Research

Panic Anxiety Education
Management Services

An Analysis of Uncued Panic Attacks
in Panic Disorder - Part6

RESULTS

Investigation into Changes and increased sensitivities

Table 13. shows the results of physical changes and increased sensitivities observed since first experiencing a panic attack or limited symptom attack.

Table 13. Perceived changes occurring since first panic/ anxiety attack.

Changes in physical responses	Panic Disorder participants	Other Anxiety Disorder participants
Feel that your nervous system is functioning differently	78%	28%
Taste sensitivity is increased	25%	6%
Sensitivity to fluorescent lights	53%	25%
Feel fluorescent lights cause panic and anxiety	36%	14%
Sensitivity to medication increased	44%	8%
Highly sensitive/ allergic to certain foods	17%	8%
Sensitive to humidity, heat of summer	64%	17%
Sensitivity to noise increased	89%	22%
Sensitivity to smell increased	47%	11%
Sensitivity to light increased	64%	25%

Many of the changes/increased sensitivities have been reported by Panic and Anxiety Disorder people for many years. The results show significant perceived changes, especially among Panic Disorder participants. Compared to other Anxiety Disorder participants, a higher proportion of Panic Disorder participants report that they feel their nervous system is functioning differently than it had before they experienced their first panic attack (78% vs 28%, P<0.002). Also Panic Disorder participants reported significant increased sensory sensitivity compared to other Anxiety Disorder participants ie. sensitivity to noise increased (89% vs 22%), sensitivity to light increased (64% vs 25%), increased sensitivity to humidity, heat of summer (64% vs 17%), sensitivity to fluorescent lights (53% vs 25%) and sensitivity to medication increased (44% vs 8%).
Interesting results include 36% of Panic Disorder participants feel that fluorescent lights can cause anxiety or a panic attack. This corresponds with a proportion of "spontaneous" panic attacks that occur in supermarkets/ places with fluorescent lighting.

CONCLUSIONS

The hypothesis investigated was the role of fear and the triggering of the adrenal "fight and flight response" within the panic attack. The results show a distinction between the 'energy' experienced in a panic attack and that of a rush of adrenalin energy. In general, a significant proportion of Panic Disorder participants report the fear response does not trigger until after they experience the 'energy' movement or dissociative experience. The Panic Disorder participants do not in fact experience these as adrenal. The three major fears of Panic Disorder are the fear of losing control, fear of dying and the fear of going insane. These three major fears arise quite expectedly because of the magnitude of what is actually happening during a panic attack. The experience is beyond the level of 'normal' experience, the energy movement is overwhelmingly beyond the person's control and the dissociative experiences are beyond normal experience. The person experiences the energy and dissociative experiences and then reacts with fear. The difference in results between Anxiety Disorder and Panic Disorder eliminate the probability of labelling the energies as anxiety symptomatic.

Model of Structure of a panic attack

Prior
Energy felt... May experience one or more of the following: 'Unusual' intense flows of 'energy' throughout the body, electric current moving through the body, wave-like motion of energy moving through the body, vibration moving through the body, white hot flame through the body, rushes of energy shaking the body, intense heat or burning pain moving through the body and less predominantly, ice cold sensation through the body. Energies may be moving in one of the 6 energy movement models defined.

Dissociation... May experience one or more of the following: your body feels expanded so that you feel huge/larger than normal, your body feels shrunk to minute proportions/smaller than usual, your eyes are closed and you are unable to open them and your feel as if your are floating, 'witness' of what is happening to you, feel as if you are falling into a void; you and your surroundings do not seem real; experience surroundings through a diffused light, fog or mist; and experience a visual sensation where stationary objects appear to move; whole body enveloped in light.
Physical symptoms... May experience one or more of the following: Sensitivity to light, tunnel vision, diminished vision, tightening of throat, indigestion, burning sensations in the stomach, digestive problems, eyes burning, intolerance to noise.
Breathing... One of the following: shallow breathing (either at a normal rate of inhalation or very rapid [2-3 breaths/sec]; normal rate/normal inhalation; or almost stopped - barely noticeable.
Other... May experience one or more of the following: seeing of 'inner' lights, hearing of 'inner' sounds, spontaneous physical jerking.

