Detailed info on medications for treating panic disorder including antidepressants and benzodiazepine tranquilizers.

A Case History

Ann was watching television after a typical workday. She suddenly developed a peculiar and very strong feeling of being lightheaded and a smothering sensation as if there were no oxygen in the air she was breathing. Then a surge of pounding rapid heartbeat began. It came on so quickly and was so severe that she became panicked that she might be dying of a heart attack! Then she felt very shaky, sweaty, and unsteady. This whole experience reached peak intensity within 60 seconds. This was the eighth such attack this month.

PANIC

"Panic" was hardly the word to describe how terrified she was feeling. It went beyond any feeling of fear that she had ever experienced. Although she had gone to the emergency room several times, nothing seemed to be found by the doctors to explain why she kept having the attacks.

She frantically searched for her car keys so that she could get to the hospital immediately. She thought desperately, "What's wrong with me?"

What it feels like

The main symptom of a Panic Disorder is the panic attack itself. Panic Disorder is a medical disorder characterized by severe and sudden episodes or "attacks" with several of the following symptoms:

• Panic, Fear of Losing Control or Dying
• Pounding Heartbeat
• Difficulty Breathing
• Smothering Sensation
• Chest Pain or Discomfort
• Tingling Numbness of The Skin
• Choking Sensation
• Lump In Throat
• Hot or Cold Feeling
• Sweatiness
• Shakiness
• Nausea
• Feelings of Unreality (Familiar Things Feel Odd)

It is important to mention that sudden episodes of the above symptoms caused by another reasonable cause are not panic attacks. Two such reasonable causes would be (1) a certain medical ailment that might mimic a panic attack, or (2) a life threatening experience immediately preceding the attack. If these reasonable causes are found not be the cause of the problem then there is the possibility of a Panic Disorder.

Panic attacks reach maximum intensity within a minute or two once they begin. They diminish slowly-over the next 30 minutes or the next several hours. It is common for the first attack to cause a person to go to an emergency medical facility. Subsequent attacks occur several times a month and are often as severe as the initial attack.

About three fourths of Panic Disorder patients are women. Panic Disorder begins most often when people are 20-30 years old. It begins less often in teenagers or persons in their forties. It is uncommon for the disorder to appear in the elderly for the first time.

It is important to note that although a few experts say it is more common in persons who experienced a separation experience as a child, many of experts feel that Panic Disorder afflicts emotionally healthy people. Persons with Panic Disorder are no more likely than the average American to have suffered from emotional problems at the time the disorder begins.

Afraid of Something

Persons experiencing repetitive, severe panic attacks may simply have panic attacks and that is all. Other persons may begin to experience a progression of bothersome or distressing panic attack "side effects". This progression commonly occurs as follows:

1. A few weeks or months prior to the first panic attack there are sometimes minor symptoms such as rapid heart beat.

2. The first major panic attack occurs. The person often seeks emergency medical evaluation at this time. The initial examination is commonly normal.

3. Continued panic attacks cause the person to seek further medical evaluations which may be inconclusive. Many panic attack sufferers go for months or years before receiving the proper diagnosis and by that time may have seen over a dozen physicians, psychologists and counselors. This appearance of "doctor shopping" may cause others to regard the sufferer as a hypochondriac.

4. An individual with Panic Disorder may begin to avoid a certain activity because it occurs to them that it would be especially embarrassing or dangerous to have an attack while engaged in that activity. A typical sufferer of Panic Disorder might think, "It's bad enough to have an attack at all, but it would be dangerous to have one on Interstate 75 because I would be preoccupied with the attack and would not be a safe driver. I might wreck my car, injuring myself or someone else!" This avoidance behavior may appear to be a fear of driving when it is really a fear of having a panic attack while driving.

5. Tendencies to avoid circumstances in everyday life may increase and extend to more activities. This extensive avoidance behavior is referred to as agoraphobia.

   Places, activities or circumstances frequently avoided by persons with Panic Disorder include the following:

   Shopping malls
   Department stores
   Restaurants
   Church
   Meetings
   Classes
   Driving
   Being alone
   Airplanes
   Elevators

6. After months or years of continuous panic attacks and the restricted lifestyle caused by the typical avoidance behavior, the sufferer of Panic Disorder may become demoralized and psychologically or physically depressed.

   Some sufferers turn to alcohol in an attempt to self-medicate or to diminish the symptoms of the disorder. This greatly complicates the individual's life and ability to seek appropriate treatment.

   Tragically, one out of every five untreated sufferers attempts to end his or her life, never realizing that there was hope and treatment available.