Panic disorder is one among the list of anxiety disorders. It is essential to differentiate between panic attack and panic disorder.
Panic Attack and Panic Disorder
- PANIC ATTACK: period of abrupt onset of intense fear and discomfort along with the symptoms, mentioned below, usually peaking within 10 minutes of the onset. Attacks can last for one minutes to 1 hour
Symptoms of a PANIC attack:
P – palpitations, paresthesia, depersonalization,
A – abdominal distress,
N – nausea
I – intense fear of dying, intense fear of losing control “going crazy”, light headedness
C – chest pain, chills, choking,
S – sweating, shortness of breath “air hunger”
- PANIC DISORDER: Panic disorder is a chronic illness characterized by recurrent panic attacks which are not triggered or expected without a clear circumscribed stimulus and associated with ≥ 1 month of: (1) persistent concern of having additional attacks or (2) worrying about consequences of attacks or (3) significant maladaptive behavioral changes related to the attack
Treatment for panic disorder has several approaches. Usually, therapies and pills go hand-in-hand.
It involves educating the patient that their symptoms are neither from a serious medical condition nor from a psychotic disorder, but rather from a chemical imbalance in the fight-or-flight response.
Cognitive behavior therapy includes applied relaxation, exposure in vivo, exposure through imagery, panic management, breathing retraining, and cognitive restructuring.
Cognitive-behavioral therapy (CBT) helps patients to understand how automatic thoughts and false beliefs/distortions lead to exaggerated emotional responses, such as anxiety, and how they can lead to secondary behavioral consequences.
C. BEHAVIOURAL THERAPY:
It employs graded exposure to anxiety-provoking stimuli.
Selective serotonin reuptake inhibitor
Relapse is common therefore a person needs to be kept on medication for 6-12 months
American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. Fifth Edition. Arlington, VA: American Psychiatric Association; 2013.
Rosenberg NK, Mellergård M, Rosenberg R, Beck P, Ottosson JO. Characteristics of panic disorder patients responding to placebo. Acta Psychiatr Scand Suppl. 1991. 365:33-8. [Medline].
PETER HAM, M.D., DAVID B. WATERS, PH.D., and M. NORMAN OLIVER, M.D.
University of Virginia School of Medicine, Charlottesville, Virginia
Ocford handbook of medicine
Usmle first aid 2016