Panic Attacks

The purpose of this material is to explain Panic Attack Disorder. It could help you to decide if you have this problem, and may offer solutions to managing panic attacks. It is intended for educational information only. If you believe, after reading this, that you might have PAD, you should see your physician who can either diagnose and treat you, or refer you to a specialist.

One of the most important things to learn about panic is the understanding of panic itself. Once it happens, a person's life changes dramatically. A panic attack has the ability to bring on the fastest and most complex changes known in the human body. It can be an overwhelming, uncontrollable dread, as if one is terribly ill, about to die or lose one's mind. It can drastically change the functioning of major glands, heart, lungs, stomach, intestines, pancreas, kidneys, bladder, eyes, and the largest muscle groups. A cascade of stimulants and hormones - adrenaline, epinephrine, glycogen, cortical, nor epinephrine, among others - floods the cells of the body via the bloodstream. The impulse is to run, get out, or hide.

The cause comes from the belief that one is trapped and helpless, by some overwhelming threat. While panic can happen as a consequence of crime or disaster, it doesn't matter whether the threat is real. Often, panic happens after several weeks or months of stress. It happens more often with persons who are very worried, perfectionist, socially avoidant, or who have had abuse in childhood.  Panic impersonates itself as a variety of medical disorders. Panic can mimic certain medical conditions, causing years of misdiagnosis. These can include hypoglycemia, complex partial seizures, drug effects, heart arrhythmia and hyperventilation syndrome. Panic partly mimics others: angina, asthma, irritable bowel, colitis, vertigo, mitral valve prolapse, post concussion syndrome, hypertension, postural hypo tension, and hiatal hernia. Yet panic can be easily diagnosed by professionals who are experienced in panic attacks.After 8 to 10 years of mostly misdirected treatment, you found that periods of panic would be followed by 1 or 2 years of some relief, only to return stronger than before. Because you still didn't know your condition, you began to feel a bit alien and became good at hiding you condition. You slowly began to give up on friendships, social life, travel, work ambition and other life plans. If male, you began a period of heavier drinking, as a way of self-medication. A kind of chronic, low grade depression set in along with lowered expectations in life. You started to get resigned to your prison.

While panic is almost always part of agoraphobia, social phobia, or any phobia, it can also turn up in other anxiety disorders, such as in obsessive-compulsives who experience panic, particularly around the need to stop the rituals of washing, checking, or cleaning. Those who have post-traumatic stress disorder do panic at least occasionally, and sometimes regularly. These persons have undergone a major trauma such as rape, assault, a natural disaster, combat, major surgery, and early childhood abuse of all kinds. Sometimes panic disorder exists in a person by itself, but is much more common with the above conditions.

Panic is also associated with some personality disorders but is not essential to their diagnosis. The avoidant personality is very shy, sees rejection everywhere, and shrinks from people. The obsessive-compulsive person is perfectionist and has excessive needs to control. The borderline personality is disorganized, quite vulnerable emotionally, and has stormy relations. 

Signs and Symptoms

The main symptom of a Panic Disorder is the panic attack itself. Panic Attack Disorder is a medical disorder characterized by severe and sudden episodes. It is important to mention that sudden episodes of the symptoms listed above caused by another reasonable cause are not panic attacks. Two such reasonable causes would be (1) a certain medical ailment that might mimic a panic attack, or (2) a life threatening experience immediately preceding the attack. If these reasonable causes are found not be the cause of the problem then there is the possibility of a Panic Disorder. Panic attacks reach maximum intensity within a minute or two once they begin. They diminish slowly over the next 30 minutes or the next several hours. It is common for the first attack to cause a person to go to an emergency medical facility. Subsequent attacks occur several times a month and are often as severe as the initial attack.

Diagnostic and Statistical Manual of Mental Disorders (DSM)

The Diagnostic and Statistical Manual of Mental Disorders (DSM) is the standard classification of mental disorders used by mental health professionals in the United States . It is intended to be applicable in a wide array of contexts and used by clinicians and researchers of many different orientations. DSM-IV has been designed for use across settings, inpatient, outpatient, partial hospital, consultation-liaison, clinic, private practice, and primary care, and with community populations and by psychiatrists, psychologists, social workers, nurses, occupational and rehabilitation therapists, counselors, and other health and mental health professionals.

Panic Attacks

Definition: Panic Attacks are comprised of discrete period of overwhelming anxiety and fear. Panic attacks come abruptly and for no apparent reason. After the onset of the panic attack a person will experience both physical and mental discomfort. These symptoms both physical and mental peak in about ten minutes. Panic attacks subside as abruptly as they begin, lasting anywhere from seconds to several hours. Most Panic Attacks do however pass in a few minutes and only in rare cases last several hours. The frequently of these attacks may vary from several times a day to only once or twice a year. After the onset of the first attack many people develop anticipatory anxiety.

ONSET: Any Age

Diagnostic Criteria ( DSM-IV ):

NOT DUE TO A SUBSTANCE, GENERAL MEDICAL CONDITION, OR OTHER DISORDER.

Discrete period of intense fear and physical / mental discomfort with four or more of the following:

1. Chills or hot flushes.

2. Derealization or Depersonalization

3. Discomfort or pain in your chest.

4. Feelings of choking.

5. Feelings of going crazy or losing control are common.

6. Feelings of lightheadedness, dizzy, faint, or unsteady.

7. Nausea or abdominal discomfort.

8. Palpitation, heart pounding or rate increase.

9. The fear of dying is common.

10.Trembling / shaking.

11.Sensation of not being able to breath or shortness of breath.

12. Sensations of tingling or numbness 

13. Sweating.

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