Panic Disorder:
Panic Attacks and Agoraphobia
What is panic disorder?
Panic disorder is a fairly common condition in which a person has
uncomfortable episodes of fear or anxiety that occur suddenly (often
without warning). The attacks--called panic attacks--can last from
minutes to hours. They may occur only seldomly, or quite frequently.
The cause, or "trigger," for these attacks may not be obvious
right away.
What happens during a panic attack?
Panic attacks are often associated with physical symptoms such as
shaking, a feeling your heart is pounding or racing, sweating, chest
pain, shortness of breath, a feeling of choking, nausea, cramping,
diarrhea, dizziness, an out-of-body sensation (a feeling of being
apart from oneself), tingling in the hands, chills or hot flashes,
and headache. A person may also have an extreme fear of losing control,
going crazy or dying during a panic attack. It is very rare for
a person to have all of these symptoms at once, although the presence
of at least 4 symptoms strongly suggests the diagnosis of panic
disorder.
Often, just the fear of having the symptoms of a panic attack is
enough to trigger the symptoms. This can lead to agoraphobia. With
agoraphobia, a person finds it difficult to leave home or another
safe area because of the fear of having a panic attack in public
or of not having an easy way to escape if the symptoms start.
Many of the symptoms that occur during a panic attack are the same
as the symptoms of diseases of the heart, lung, intestine or nervous
system. The similarities of panic disorder to other diseases may
add to the person's fear and anxiety during and after a panic attack.
Should I seek treatment if I'm having panic
attacks?
Because of embarrassment or the fear of taking medicine, many people
who have panic attacks don't seek medical care. These people avoid
the simple treatments that can help control their problem. If you
have panic attacks, it is very important to seek medical care and
discuss your problem with your doctor. After you have been evaluated
thoroughly, your doctor will be able to tell you if the panic attacks
are related to panic disorder or are caused by another problem.
Will medicines help my panic disorder?
Several medicines make panic attacks less severe or stop them altogether.
Of the many antidepressants used, paroxetine (brand name: Paxil)
and sertraline (brand name: Zoloft) have been approved by the U.S.
Food and Drug Administration (FDA) to treat panic disorder. Antidepressants
are very effective in preventing anxiety and panic attacks, and
they often completely stop the attacks. You don't have to be depressed
for them to help. Side effects are rare and usually mild. Antidepressants
will not make you lose control or change your personality. These
medicines can be used for as long as necessary, even for years.
Of the other medicines used, alprazolam (brand name: Xanax) and
clonazepam (brand name: Klonopin) are approved by the FDA for panic
disorder. These medicines work by giving relief from fear and anxiety.
They should be used for only a short period of time (a few weeks
to a few months), unless you absolutely can't function without them.
Never suddenly stop taking them. If you want to stop, they should
be slowly tapered off over several weeks under your doctor's supervision.
Would counseling help?
Several kinds of psychologic counseling are very effective for treating
panic disorder and are as effective as medicine. Counseling does
not work as fast as medicine. The combination of both psychologic
counseling and medicine seems to be the best treatment for panic
disorder.
How long does treatment last?
How long treatment should continue depends on you. The complete
elimination of panic attacks is a reasonable goal. Your doctor will
design a treatment plan just for you. A treatment period lasting
at least 6 to 9 months is usually recommended. Some people with
panic disorder are able to stop taking medicine after only a short
time, and some people need treatments over long periods of time
or even for their lifetime.
Who can I contact for more information?
For more information about panic attacks,
panic disorder and agoraphobia, and perhaps for the location of
support groups in your area, you can write or call one of the following:
Anxiety Disorders Association of America
11900 Parklawn Drive
Suite 100
Rockville, MD 20852-2624
Telephone: 301-231-9350
National Institute of Mental Health
NIMH Public Inquiries
6001 Executive Blvd.,
Room 8184, MSC9663
Bethesda, MD 20892-9663
Telephone: 800-647-2642
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