Panic Disorder

People with panic disorder have feelings of terror that strike suddenly and repeatedly with no warning. They can’t predict when an attack will occur, and many develop intense anxiety between episodes, worrying when and where the next one will strike. In between times there is a persistent, lingering worry that another attack could come any minute.

When a panic attack strikes, most likely your heart pounds and you may feel sweaty, weak, faint, or dizzy. Your hands may tingle or feel numb, and you might feel flushed or chilled. You may have chest pain or smothering sensations, a sense of unreality, or fear of impending doom or loss of control.

You may genuinely believe you’re having a heart attack or stroke, losing your mind, or on the verge of death. Attacks can occur any time, even during nondream sleep. While most attacks average a couple of minutes, occasionally they can go on for up to 10 minutes. In rare cases, they may last an hour or more.

Panic disorder strikes between 3 and 6 million Americans, and is twice as common in women as in men. It can appear at any age–in children or in the elderly–but most often it begins in young adults. Not everyone who experiences panic attacks will develop panic disorder– for example, many people have one attack but never have another. For those who do have panic disorder, though, it’s important to seek treatment. Untreated, the disorder can become very disabling.

Panic disorder is often accompanied by other conditions such as depression or alcoholism, and may spawn phobias, which can develop in places or situations where panic attacks have occurred. For example, if a panic attack strikes while you’re riding an elevator, you may develop a fear of elevators and perhaps start avoiding them.

Some people’s lives become greatly restricted — they avoid normal, everyday activities such as grocery shopping, driving, or in some cases even leaving the house. Or, they may be able to confront a feared situation only if accompanied by a spouse or other trusted person. Basically, they avoid any situation they fear would make them feel helpless if a panic attack occurs. When people’s lives become so restricted by the disorder, as happens in about one-third of all people with panic disorder, the condition is called agoraphobia. A tendency toward panic disorder and agoraphobia runs in families. Nevertheless, early treatment of panic disorder can often stop the progression to agoraphobia.

Criteria involved in the diagnosis of Panic Disorder

The experience of recurrent, unexpected Panic Attacks, and at least one of the attacks has been followed by 1 month (or more) of one (or more) of the following:

  • Persistent concern about having future Panic Attacks
  • Excessive worry about the attack itself or its consequences (e.g., “losing it,” “going nuts,”
  • Presence or absence of Agoraphobia.

A panic attack is defined as a discrete period of intense fear or discomfort, where some of the following symptoms appear abruptly and can reach a peak within ten minutes:

  • Pounding heart/accelerated heart rate
  • Sweating
  • Trembling/shaking
  • Shortness of breath
  • Feeling of choking
  • Chest pain or discomfort
  • Nausea
  • Dizziness, lightheadedness
  • Fear of losing control or going crazy
  • Fear of death
  • Chills or hot flushes

If these symptoms seem relevant to you, we can help. Feel free to contact us by calling our main desk at (617) 353-9610, or by emailing Bonnie Brown, our nurse administrator, at bonnieb@bu.edu. Also, if you qualify for one of our ongoing research studies, you may be eligible to receive free treatment as a part of our current research opportunities.

References

American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders, fourth edition. Washington, DC: American Psychiatric Association.

National Institutes of Health, National Institute of Mental Health, NIH Publication No. 95-3879 (1995).

Some information courtesy of Mental Health Net (1999)