During
Energy felt...May experience one or more of the following: hot prickly sensation moving through the body, intense heat or burning pain moving through the body, rushes of energy shaking the body, 'unusual' intense flows of 'energy' throughout the body, electric current moving through the body, vibration moving through the body.
Dissociation... May experience one or more of the following: feel as if you are falling into a void; feel as if you are pressed to ground, you and your surroundings do not seem real; experience surroundings through a diffused light, fog or mist; 'witness' of what is happening to you; "outside" of body either situated alongside, above or behind it; your eyes are closed and you are unable to open them and your feel as if your are floating.
Physical symptoms... May experience one or more of the following: missed heart beats, chest pain, hyperventilation, tightening of throat, difficulty breathing, increased pulse rate, choking sensations, nausea, sensitivity to light, tunnel vision, diminished vision, feeling faint, lightheadedness, giddiness, pins and needles, diarrhoea, shaking/trembling, localised pressure, burning sensation in the stomach, abdominal pain, eyes burning, intolerance to noise, temporary paralysis, hot flashes, flushing face, cold flushes.
Breathing... One of the following: shallow breathing, rapid [2-3 breaths/sec].
Other... May experience one or more of the following: seeing of 'inner' lights, hearing of 'inner' sounds, spontaneous physical jerking.
After
Physical symptoms... May experience one or more of the following: nausea, shaking/trembling, headaches, depression, sensitivity to light, diminished vision, diarrhoea, cold flushes.
Breathing... One of the following: long, slow and deep or shallow (either normal rate of inhalation or very rapid [2-3 breaths/sec]).
Continual
Energy felt... "ants crawling" sensation over the body; ice cold sensation through the body; itching sensation through the body; rippling sensation through the body; tingly sensation; creeping sensation.
Dissociation... May experience one or more of the following: 'witness' of what is happening to you; "outside" of body either situated alongside, above or behind it; you and your surroundings do not seem real; experience a visual sensation where stationary objects appear to move; you feel as if your are floating.
Physical symptoms... May experience one or more of the following: difficulty sleeping, lack of concentration, neck aches, extreme exhaustion, appetite swings, depression, abdominal pain, digestive problems, hot flashes, giddiness, feeling faint, lightheadedness, localised pressure, night sweats, shaking/trembling, headaches, lower back pain, backaches, sciatica, numbness of the hands and feet, migratory unexplainable body pains, recurrent pelvic pains, unexplainable rashes, chronic/temporary pains all over the body.
Other... May experience one or more of the following: sensory sensitivities.

A model for the physiological structure of the uncued panic attack has been developed through the investigation into 'energy' movement, dissociative experiences, physical symptoms, 'inner' light and sound phenomenon, spontaneous physical jerking, breathing, perceived physical changes/increased sensory sensitivities.

References

1. American Psychiatric Association 1980, Diagnostic & Statistical Manual of Mental Disorders, 3rd edn, APA, Washington.
2. American Psychiatric Association 1994, Diagnostic & Statistical Manual of Mental Disorders, 4th edn, APA, Washington.
3. American Psychiatric Association 1987, Diagnostic & Statistical Manual of Mental Disorders, revised 3rd edn, APA, Washington.
4. Thomas W.Udhe: the Anxiety Disorders. Principles and Practice of Sleep Medicine, 2nd edn, 1994, pp 871-94
5. C. Weekes (1962): Self Help for your Nerves. London: Angus & Robertson pp33.
6. J. Hafner (1986). Marriage and Mental Illness. New York: The Guildford Press pp 39
7. Sheehan (1983). The Anxiety Disease. Charles Scribner's Son N-1.
8. G.W. Brown & T.O. Harris: Aetiology of Anxiety and Depressive Disorders in an inner-city population. 1. Early adversity. Psychological Medicine, 1993, 23, pp 143-154.
9. E. Bliss (1986): Multiple personality, allied disorders, and hypnosis. Oxford University Press, New York, pp 188-89
10. E. Bernstein PhD & F. Putnam MD (1986): Development, Reliability, and Validity of a Dissociation Scale. The Journal of Nervous and Mental Disease, Vol. 174, No. 12, pp 727-32.

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