Panic Attacks, The disorder and causes.
Panic disorder is an anxiety disorder characterized by recurring severe panic attacks.
It may also include significant behavioral change lasting at least a
month and of ongoing worry about the implications or concern about
having other attacks. The latter are called anticipatory attacks (DSM-IVR). Panic disorder is not the same as agoraphobia
(fear of public places), although many with panic disorder also suffer
from agoraphobia. Panic attacks cannot be predicted, therefore an
individual may become stressed, anxious or worried wondering when the
next panic attack will occur. There are other schools of thought that Panic disorder is differentiated as a medical condition, or chemical imbalance.
The DSM-IV-TR describes Panic disorder and Anxiety differently. Panic
attacks have a sudden or out-of-blue cause that lasts shorter with more
intense symptoms, as opposed to Anxiety attacks having stressors that
build to less severe reactions and can last for weeks or months.
Panic attacks can occur in children, as well as adults. Panic in young
people may be particularly distressing because the child has less
insight about what is happening, and his/her parent is also likely to
experience distress when attacks occur.
Signs and Symptoms of a Panic Attack Or Disorder
Panic disorder sufferers usually have a series of intense episodes of extreme anxiety during panic attacks.
These attacks typically last about ten minutes, but can be as
short-lived as 1–5 minutes and last as long as twenty minutes or until
medical intervention. However, attacks can wax and wane for a period of
hours (panic attacks rolling into one another), and the intensity and
specific symptoms of panic may vary over the duration. Common symptoms
of an attack include rapid heartbeat, perspiration, dizziness, dyspnea, trembling, uncontrollable fear
and hyperventilation. Other symptoms are sweating, shortness of breath,
sensation of choking, chest pain, nausea, numbness or tingling, chills
or hot flashes, and some sense of altered reality. In addition, the person usually has thoughts of impending doom.
Individuals suffering from an episode have often a strong wish of
escaping from the situation that provoked the attack. The anxiety of
Panic Disorder is particularly severe and noticeably episodic compared
to that from Generalized Anxiety Disorder. There are instances when
panic attacks are provoked by exposure to certain stimuli e.g. seeing a
mouse. Other attacks may emanate out of nowhere or in specific settings
e.g. the dentist's office.
Some individuals deal with these events on a regular basis, sometimes
daily or weekly. The outward symptoms of a panic attack often cause
negative social experiences (e.g. embarrassment, social stigma, social isolation, etc.).
Limited symptom attacks are similar to panic attacks, but have fewer symptoms. Most people with PD experience both panic attacks and limited symptom attacks.
Limited symptom attacks are similar to panic attacks, but have fewer symptoms. Most people with PD experience both panic attacks and limited symptom attacks.
Causes?
here is no single cause for panic disorder, however, panic disorder has been found to run in families, and suggests that inheritance
plays a strong role in determining who will get it. It has also been
found to exist as a co-morbid condition with many hereditary disorders,
such as bipolar disorder, and a genetic predisposition to alcoholism.
Psychological factors, stressful life events, life transitions,
environment, and thinking in a way that exaggerates relatively normal
bodily reactions are also believed to play a role in the onset of panic
disorder. Often the first attacks are triggered by physical illnesses,
major stress, or certain medications.
People who tend to take on excessive responsibilities may develop a
tendency to suffer panic attacks. Post-traumatic stress disorder (PTSD) patients also show a much higher rate of panic disorder than the general population.
There is some evidence to suggest hypoglycemia, hyperthyroidism, mitral valve prolapse, labyrinthitis, pheochromocytoma and respiratory conditions can cause or aggravate panic disorder.
Prepulse inhibition has been found to be reduced in patients with Panic Disorder.
Stimulants like caffeine, in excess, are a rather common cause for panic attacks. Many SSRIs also have stimulant side-effects during the beginning of treatment which may exacerbate the condition and have actually caused first-time panic attacks in otherwise healthy individuals being treated for depression.
Flöttmann describes the genesis of panic psychodynamically. Panic is a stress symptom. Fear is characteristic of each developmental stage because of feeling of guilt or symbiotic binding. Floating fear or panic stands for the parental stressing call: "Come back to me. You'll panic in your life, you'll have fear of sexuality, fear of separation from me, of being autonomous, and you'll have fear in any situation in your life! You'll feel anxiously, if you do anything that is separating you from mother or father. Don't grow up!" It is the panic that appears in any developmental moment of life.
There are other researchers looking at some individuals with panic disorder as having a chemical imbalance within the limbic system and one of its regulatory chemicals GABA-A. The reduced production of GABA-A sends false information to the amygdala which regulates the body's "fight or flight response" mechanism and in return, produces the physiological symptoms that lead to the disorder. Clonazepam, an anticonvulsant benzodiazepine with a long half-life, has been successful in keeping the condition in check.
There is some evidence to suggest hypoglycemia, hyperthyroidism, mitral valve prolapse, labyrinthitis, pheochromocytoma and respiratory conditions can cause or aggravate panic disorder.
Prepulse inhibition has been found to be reduced in patients with Panic Disorder.
Stimulants like caffeine, in excess, are a rather common cause for panic attacks. Many SSRIs also have stimulant side-effects during the beginning of treatment which may exacerbate the condition and have actually caused first-time panic attacks in otherwise healthy individuals being treated for depression.
Flöttmann describes the genesis of panic psychodynamically. Panic is a stress symptom. Fear is characteristic of each developmental stage because of feeling of guilt or symbiotic binding. Floating fear or panic stands for the parental stressing call: "Come back to me. You'll panic in your life, you'll have fear of sexuality, fear of separation from me, of being autonomous, and you'll have fear in any situation in your life! You'll feel anxiously, if you do anything that is separating you from mother or father. Don't grow up!" It is the panic that appears in any developmental moment of life.
There are other researchers looking at some individuals with panic disorder as having a chemical imbalance within the limbic system and one of its regulatory chemicals GABA-A. The reduced production of GABA-A sends false information to the amygdala which regulates the body's "fight or flight response" mechanism and in return, produces the physiological symptoms that lead to the disorder. Clonazepam, an anticonvulsant benzodiazepine with a long half-life, has been successful in keeping the condition in check.