Panic disorder is a form of anxiety in which patients suffer recurrent crises or panic attacks. Thus, the crises recur unexpectedly because there is no obvious sign of threat or trigger at the time of symptom onset.
Symptoms of a panic attack
The person who suffers a panic attack or panic attack suddenly feels discomfort and intense fear, almost terror. This sensation is accompanied by a series of bodily symptoms that increase the anxiety of the sufferer.
- Dyspnea: sensation of suffocation or difficulty in breathing.
- Chest pain, usually accompanied by tachycardia and palpitations.
- Elevated sweating, usually in the hands.
- Dysphagia: feeling that you cannot swallow.
- Tremors, which appear first in the upper extremities, but may involve the whole body. The person feels as if shaken by an electric current.
- Dry mouth.
- Lack of thermal regulation, sensations of intense heat and cold.
- Dizziness and vertigo, which are also often accompanied by headache.
- Digestive discomfort, from mild pain to vomiting.
Duration of a panic attack
This experience usually reaches its maximum intensity within a few minutes and can last up to half an hour. During the panic attack it is easy for the person to cry because of the fear itself. When the attack is over, the person feels extremely tired, close to exhaustion.
Evolution of panic disorder
In spite of being of short duration, for those who suffer from it, it lasts forever. Usually, people suffer a panic attack that “leaves its mark” on them. This fear leads the patient to avoid certain situations or places and avoid certain things: those that could resemble the moment or place where he/she had his/her first experience with the panic attack; for example, if it happened in a supermarket, he/she will not go to this establishment, of course… But it is also possible that he/she makes what is called an overgeneralization, and not only does not go to the supermarket, but tries to avoid any store where there is a queue at the cash register, where there is a certain light or where there may be a lot of people.
In addition, you are likely to start considering all stores in terms of whether or not you can get help if you have a new panic attack. This leads to increased avoidance behaviors. If the attacks are repeated, the person will expand the “danger places”: public transport, the cinema, crowds, elevators…
These thoughts arise automatically, since the brain of the affected person is very quick in the interpretation of the alarm signal, and in many occasions it is not possible to discriminate if the physiological symptoms appear first, product of the activation of the hypothalamus-pituitary-adrenal axis and after this trigger comes the thought, or if the sequence is the inverse, the subject’s own thought becomes a threat and triggers the whole physiological response.
Risks of panic disorder
One of the complications for people suffering from panic disorder is the possibility of developing demoralization due to the precarious equilibrium in which they live, and this can lead to a real depressive syndrome.
Another risk is the possibility of developing a pathological pattern of alcohol consumption, if the person with panic attacks finds that alcohol initially helps him/her to cope with distressing situations, or self-medication, usually with benzodiazepines, consumed without proper medical control.
Agoraphobia
Then, the patient not only presents the diagnosis of panic disorder, but has developed agoraphobia. But agoraphobia refers to the fear provoked by actual or anticipatory exposure to a wide range of situations.
Treatment of anxiety and agoraphobia
For the panic disorder it is usually essential to prescribe a treatment by the specialist in Psychiatry, which is usually:
- A pharmacological approach that combines at first some type of anxiolytic to reduce anticipatory anxiety or to jugular the crises, with an antidepressant drug, which reduce and control the frequency of these. Obviously, the intake of drugs will be under strict control by a specialist.
- A psychotherapeutic approach, of cognitive-behavioral orientation to minimize the limiting effects on the patient’s life.
Nowadays, the treatment of anxiety is very effective, both for panic attacks and agoraphobia. However, without treatment this anxiety pathology:
- It tends to become chronic.
- It runs the risk of presenting the mentioned complications.
- They interfere notably in the quality of life of the patient.
- Sufferers are more likely to suffer from other medical (and also psychological) problems.