Symptoms of Panic Disorder

[David Baxter PhD]

Panic Disorder
The Counselling Connection
Wednesday, January 27th, 2010

People with panic disorder suffer severe attacks of anxiety which can make them feel as though they are having a heart attack or are going crazy. Symptoms include heart palpitations, chest pain or discomfort, sweating, trembling, dizziness, difficulty breathing and feelings of losing control.

Panic disorder involves at least one of these attacks followed by a month or more of persistent concern about either

• having another attack,
• worry that the attack means he or she is going crazy or has severe health problems, or
• a significant change in behaviour as a result of the attack (e.g., avoiding places where an attack might occur).

The American Psychiatric Association (2000) defines a panic attack as fear or discomfort that arises abruptly and peaks in 10 minutes or less, and can occasionally last for hours. They are usually unpredictable, and this can lead a sufferer to avoid certain places or situations where a panic attack may occur and from where escape would be difficult or embarrassing.

There are three types of panic attacks:

1. Spontaneous (uncued) panic attacks: These forms of attack seem to come ?from out of the blue? and are not triggered by any situation in particular. They tend to occur during period of sleep or when relaxing.
2. Situational (Cued) panic attacks: Occur mostly in a situation where a previous attack has occurred.
3. Situational pre-disposed panic attacks: While being pre-disposed to having a panic attack in a certain situation, the person may or may not have an attack either in the situation or immediately afterward - see Panic Anxiety Disorder Association

Although panic attacks sometimes seem to occur out of nowhere, they generally happen after frightening experiences, prolonged stress, or even exercise. Many people who have panic attacks think they are having a heart attack and often end up at the doctor or emergency department.

Even if tests show nothing out of the ordinary, the person will still worry, and this further elevates their anxiety levels. Marcks, Weisberg and Keller (2009) suggest that individuals with panic disorder experience considerable impairment and disability including occupational difficulties, impaired wellbeing and reduced quality of life.

Heightened awareness, referred to as hypervigilance, with regard to any change in the normal function of the human body, will be noticed and misinterpreted as a possible life threatening illness. Normal changes in heartbeat, such as when climbing a flight of stairs or after exercise, are often interpreted by someone who has recently experienced a panic attack as an impending heart attack or the onset of another panic attack. Some sufferers worry so much they may leave their job or refuse to leave home to avoid future attacks. This can lead to a diagnosis of panic disorder with agoraphobia.

The Panic Cycle:

1. Perceived Threat
2. Apprehension or worry (about having a panic attack or about distressing situation)
3. Body sensation (e.g. heart palpitations, chest pain or discomfort, sweating, trembling, dizziness)
4. Interpretation of sensations as catastrophic