Panic Disorder What is Panic Disorder ? Panic Disorder is one of the anxiety disorders. It is characterized by having experiences of intense fear and physical symptoms such as sweating and heart palpitation (i.e., panic attacks) that come suddenly within few minutes without warning or any obvious reasons. Although they occur in situations that are usually not threatening, people with panic disorder may feel terrify and worry if they are having a heart attack, going “crazy” or even going to die. They also have persistent fear of having future panic attacks and avoid situations that they believe the attacks are likely to occur again. Such worries and avoidance can cause significant impairment on their daily functioning. What are the causes of Panic Disorder ? A number of factors may be involved in the causes of panic disorders. Stressful life events and major life transitions, such as long-term unemployment, loss of a loved one can trigger panic disorders. Initially, when people are under considerable stress, the brain’s normal mechanism for reacting to a threat is activated. This is the so-called “flight-or-fight” response. Nonetheless, as such attacks seem to come “out of the blue”, they are usually interpreted as signs of life-threatening disease or “going crazy”. Subsequently, when mild bodily responses to external triggers (like exercising, caffeine consumption) were realized, some people develop an intense apprehension of having another attack and such heightened anxiety then could actually bring on a panic attack. Do I have Panic Disorder ? Panic disorder is marked by recurrent, spontaneous panic attacks and constant worry about having another attack or the cause of the attack. A panic attack is a sudden and intense period of fear or discomfort that comes without any reasons or signals. During the attack, at least 4 or more of the following symptoms are experienced: 1) Quick or pounding heart rate 2) Sweating 3) Shaking 4) Difficult to breathe 5) Shortness of breath or choking 6) Chest pain or discomfort 7) Nausea 8) Dizziness, sense of going to faint 9) Hots and chills 10) Tingling sensation or numbness over limbs 11) Derealization or depersonalization 12) Fear of dying 13) Fear of losing control, going crazy The Course of Panic Disorder ? Having the experience of first one or two panic attacks, some people will start to worry about having the coming back of panic attacks. These worries may also be specific to where the first attack took places, e.g. at confounding places like inside the tunnel or elevators, or crowded situations like a busy shopping mall. They then begin to avoid these situations, going outdoors or going out alone and develop “agoraphobia”. These are mainly because they have to avoid all situations that can trigger an attack or situation they might not be able to get help. Subsequently, the quality of life, including their social life and work, can be severely affected by the disorder. What are the treatments to Panic Disorder ? 1) Medication Some anti-depressants and anti-anxiety medications are used to treat panic disorders. You should seek professional advice from doctors for the use of medications. 2) Psychological Treatment Cognitive-behaviour therapy (CBT) is empirically one of the best psychological treatments to panic disorder and agoraphobia. In CBT, one of the most frequently used techniques is exposure therapy. The main objective in exposure is to deal with the situational avoidance and actual physical sensations in panic attacks. Patients will learn to face and manage those situations they previously avoided (e.g. crowded areas or elevators) by in vivo exposure; or handle the panic symptoms by interoceptive exposure. In addition, relaxation training and cognitive restructuring on the appraisals towards panic attacks are also major parts of psychological treatment.