Panic (or severe anxiety) that occasionally happens when we encounter a stressful or serious event with drastic outcomes is normal. However, when a person has severe, recurrent panic attacks which cause significant impairment to his life, he may be suffering from panic disorder.  

Personality factors, stressful life events, transition periods in a new environment and a past traumatic experience can increase the probability of developing panic disorder.

Signs and Symptoms of Panic Disorder

The following symptoms are commonly used to diagnose panic disorder:

• Recurrent, unexpected panic attacks
• At least one of the attacks is followed by any of the following for a month:
• Persistent concern about having additional attacks (anticipatory anxiety)
• Worry about the implications of the attack or its consequences (for example, losing control, having a heart attack and “going crazy”)
• Significant change in behaviour related to the attacks

Sufferers often experience:

• A sudden and unexpected onset of pounding heartbeat
• Shakes
• Cold sweat
• Breathlessness
• Dizziness, unsteadiness or faintness
• Choking
• Nausea or abdominal stress
• Feeling of unreality
• Numbness or tingling in the hands and feet
• Hot and cold flashes
• Chest pain or discomfort 
• Fears of going crazy or losing control

These are conditions associated with intense fear and tension. Sufferers and their families often mistake the physical symptoms of panic attack as a medical condition (for example, heart problems or a severe asthmatic attack), and therefore present themselves to the Accident and Emergency department of the nearest hospital. The physical and laboratory examinations, however, may not show that there is anything physically wrong with the sufferer.

How to Treat Panic Disorders

If untreated, the panic attacks usually occur several times a week or even daily. Recurrent attacks may continue for several weeks or months and may even continue for years especially if associated with agoraphobia. During this time there may be periods of full or partial remission (i.e., with no panic attacks or only mild attacks with few symptoms). 

Early assessment and treatment are essential. Psychotherapy is effective in addressing panic disorder and where appropriate, antidepressants may be prescribed. People with panic disorder may need treatment for other emotional problems that may arise because of the disorder. These include clinical depression or alcohol/tranquiliser abuse which can interfere with recovery.

Psychotherapy

Cognitive behavioural therapy (CBT) is an effective treatment for panic disorder. CBT helps a person identify and reconstruct negative automatic thoughts and beliefs linked to an experience that provokes panic. Other forms of psychotherapy such as interpersonal psychotherapy (IPT) and psychodynamic therapy have also shown benefits. These therapies can help by working through conflicts in interpersonal relationships — including problems in early relationships from childhood that are affecting present relations. Relaxation techniques are useful and can be used to stop or prevent symptoms of anxiety from escalating into panic.

Other forms of psychotherapy such as interpersonal psychotherapy (IPT) and psychodynamic therapy have also shown benefits. These therapies can help by working through conflicts in interpersonal relationships — including problems in early relationships from childhood that are affecting present relations. Relaxation techniques are useful and can be used to stop or prevent symptoms of anxiety from escalating into panic.

Medication 

Antidepressant medicines alter the chemical imbalance in the brain, which helps to block symptoms of panic. These medicines can treat both the anxiety and depressive symptoms that may coexist in many sufferers.

A combination of psychotherapy and medication can often produce good results, with noticeable improvements within six to eight weeks. Psychotherapy can improve the effectiveness of medication, help people who have not responded to medicines, and reduce the likelihood of relapse for those who have discontinued medication. 

Other Support

Many sufferers will also benefit from self-help or support groups, and community resources such as available helplines. There are also many websites with useful information for people to find out more about this condition. Better awareness of this condition and professional help will enable sufferers to better deal with this illness. A healthy lifestyle including positive thinking, stress management  and proper diet, is also essential for good mental health.

To make an appointment to see a doctor, please call 6389 2200.