Psychiatry has been in charge of anxiety disorders since the end of the 19th century. Now there is a huge array of various anxiety disorders, which range from generalized anxiety disorder to panic disorder, phobias, obsessive-compulsive disorder, post-traumatic stress disorders and even separation anxiety.
Some accounts have the rates of anxiety disorder at 18 percent of American adults having one or more of the disorders. Of 800 Moroccan subjects in a 2007 study, a 20.1 percent rate was generalized to the population with a 99 percent calculated sample size and a confidence level of 666. This indicates that anxiety disorders of various types are a worldwide issue.
Anxiety disorders manifest in general anxiety and fear, often with physiological symptoms of headache, excessive sweating, heart palpitations, hypertension and muscle spasms. Of the anxiety disorders, Panic Disorder can be one of the most dangerous and debilitating. Some episodes can involve sudden loss of consciousness, trembling, dizziness, difficulty in breathing or shortness of breath(hyperventilation and dypsnea), a feeling of choking, and even symptoms that mimic heart attacks.
There are recurring and severe panic attacks and often significant change in behavior that lasts at least a month. The added worries about having panic attacks can lead to “anticipatory attacks”.
Panic attacks are distinctly different from agoraphobia, but may accompany agoraphobic types of disorder at a rate of 39 percent of panic disorder sufferers. The attacks are generally brief, lasting from a minute to twenty minutes. They can require hospitalization or medical intervention and can be completely debilitating.
The origins of panic disorder can be genetic, with an added connection to bipolar disorder and alcoholism. Life situations can include post-traumatic stress disorder, stressful jobs, events, or transitions in life style or circumstances. A propensity toward thoughts that result in exaggerated physical reactions can also be a precursor.
Caffeine and other stimulants can trigger panic attacks, and there is a link between substance abuse and panic attacks. Smoking, alcohol and sedatives, and some withdrawal syndromes have connections, also.
There are some ideas that hypoglycemia, hyperthyroidism and other conditions might be causes of panic disorders.
For a diagnosis, a patient has to have no other explanatory cause, such as another mental disorder or the result of a substance. There must be both recurrent and unexpected attacks, followed by a month or more of persistent worries about more attacks, worries about the social and other implications of the attack, and a significant change in behavior that relates to the attacks.
Treatment is generally successful. For the immediate attack, square breathing, where the identical amount of time to breathe in, hold, and breathe out air is highly effective. Biofeedback has been promising in teaching individuals to control their bodies.
For the general condition, there is psychotherapy, cognitive behavioral therapy to fix the thinking processes. Being able to identify the major stresses in life and to deal with them is very effective.
There may be accompanying clinical depression, alcoholism and agoraphobia that take more work and care. Difficult or problematic families who do not support well are roadblocks to recovery.
Drug therapy should be a last resort for more severe cases of panic disorder, but combined with psychotherapy, can have good results.
The first thing for the patient with panic disorder to know is that they are not “crazy” and should not put up with any social stigma that is associated with having the disorder.
References:
Nadia Kadri, et al, “Prevalence of anxiety disorders: a population-based epidemiological study in metropolitan area of Casablanca, Morocco”, 2007
http://www.annals-general-psychiatry.com/content/6/1/6
Wikipedia, “Panic Disorder”
http://en.wikipedia.org/wiki/Panic_disorder
