What is panic disorder? Symptoms of panic disorder plus description of panic attack and how can you overcome it.

Imagine this: you've just entered your office building. You're headed for the elevator at a trot--maybe a little late. You punch the button. Suddenly you feel an intense sense of foreboding. Then raw fear. Something terrible is about to happen. You feel as if you may die the next second.

The elevator doors open. But you're too frightened to get on. You stand there in the lobby with your heart pounding, barely able to breathe. Other office workers file past you, looking back over their shoulders to see if something is wrong.

Something is. What's happened and what happens regularly to one in fifty people is a panic attack, the "crisis phase" of panic disorder. The crushing fear of the panic attack most often passes after a few minutes, but in its wake it leaves a residue of uneasiness: when might the panic come again?

"I'm just freaking out and I feel like my body's freaking out. I mean the shaking and the breathing and the sweats, and the heart and the pain in the chest--I feel like I'm going to have a heart attack or something. Except I never do..."

Panic Disorder Sufferer

Everyone has anxious times. Modern life, with its pace, its pressures to perform and produce, and its difficult relationships, seems at times almost to be a factory for stress. But the normal life's normal strains are not the stuff of panic disorder. The panic attacks stemming from the illness often strike in familiar places where there is seemingly "nothing to be afraid of." But when the attack comes, it comes as if there were a real threat, and the body reacts accordingly. Surroundings can take on an unreal cast, and a combination of symptoms sparks like the current in a crosswired fire alarm: the heart races, breathing gets shallower and faster, the whole nervous system signals: DANGER. The person suffering under this barrage may be convinced he or she is having a heart attack or stroke, or that he or she is going crazy or going to die.

Researchers have determined that panic attacks are usually classified as being part of a panic disorder if they occur frequently (one or more times during a given four-week period) and are accompanied by at least four of the following symptoms:

• Sweating
• Shortness of breath
• Heart palpitations
• Chest discomfort
• Unsteady feelings
• Choking or smothering sensations
• Tingling
• Hot or cold flashes
• Faintness
• Trembling
• Nausea or abdominal distress
• Feelings of unreality
• Fears of losing control, dying, or going insane

Not all attacks or all people have the same symptoms.

The sense of danger and physical discomfort the panic attacks bring is so intense that many interpret them as the precursors of a heart attack or stroke, or the product of a brain tumor. Consequently, many panic disorder sufferers show up in emergency rooms where doctors unfamiliar with the illness judge that the patient is in no danger and send them home. This embarrassing process may repeat itself many times if the proper diagnosis isn't made.

"Most of my attacks came on when I was on the subway, and it got to the point where I couldn't take the subway anymore and it was affecting my work because I would be out of work a lot from not being able to take the subway. But eventually, I made myself take the subway, though I still experienced the attacks."
(Panic Disorder Sufferer)

Trying to Avoid More Panic Attacks

Once a panic disorder sufferer's first attack begins to ebb, he or she may be tempted to believe it was a fluke. The EKG showed nothing untoward; the emergency room doctor said to go home and get some rest, that he or she was probably only overtired. The jagged emotions seem like a dim memory until the next time.

When another attack does come, the panic disorder sufferer naturally begins to search for a cause. Often, he or she will begin to avoid situations or places where episodes have occurred. He or she may stop going to the ballpark, or avoid driving or riding elevators, since these activities seem to be triggers. The sufferer may even become reclusive, reasoning that it's better to suffer alone than to endure the attacks in the open where there's no escape from the fear and humiliation and little chance of help. This paring away of accustomed patterns is called phobic avoidance. It may help temporarily with the fear of the attack and its accompanying loss of control, but it makes a normal home and work life nearly impossible. It steals the savor from life. And it doesn't keep the attacks from happening.

Untreated panic disorder can produce other side effects. Fear of the fear the attacks bring, or anticipatory anxiety, can be one unfortunate outgrowth. The sufferer never knows when another attack will come, and is always steeled for it. Studies have shown that agoraphobia, literally "fear of the marketplace," is often coupled with panic disorder. It can drive those with panic disorder to skirt public places, though paradoxically they fear being alone. This pattern may progress to the point that the panic disorder victim fears leaving his or her home without a trusted companion, or fears leaving home, period. Obviously this is wearing to the sufferer's family and friends. Those who must leave the house for the office can also suffer front a sort of agoraphobia which leaves them shackled to their route between home and office, unable to deviate from their workaday pattern.

Confined to such a limited lifestyle which puts so much strain on relations with friends and family, panic disorder sufferers also more easily become prey to depression and its complications than does the average person. Recent studies have suggested also that two out of three people with panic disorder also experience depression over their lifetime. Also, panic disorder sufferers often further complicate their illness with drug and alcohol abuse. This form of "self medication" is sadly ironic: researchers believe that drugs or alcohol themselves pull down mood and worsen anxiety, condemning the victim of panic disorder to a downward spiral of anxiety, depression, and more panic.

"But the thing that made me so frightened, I think, was just not knowing what was wrong with me."
(Panic Disorder Sufferer)