Obsessive-Compulsive Disorder (OCD)

In OCD, a person becomes trapped in a pattern of repetitive thoughts and behaviors that are senseless and distressing but extremely difficult to overcome. Such rituals as counting, prolonged handwashing, and repeatedly checking for danger may occupy much of the person's time and interfere with other activities. Today, OCD can be treated effectively with medications or cognitive-behavioral therapies.

Alcohol Abuse

About 30 percent of people with panic disorder abuse alcohol. A person who has alcoholism in addition to panic disorder needs specialized care for the alcoholism along with treatment for the panic disorder. Often the alcoholism will be treated first.

Drug Abuse

As in the case of alcoholism, drug abuse is more common in people with panic disorder than in the population at large. In fact, about 17 percent of people with panic disorder abuse drugs. The drug problems often need to be addressed prior to treatment for panic disorder.

Suicidal Tendencies

Recent studies in the general population have suggested that suicide attempts are more common among people who have panic attacks than among those who do not have a mental disorder. Also, it appears that people who have both panic disorder and depression are at elevated risk for suicide. (However, anxiety disorder experts who have treated many patients emphasize that it is extremely unlikely that anyone would attempt to harm himself or herself during a panic attack.)

Anyone who is considering suicide needs immediate attention from a mental health professional or from a school counselor, physician, or member of the clergy. With appropriate help and treatment, it is possible to overcome suicidal tendencies.

There are also certain physical conditions that are often associated with panic disorder:

Irritable Bowel Syndrome

The person with this syndrome experiences intermittent bouts of gastrointestinal cramps and diarrhea or constipation, often occurring during a period of stress. Because the symptoms are so pronounced, panic disorder is often not diagnosed when it occurs in a person with irritable bowel syndrome.

Mitral Valve Prolapse

This condition involves a defect in the mitral valve, which separates the two chambers on the left side of the heart. Each time the heart muscle contracts in people with this condition, tissue in the mitral valve is pushed for an instant into the wrong chamber. The person with the disorder may experience chest pain, rapid heartbeat, breathing difficulties, and headache. People with mitral valve prolapse may be at higher than usual risk of having panic disorder, but many experts are not convinced this apparent association is real.

CAUSES OF PANIC DISORDER

The National Institute of Mental Health supports a sizable and multifaceted research program on panic disorder—its causes, diagnosis, treatment, and prevention. This research involves studies of panic disorder in human subjects and investigations of the biological basis for anxiety and related phenomena in animals. It is part of a massive effort to overcome the major mental disorders, an effort that is taking place during the 1990s—the Decade of the Brain. Here is a description of some of the most important new research on panic disorder and its causes.

Genetics

Panic disorder runs in families. One study has shown that if one twin in a genetically identical pair has panic disorder, it is likely that the other twin will also. Fraternal, or non-identical twin pairs do not show this high degree of "concordance" with respect to panic disorder. Thus, it appears that some genetic factor, in combination with environment, may be responsible for vulnerability to this condition.

NIMH-supported scientists are studying families in which several individuals have panic disorder. The aim of these studies is to identify the specific gene or genes involved in the condition. Identification of these genes may lead to new approaches for diagnosing and treating panic disorder. Families interested in participating in such a study should call the NIMH at (301) 496-8977.