Panic Disorder

Just the Facts

What is a Panic Attack?

• A panic attack is a period of intense fear or discomfort.
• Typically it has an abrupt onset.
• Usually it lasts no more than 30 minutes

Physiological Symptoms

• Racing, skipping, or pounding heartbeat
• Chest pains, pressure, discomfort
• Dizziness, lightheadedness, nausea
• Shortness in breath, difficulty breathing
• Trembling or shaking
• Sweaty or clammy hands
• Choking sensations or lump in the throat
• Stomach problems or sudden diarrhea
• Tingling or numbness in parts of the body
• Flushes or chills
• Dreamlike sensations or perceptual distortions
• Terror — a sense that something unimaginably a sense that something unimaginably horrible is about to occur and one is powerless to prevent it
• Fear of losing control and doing something embarrassing
• Fear of dying

From Panic Attack to Panic Disorder

A panic attack typically lasts for several minutes and is one of the most distressing conditions that a person can experience. Most who have one attack will have others. When someone has repeated attacks, or feels severe anxiety about having another attack, he or she is said to have panic disorder.

Prevalence & Epidemiology

At least 1.6 percent of adult Americans, or 3 million people, will have panic disorder at some time in their lives. Epidemiologic data collected from a variety of countries have documented similarities in lifetime prevalence (1.6% - 2.2%).

Age at first onset typically in a person's twenties. While the full-blown syndrome is usually not present until early adulthood, limited symptoms often occur much earlier. Women are affected twice as frequently as men.

Family studies using direct interviews of relatives and family history studies have shown that panic disorder is highly familial. Results from studies conducted in different countries (United States, Belgium, Germany, Australia) have shown that the average risk of panic disorder is 8 times higher in first-degree relatives with degree relatives with panic disorder.

A recent family data analysis showed that those with early onsets (at age 20 or before) were the most familial, carrying a risk that is 17 times greater. Results from twin studies have also suggested a genetic contribution to the disorder.

Associated Features

• A fear of dying
• "Going crazy"
• "Totally losing touch with reality"
• Losing control of emotions or behavior

The experience generally provokes a strong urge to escape or flee the place where the attack began. When associated with chest pain or shortness of breath, frequently results in seeking aid from a hospital emergency room or other type of urgent assistance.

Comorbidity

Panic attacks are often experienced by sufferers of:

• Anxiety disorders
• Agoraphobia
• Other psychological conditions involving anxiety

What type of disorders?

• Social phobia = about 30%
• Generalized anxiety disorder = about 25%
• Specific phobia = about 20%
• Obsessive-compulsive disorder = about 15%

90.4% of panic disorder patients also met criteria for at least one other psychiatric diagnosis.

• Only 6.8% of the panic disorder sample met DSM-IV criteria for panic disorder alone.
• 31% of the panic disorder sample had two psychiatric diagnoses
• 29.1% had three diagnoses
• 33% had four or more diagnoses

Panic Disorder to Agoraphobia

The high comorbidity rate makes treating the debilitating symptoms of a panic attack more difficult and complex. Furthermore, approximately one-half of people with panic disorder at some point develop such severe avoidance as to warrant a separate description of panic disorder with agoraphobia.

Agoraphobia is typically thought of as a fear of public places. However, with panic disorder, agoraphobia is actually a fear of being someplace where escape is difficult, for example in a crowded street, theater, church, subway, driving on a bridge, or a shopping mall. The person with agoraphobia fears that a panic attack might take place and they would be unable to get to safety.

More about Panic Attacks and Anxiety Disorders at BrainPhysics...

Disclaimer: This information should not be considered medical advice and should not substitute the judgment of a competent psychiatrist.

Credits: Excerpted from Eda Gorbis, PhD, MFT; Jenny C. Yip, PsyD; Using Interoceptive Exposure to Treat Panic Attacks Comorbid with other Anxiety Disorders (go there now).