In panic disorder, a person suffers from brief attacks of intense terror and apprehension that cause trembling and shaking, confusion, dizziness, nausea, difficulty breathing, and feelings of impending doom or a situation that would be embarrassing. One who is often plagued by sudden bouts of intense anxiety might be said to be afflicted by this disorder. The American Psychiatric Association (2000) defines a panic attack as fear or discomfort that arises abruptly and peaks in 10 minutes or less, and can occasionally last hours.
Although panic attacks sometimes seem to occur out of nowhere, they generally happen after frightening experiences, prolonged stress, or even exercise. Many people who have panic attacks (especially their first one) think they are having a heart attack and often end up at the doctor or emergency room. Even if the tests all come back normal the person will still worry, with the physical manifestations of anxiety only reinforcing their fear that something is wrong with their body. Heightened awareness (hypervigilance) of any change in the normal function of the human body will be noticed and interpreted as a possible life threatening illness by an individual suffering from panic attacks.
Normal changes in heartbeat, such as when climbing a flight of stairs will be noticed by a panic sufferer and lead them to think something is wrong with their heart or they are about to have another panic attack. Some begin to worry excessively and even quit jobs or refuse to leave home to avoid future attacks. Panic disorder can be diagnosed when several apparently spontaneous attacks lead to a persistent concern about future attacks.
Occurrence
Panic Disorder is a serious health problem but can be successfully treated. It is estimated that up to 1.7 percent of the adult American population has Panic Disorder at some point in their lives. It typically strikes in early adulthood; roughly half of all people who have Panic Disorder develop the condition before age 24, especially if the person has been subjected to a traumatic experience. However, some sources say that the majority of young people affected for the first time are between the ages of 25 and 30. Women are twice as likely as men to develop Panic Disorder.
Panic Disorder can continue for months or even years, depending on how and when treatment is sought. If left untreated, it may worsen to the point where the person's life is seriously affected by panic attacks and by attempts to avoid or conceal the condition. In fact, many people have had problems with friends and family or employment while struggling to cope with Panic Disorder. Some people with Panic Disorder may begin to lie to conceal their condition. In some individuals symptoms may occur frequently for a period of months or years, then many years may pass symptom-free. In others, the symptoms persist at the same level indefinitely. There is also some evidence that many individuals (especially those who develop symptoms at an early age) may experience a cessation of symptoms naturally later in life (i.e. past age 50).
DSM-IV Criteria
DSM-IV diagnostic criteria for panic disorder with (or without) agoraphobia:
A. Both (1) and (2):
recurrent unexpected panic attacks
at least one of the attacks has been followed by 1 month (or more) of one (or more) of the following:
persistent concern about having additional attacks
worry about the implications of the attack or its consequences (e.g., losing control, having a heart attack, "going crazy")
significant change in behavior related to the attacks
B. The presence (or absence) of agoraphobia C. The panic attacks are not due to the direct physiological effects of a substance (e.g., a drug of abuse, a medication) or a general medical condition (e.g., hyperthyroidism). D. The panic attacks are not better accounted for by another mental disorder, such as social phobia (e.g., occurring on exposure to feared social situations), specific phobia (e.g., on exposure to a specific phobic situation), obsessive-compulsive disorder (e.g., on exposure to dirt in someone with an obsession about contamination), post-traumatic stress disorder (e.g., in response to stimuli associated with a severe stressor), or separation anxiety disorder (e.g., in response to being away from home or close relatives).
Checklist
Take this test, then print it out and show the results to your health care provider.
Are you troubled by:
Yes No
Repeated, unexpected "attacks" during which you suddenly are overcome by intense fear or discomfort, for no apparent reason?
During this attack, did you experience any of these symptoms?
Yes No
Pounding heart
Yes No
Sweating
Yes No
Trembling or shaking
Yes No
Shortness of breath
Yes No
Choking
Yes No
Chest pain
Yes No
Nausea or abdominal discomfort
Yes No
"Jelly" legs
Yes No
Dizziness
Yes No
Feelings of unreality or being detached from yourself
Yes No
Fear of dying
Yes No
Numbness or tingling sensations
Yes No
Chills or hot flashes
Yes No
Do you experience a fear of places or situations where getting help or escape might be difficult, such as in a crowd or on a bridge?
Yes No
Does being unable to travel without a companion trouble you?
For at least one month following an attack, have you:
Yes No
Felt persistent concern about having another one?
Yes No
Worried about having a heart attack or going "crazy"?
Yes No
Changed your behavior to accommodate the attack?
Having more than one illness at the same time can make it difficult to diagnose and treat the different conditions. Illnesses that sometimes complicate an anxiety disorder include depression and substance abuse.
With this in mind, please take a minute to answer the following questions:
Yes No
Have you experienced changes in sleeping or eating habits?
More days than not, do you feel:
Yes No
Sad or depressed?
Yes No
Disinterested in life?
Yes No
Worthless or guilty?
During the last year, has the use of alcohol or drugs:
Yes No
Resulted in your failure to fulfill responsibilities with work, school, or family?
Yes No
Placed you in a dangerous situation, such as driving a car under the influence?
Yes No
Gotten you arrested?
Yes No
Continued despite causing problems for you and/or your loved ones?
Although panic attacks sometimes seem to occur out of nowhere, they generally happen after frightening experiences, prolonged stress, or even exercise. Many people who have panic attacks (especially their first one) think they are having a heart attack and often end up at the doctor or emergency room. Even if the tests all come back normal the person will still worry, with the physical manifestations of anxiety only reinforcing their fear that something is wrong with their body. Heightened awareness (hypervigilance) of any change in the normal function of the human body will be noticed and interpreted as a possible life threatening illness by an individual suffering from panic attacks.
Normal changes in heartbeat, such as when climbing a flight of stairs will be noticed by a panic sufferer and lead them to think something is wrong with their heart or they are about to have another panic attack. Some begin to worry excessively and even quit jobs or refuse to leave home to avoid future attacks. Panic disorder can be diagnosed when several apparently spontaneous attacks lead to a persistent concern about future attacks.
Occurrence
DSM-IV Criteria
A. Both (1) and (2):
B. The presence (or absence) of agoraphobia
C. The panic attacks are not due to the direct physiological effects of a substance (e.g., a drug of abuse, a medication) or a general medical condition (e.g., hyperthyroidism).
D. The panic attacks are not better accounted for by another mental disorder, such as social phobia (e.g., occurring on exposure to feared social situations), specific phobia (e.g., on exposure to a specific phobic situation), obsessive-compulsive disorder (e.g., on exposure to dirt in someone with an obsession about contamination), post-traumatic stress disorder (e.g., in response to stimuli associated with a severe stressor), or separation anxiety disorder (e.g., in response to being away from home or close relatives).
Checklist
Are you troubled by:
For at least one month following an attack, have you:
Having more than one illness at the same time can make it difficult to diagnose and treat the different conditions. Illnesses that sometimes complicate an anxiety disorder include depression and substance abuse.
With this in mind, please take a minute to answer the following questions:
More days than not, do you feel:
During the last year, has the use of alcohol or drugs: