Could this be you or your family member? The symptoms: panic attacks, panic disorder, and agoraphobia Panic attacks Panic attacks are sudden, extreme feelings of fear and/or discomfort often peaking within a few minutes and often lasting no more than 10 minutes (although 20 to 30 minutes is possible) before subsiding. The DSM defines them as an incident in which someone has at least four of the following symptoms, divided into somatic and cognitive categories: Somatic symptoms: Palpitations and/or pounding heart Shortness of breath or feeling of being smothered Chest pain or discomfort Choking sensation Trembling or shaking Sweating Nausea or abdominal discomfort Feeling dizzy, lightheaded, unsteady, or faint Numbness or tingling Hot flashes or chills De-realisation or depersonalisation (a sense of things being unreal or feeling detached from oneself) Cognitive symptoms: Fear of dying Fear of losing control or going crazy (Jacofsky, Santos, Khemlani-Patel, & Neziroglu, 2013; ADAA, 2014; Otto & Murray, n.d.) When a person experiences fewer than four symptoms, it is known as a limited-symptom panic attack. In these cases, the most common symptom is shortness of breath, due to hyperventilation. Panic attacks are characterised by perception of danger occurring in the present moment, as opposed to other anxiety disorders, which are future-oriented (that is, worry about what might happen). Panic attacks are generally accompanied by intense fear or terror, a sense of doom, and a need to escape. Once they begin, they tend to recur (Jacofsky et al, 2013). Panic disorder Panic disorder is characterised by recurrent unexpected panic attacks. The other criterion in the DSM-5 is that there is: Worry about future attacks Worry about the consequences of the attack (i.e., having a heart attack) Substantial behavioral changes in response to the attacks as the person attempts to avoid situations, persons, and places which he or she fears may trigger another attack (Otto & Murray, n.d.) It is important to note that panic disorder is often accompanied by other health problems, such as depression or substance abuse; these conditions need to be treated separately, but the presence of symptoms related to them can mask the panic, making diagnosis of the panic disorder difficult (NIMH, n.d. -b). Agoraphobia People who experience repeated attacks can become significantly disabled by their condition. About one-third of people with panic disorder go on to develop agoraphobia – literally meaning “fear of open spaces” – in which they avoid public places where immediate escape might be difficult (ADAA, 2014). They come to have lives so restricted that they avoid normal activities, such as driving or grocery shopping; they may be limited in where they are willing to live, work, or recreate, especially in instances where an attack may have occurred, say, in a lift (no more living in fifteenth floor flats!), or on a particular road (forget that neighbourhood altogether!). Agoraphobics often become housebound or perhaps they only feel able to face a feared situation accompanied by a spouse or other “safe” person. The clinical characterisation is that ago raphobia: Entails anxiety about being in situations related to perceived inability to escape or get help if a panic attack occurs Causes sufferers to avoid situations or endure them with significant distress
Posted on: Thu, 13 Nov 2014 19:43:44 +0000
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