has it, the other twin will also develop the disorder 40% of the time – but heredity is certainly not the only cause of panic disorder.
More commonly, various psychological factors are associated withpanic disorder. For example, major life transitions or stressful events, such as divorce, a death in the family or job loss, can all trigger the onset of the disorder. People with post-traumatic stress disorder are also much more likely to develop panic disorder, as are people suffering from chronic stress.
Certain physical conditions can also lead to panic attacks. All of the following conditions are associated with panic attacks:
- Cardiac problems, including mitral valve prolapse
- Inflammation of the inner ear
- Respiratory conditions
Sometimes, the first panic attack comes after a serious physical illness or as a result of taking certain medications. At other times, panic disorder develops as a symptom of withdrawal from a particular medication.
There’s also a strong correlation between panic disorder and other psychological problems, including recurring depression, bipolar disorder and substance abuse. In the case of substance abuse, panic disorder can be triggered by stimulant drugs. Cocaine, nicotine, excessive caffeine, methamphetamines and other stimulants can all begin the cycle of a panic attack. Likewise, alcohol abuse can exacerbate panic disorder.
Ironically, panic disorders can also trigger substance abuse. For instance, someone who suffers from frequent panic attacks may begin to abuse alcohol in an attempt to lessen the frequency or severity of their symptoms. Unfortunately, in the long run this attempt to self-medicate is counter-productive, as studies show that alcohol abuse only makes panic disorder worse.
After the initial panic attacks emerge, a panic attack can be triggered again whenever the patient feels that he or she is under threat. The “threat” is an exaggerated one that normally would not feel threatening for someone without panic disorder; for example, for people who suffer from panic disorder with agoraphobia, a panic attack can be triggered just by leaving one’s house or going to a public place.
Different Types of Panic Disorder
The two main types of panic disorder are panic disorder with agoraphobia and panic disorder without agoraphobia. Agoraphobia is the fear of open or public places from which a person fears that escape is impossible. Originally, the medical profession assumed that the agoraphobia was the primary psychological disturbance and that panic attacks arose as a result of the agoraphobia. Today, however, it is understood that the panic disorder often comes first, with agoraphobia developing as a secondary symptom. The person suffering from panic disorder usually feels a worry that they might experience an attack while they are in public or in a place where they cannot find help or flee during the attack.
Treatment Options for Panic Disorder
There are both medication-oriented and non-medication-oriented treatments for panic disorder. The medications most often used to treat panic disorder are the drugs known as SSRIs, or selective serotonin reuptake inhibitors. SSRIs have been used for many years to treat both panic and other anxiety disorders. Common panic disorder SSRI medications include Zoloft, Paxil and Celexa. From the SSNRI (selective serotonin and norepinephrine reuptake inhibitors) group, the medications Effexor, Cymbalta and Pristiq are used for panic disorders, and from the benzodiazepine group of medications, lorazepam and clonazepam are also used.
However, these medications may be associated with side effects.. Therefore, rather than treating panic disorders with medication alone, many clinicians will utilize a treatment strategy that uses some combination of medication and specific psychotherapies.
Panic Disorder FAQ
How does panic disorder differ from GAD or phobic conditions?
As mentioned above, generalized anxiety disorder is characterized by a constant level of excessive worry. By contrast, panic disorder is characterized by brief bouts of severe panic attacks, characterized by the symptoms listed above.
As for phobic conditions, such as social phobia, panic disorder is not the same as a phobia. Sometimes, phobias can result from panic disorder, but phobias can also result from other circumstances. For example, a bad experience with a particular animal, person or situation can give rise to a panic whenever that particular stimulus is seen or thought of again. Panic disorder, on the other hand, need not be related to a specific stimulus and in fact the reasons for a particular panic attack can be difficult to determine.
What happens if panic disorder goes untreated?
It is unfortunate that the majority of people who suffer from panic disorder never seek treatment for their condition. In this case, panic attacks can continue unabated for many years. The ongoing panic attacks can then develop into other mental illnesses, including the self-medication problems mentioned above but also including the development of phobias, depression, poor performance at work or school, suicidal behavior, etc. Because of the physical stress a panic attack places upon the body, people who undergo repeated panic attacks for many years are also at greater risk for developing heart disease.
Can panic disorder ever completely go away?
Perhaps one reason that people do not seek treatment for their panic disorder is the fear that they can never be completely cured. With this pessimistic point of view, they forgo treatment, feeling that they are a hopeless case.
In reality, however, panic disorder can be managed so that patients experience few – if any – symptoms of the disorder. Panic disorder can be difficult to treat; as mentioned above, there is no single cause for panic disorder, so uncovering the root of the problem and properly treating it does take time and sometimes patients experience dead ends in their treatment and have to try something different.
Over the long term, patients suffering from panic disorder can learn to change their way of thinking and their lifestyle so that panic attacks become less and less frequent. Eventually, many patients who have diligently followed a proper treatment plan will experience a cessation or near-cessation of all their panic disorder symptoms. The predisposition to panic attacks may still be present, but for these patients the symptoms of panic disorder gradually disappear.
Why Use Bridges to Recovery Residential Treatment for Panic Disorder?
A residential treatment program for panic disorder, such as the treatment program at Bridges to Recovery, offers many advantages over similar treatment offered in an out-patient setting. To begin with, the residential treatment model enables individuals suffering from panic disorder to take a “time out” in their lives to spend time addressing the underlying causes perpetuating their experience of panic disorder. During their time at Bridges to Recovery, these individuals can spend time journaling, attending both private and group therapy sessions, engaging in physical exercise and cultural outings, and learning new ways of thinking to replace automatic negative thoughts with more realistic and constructive thoughts and perceptions.
The treatment facilities at Bridges to Recovery are comfortable and private. Each of the three Southern California locations has a private chef who prepares nutritious, personalized meals; a housekeeper who handles laundry and cleaning; wireless computer networks to enable patients to keep in touch with friends, families, and the workplace; and areas where patients can socialize and relax.
If you’re suffering from a panic disorder and haven’t experienced success with other forms of treatment, contact Bridges to Recovery today to inquire about our residential treatment options. The time you spend at our treatment facility will be both relaxing as well as instructive. You will leave knowing that you have made significant progress in the management of your panic disorder.