About 2 percent of people in the United States suffer from panic disorder during any given year, and the condition affects more than twice as many women as men. People with panic disorder may experience panic attacks frequently, such as daily or weekly, or more sporadically. Additionally, panic attacks may occur as part of other anxiety disorders, such as phobias-in which a specific object or situation triggers the attack-and, more rarely, post-traumatic stress disorder.
People with panic disorder frequently develop agoraphobia, a fear of being in places or situations from which escape might be difficult if a panic attack occurs. People with agoraphobia typically fear situations such as traveling in a bus, train, car, or airplane, shopping at malls, going to theaters, crossing over bridges or through tunnels, and being alone in unfamiliar places. Therefore, they avoid these situations and may eventually become reluctant to leave their home. In addition, people with panic disorder appear to have an increased risk of alcoholism and drug dependence. Some studies indicate they also have a higher risk of depression and suicide.
Causes Of Panic DisorderPanic disorder, both with and without agoraphobia, results from a combination of biological and psychological factors. Some individuals may inherit a vulnerability to stress and anxiety and an increased risk of experiencing panic attacks. In addition, certain physiological cues may trigger a panic attack. For example, if a person experiences a racing heart during a panic attack, he or she may begin to associate this sensation with panic attacks. A rapid heartbeat, even if caused by exercise, may then trigger future panic attacks.
Not everyone who experiences a panic attack develops panic disorder. For example, most people experience a rapid heartbeat after running but do not perceive the sensation as dangerous. Those who develop panic disorder tend to interpret their physical sensations as more terrible than they really are. Some psychologists believe that early childhood experiences of separation from important people, such as parents, increase the risk of developing panic disorder.
Panic Disorder Treatments Mental health professionals usually treat panic disorder with medications, specialized psychotherapy, or a combination of both. Benzodiazepines, a group of tranquilizing drugs that includes alprazolam (Xanax) and diazepam (Valium), often reduce anxiety with few physical side effects. However, these medications can be addictive and may impair movement and concentration in some people. Some antidepressant drugs, such as imipramine (Tofranil), also reduce panic symptoms in some people but can produce side effects such as dizziness or dry mouth. Another class of drugs, selective serotonin reuptake inhibitors (SSRIs), appear to reduce panic symptoms with fewer side effects. SSRIs used to treat panic disorder include paroxetine (Paxil) and fluvoxamine (Luvox). Medication eliminates panic symptoms in 50 to 60 percent of patients. For many patients, however, panic attacks return when they stop taking the medication.
Research has shown that cognitive-behavioral therapy, a type of psychotherapy, eliminates panic attacks in 80 to 100 percent of patients. In this method, therapists help patients re-create the physical symptoms of a panic attack, teach them coping skills, and help them to alter their beliefs about the danger of these sensations. Patients with agoraphobia face their feared situations under the therapist’s supervision, using coping skills to overcome their strong anxiety. These coping skills may include physical relaxation techniques, such as deep breathing and muscle relaxation, as well as cognitive techniques that help people think rationally about anxiety-provoking situations. About 70 percent of panic disorder patients who also have moderate to severe agoraphobia benefit from this type of treatment.
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