Introduction
One of my special clinical interests is panic disorder. Panic disorder is an example of the link between mind and body and how they can have a strong impact on each other. About 6 million American adults ages 18 and older, or about 2.7 percent of people in this age group struggle with this disorder. (NIMH)
Symptoms
Patients generally report repeated, generally unpredictable episodes of extreme fear and discomfort starting suddenly and peaking within 10 minutes. Common symptoms during these episodes called “panic attacks” are:
- hyperventilation or shortness of breath
- fast heart rate or palpitations
- chest pain
- trembling or shaking
- numbness or tingling in fingers and other extremities
- feelings of choking
- nausea
- dizziness or lightheadedness
- chills or hot flashes
- feelings that the world is unreal (derealization)
- feelings that the patient is observing herself from the outside (depersonalization)
- fears of losing control or going crazy
- fears of dying
Diagnosis
Panic disorder is diagnosed clinically, based on history. There is no blood test or imaging test that is diagnostic for panic disorder. That being said, the symptoms of panic disorder mimic many medical illnesses, including potentially life-threatening conditions like heart attack or stroke. It is critical for the patient to be medically cleared before arriving at the diagnosis of panic disorder.
Treatment
Treatment can involve psychotherapy, medications, or combined treatment, depending on patient preference and severity of symptoms.
- Psychotherapy: Cognitive Behavioral Therapy (CBT) has been proven to be very effective for panic disorder. The CBT workbook my patients have found to be most helpful for panic disorder is Mastery of Your Panic and Anxiety Workbook by Craske and Barlow. Many patients find it helpful to go through the workbook and suggested exercises with the guidance of a mental health professional, though the workbook is made to be self-guided.
- Medications: The most commonly used medications for treating panic disorder are the selective serotonin reuptake inhibitors (SSRI’s) and benzodiazepenes. These medications can be prescribed by your primary care doctor, or by your psychiatrist.
- Combined Treatment: For some patients, the combination of psychotherapy and medications is the most effective form of treatment. If CBT is successful, patients are often able to eventually decrease or even stop their medications.
For Further Information
See the Anxiety Disorders Association of American (ADAA) website, or contact a qualified mental health professional.
Article written 8/30/09 by Minyang Mao, M.D.
Disclaimer: This article is intended as an educational resource only, and is not intended to be a replacement for treatment. For evaluation and treatment, please contact a qualified mental health professional.