Understanding Panic Attacks
The most essential thing to learn about panic attacks are the experience of panic itself. Once it happens, a person’s life changes dramatically. Panic attacks bring on the fastest and most complex changes known in the human body. It is experienced as overwhelming, uncontrollable dread, as if one is terribly ill, about to die or lose one’s mind. It drastically changes the the functioning of major glands, heart, lungs, stomach, intestines, pancreas, kidneys, bladder, eyes, and the largest muscle groups. Even violent poisons or traumatic injuries have less effect. A cascade of stimulants and hormones – adrenaline, epinephrine, glycogen, cortical, norepinephrine, among others – flood all the cells of the body via the bloodstream. The impulse is to run, get out, or hide.
The immediate cause is believing one is trapped and helpless, by some overwhelming threat. While panic can happen as a consequence of crime or disaster, it doesn’t matter whether the threat is real. Often, panic happens after several weeks or months of stress. It happens more often with persons who are very worried, perfectionist, socially avoidant, or who have had abuse in childhood. Heredity may play some part. What keeps panic going, and getting more intense and frequent, is worrying excessively about it and strenuously avoiding situations that appear to bring panic . Look up Signs and Symptoms of Panic Disorder for more details.
Panic attacks masquerade as a variety of medical disorders. Panic mimics some medical conditions almost completely, causing years of misdiagnosis. These are hypoglycemia, complex partial seizures, drug effects, heart arrhythmia and hyperventilation syndrome. Panic partly mimics others: angina, asthma, irritable bowel, colitis, vertigo, mitral valve prolapse, post concussion syndrome, hypertension, postural hypotension, and hiatal hernia. Almost everyone who panics believes they have a serious physical illness, and go from doctor to doctor for several years as symptoms shift. Yet panic is easily diagnosed by professionals experienced in panic.
About 7.2% of all adults, or 1 in 15, have a panic disorder which is a primary part of their disorder, (NIH, 1993). In any given year, about 1/3 of American adults have at least one panic attack; most of these adults never develop repeated panic attacks. This startling data means that a phobia/panic disorder is the most common emotional disorder, more common than alcohol abuse or depression. Phobia/panic disorder also has the lowest rates for seeking help and finding it, about 22%. Phobia is the most common and the most hidden condition at the same time.
After a few months of panic, about 10% of people become housebound and unable to leave home alone. After a few years, about 30% of panic sufferers have a loss of job, pay or job responsibilities. Some 17% are at risk for alcoholism and about 40% risk a chronic depression as life opportunities are cut off. A majority have marital problems and much reduced travel and social life. The economic cost has been estimated at about $2600/year in misdirected treatment, and about $12,000 a year in lowered job earnings. For most, panic closes life off like a prison.
If you areagoraphobic, there’s a 40% chance you had near relatives who were phobic. You may have suffered early abuse. In addition, there may have been a lot of instability in your home, such as repeated moves or foster care. You have had the usual childhood phobias – snakes, darkness, lightning – and they cleared up by themselves. You may have had your first panic as part of a school phobia.
Yourphobia most likely started with a panic attack about age 23, as if “out of the blue”. After a while you saw that only certain situations brought it on, those in which you were trapped in some way. Just before the first attack, you were likely to have been under unusual stress, responsibility, or loss of security. Then you soon started to avoid those panic situations and to worry and dread going back to them. Very soon you began multiple consultations with several physicians to check out your alarming symptoms, which shifted from year to year. By the end of the first year you were already avoiding crowds, stores, transportation, and closed in spaces. There was a 10% chance you became housebound.
After 8 to 10 years of mostly misdirected treatment, you found that periods of panic would be followed by 1 or 2 years of some relief, only to return stronger than before. Because you still didn’t know your condition, you began to feel a bit alien and became good at hiding you condition. You slowly began to give up on friendships, social life, travel, work ambition and other life plans. If male, you began a period of heavier drinking, as a way of self-medication. A kind of chronic, low grade depression set in along with lowered expectations in life. You started to get resigned to your prison.
After 20 or more years of havingagoraphobia, you found you could get by in safe areas or with a safe friend, but your life became narrow and limited. You became very dependent on your partner to travel. In fact, your relationship got strained as your partner felt increasingly helpless and distant. There was less sexual desire. There was a good chance you had some loss of your work role and impaired work performance. Amazingly, you have not learned what to call your condition. It has become a way of life, the way your life has turned out.
While panic attacks are always part ofagoraphobia,social phobia
,or any phobia, it also turns up some of the time in other anxiety disorders. About 30% of obsessive-compulsives experience panic attacks, particularly around the need to stop the rituals of washing, checking, or cleaning. A good estimate is that about 40% of those of who havepost-traumatic stress disorder do have panic attacks at least occasionally, and sometimes regularly. These persons have undergone a major trauma such as rape, assault, a natural disaster, combat, major surgery, and early childhood abuse of all kinds. Sometimespanic disorder exists in a person by itself, but is much more common with the above conditions.
Panic attacks are associated with somepersonality disorders but is not essential to their diagnosis. The avoidant personality is very shy, sees rejection everywhere, and shrinks from people. The obsessive-compulsive person is perfectionist and has excessive needs to control. The borderline personality is disorganized, quite vulnerable emotionally, and has stormy relations.
By: Amy Korkiakoski – Amy Korkiakoski – amykorkiakoski@anxietypanic.com 