Panic Disorder: An Endless Loop

In Unit 12, we discussed the many psychological disorders that exist, what categorizes them, and in Unit 13, how to treat them. One of the categories of psychological disorders we learned about were the anxiety disorders. Panic disorder, an anxiety disorder, is characterized by four "stages," which are on a continuous loop. The first is body sensations, in which an unusual bodily sensation (e.g. pounding heart), makes you react with fear that something bad is going to happen. The second is a panic attack, where your continued over-reaction to the bodily sensations triggers more fear and eventually leads to a full-fledged panic attack. The third is high anxiety: Once the panic attack subsides, you are left feeling anxious and in a very sensitive state. And the fourth is fear of fear. You fear of having another panic attack keeps your anxiety levels high and this leads to further unusual bodily sensations. The panic loop is now established. 

Panic disorder is like "anxiety on steroids," and can occur at any time. The person will feel as if they are going to die. Sometimes it is caused by something specific, other times not. However, the fear and dread of having another attack is completely frightening. Panic attacks are characterized by this intense terror of disaster or of losing control even when there is no real, imminent danger. A person can also have a physical reaction during a panic attack, and may feel as if they are having a heart attack. Panic disorder sometimes runs in families, but there is no concrete evidence for why some have it and others do not. Researchers have found several parts in the brain associated with fear and anxiety (the amygdala, for example), and are also further investigating the relative contributions of stress and environment. 

According to the National Institute of Mental Health, people with panic disorder may have the following: "sudden and repeated attacks of fear, a feeling of being out of control during a panic attack, an intense worry about when the next attack will happen, a fear or avoidance of places where panic attacks have occurred in the past, and physical symptoms during an attack, such as a pounding or racing heart, sweating, breathing problems, weakness or dizziness, feeling hot or a cold chill, tingly or numb hands, chest pain, or stomach pain." 

As aforementioned, these attacks occur spontaneously, even during sleep. An attack typically peaks at 10 minutes, but the symptoms may endure for a longer period. The panic disorder can be so encompassing that if it materializes in say, an elevator, some with panic disorder may begin to fear elevators in general. It's a crippling condition. Some people become so disabled by the disorder that they cannot participate in daily activities or lead normal lives. About one-third become housebound and it spirals into agoraphobia, and they are only able to confront a feared situation when in the company of a spouse or other trusted individual.  Panic disorder is often accompanied by other  problems, such as depression, drug abuse, or alcoholism. 

Panic disorder affects approximately 6 million American adults and is twice as prevalent in women as men. Panic attacks usually begin in late adolescence or early adulthood, but not everyone who experiences panic attacks will develop panic disorder. Many people have just one attack and never have another. Although it appears to be inherited, panic disorder is highly treatable, usually by using psychotherapy, specifically cognitive therapy, or medicine, and sometimes both.