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Managing panic disorder

Panic disorder is characterised by sudden episodes of acute apprehension or intense fear that occur “out of the blue” without any apparent cause. Intense panic usually lasts no more than a few minutes, but in unusual instances, can return in waves for a period of up to two hours.

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Prevalence

About 20% of adults will experience at least one panic attack at some time in their lives.
Panic disorder tends to have a sudden onset, most frequently during late 20s and early 30s with most patients vividly remembering their first episodes.

Symptoms / What to expect

During the panic episode itself, the following symptoms can occur:

  • Shortness of breath
  • Heart palpitations
  • Dizziness, unsteadiness, or faintness
  • Choking
  • Sweating
  • Nausea or abdominal distress
  • Feeling of unreality
  • Numbness or tingling in hands and feet
  • Hot and cold flashes
  • Chest pain or discomfort
  • Fears of going crazy or losing control

Panic disorder may be associated with no impairment in social or occupational functioning, or else may be associated with extreme impairment, particularly if combined with agoraphobia. Panic disorder, in general is a chronic disorder, although its course is variable both among patients and within patients.

If untreated, the panic attacks usually occur several times a week or even daily. Recurrent attacks may continue for several weeks or months and may even continue for years especially if associated with agoraphobia. During this time there may be periods of full or partial remission (i.e., with no panic attacks or only mild attacks with few symptoms).

Causes

  • Genetics – Specific hereditary vulnerability
  • Biochemical – The nor-adrenergic system plays a significant role in the origin of panic attacks. In people who suffer from panic attacks, the nor-adrenergic system fluctuates easily and is prone to higher level of stimulation
  • Cognitive – Misinterpretation of physical sensations as threatening or having a serious medical condition

Treatment

Bio-psycho-social intervention.

  • Pharmacological – Medications eg. anti-depressants and sedatives (short-term)
  • Psychological – Behaviour therapy, relaxation exercises family education
  • Social – Appropriate adjustments to environmental factors

Seek treatment early. Don’t suffer unnecessarily. Help is available and effective.

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