Panic: The Review

Panic has not always been recognized as an exclusively psychiatric condition. Research in this area continued along separate medical and psychological axes until 1980, when the development of Diagnostic and Statistical Manual criteria established the overall concept of panic disorder. Females are almost twice as likely as males to suffer from panic disorders, and about seven times as likely to suffer repeated panic attacks. Overall, panic disorders or panic attacks occur in up to one in ten of the general population.

     According to the American Psychiatric Association, a panic attack, which is the core feature of panic disorder, is a period of intense fear or discomfort that strikes suddenly, often in familiar places, where there is seemingly nothing threatening an individual. But when the attack comes, it feels as if there is a real threat, and the body reacts accordingly. The discomfort and sense of danger the attack brings is so intense that people with panic disorders often believe they are having a heart attack or some other life-threatening illness (APA). Many people don’t know that their disorder is real and highly responsive to treatment. Some are afraid or embarrassed to tell anyone, including their doctors and loved ones, about what they experience for fear of being considered a hypochondriac (health phobia). Instead they suffer in silence, distancing themselves from friends, family, and others who could be helpful or supportive.

      There are many symptoms of panic disorder, and many of these symptoms advance and cause more damaging effects on the well-being of the individual. Panic Disorder is a variable disorder in terms of physical, physiological and cognitive symptoms of panic attack. According to Ramazan Konkan, it has been suggested that, since there are panic attacks consisting of very different symptom clusters, there may be subtypes of this disorder and that failure to distinguish these subtypes may lead to theoretical, methodical and treatment errors.

   Panic attacks are usually classified as being part of panic disorders if they occur more than once and are accompanied by the following symptoms: sweating, shortness of breath, rapid or pounding heartbeat, chest pain, nausea, faintness, chills or hot flashes, disconnected feeling, fear of losing control, and so on. Beyond the panic attacks themselves, a key symptom of panic disorder is the persistent fear of having future panic attacks. The fear of these attacks can cause the person to avoid places and situations where an attack has occurred or where they believe an attack may occur. Some people stop going into situations or places in which they’ve previously had a panic attack in anticipation of it happening again. These people have agoraphobia, and they typically avoid public places where they feel immediate escape might be difficult, such as shopping malls, public transportation, or large sports arenas. About one in three people with panic disorder develops agoraphobia. Their world may become smaller as they are constantly on guard, waiting for the next panic attack. Some people develop a fixed route or territory, and it may become impossible for them to travel beyond their safety zones without suffering severe anxiety (ADAA).

      There is a genetic component to panic disorder because it often runs in families, and this supports the idea that the condition may be inherited. On the other hand, people posit that panic disorder is a learned behavioral response to stressful situations. Also, they suggest that initial panic attacks are based on the body’s natural fear reaction occurring at an inappropriate time (APA). The American Psychotherapy Association states that studies have shown as many as 30% of immediate family members share panic disorder. Also, genetic factors were responsible for 35% to 39% of panic disorder and agoraphobia (APA). Biologically, Panic disorder may be caused by problems in regulating brain areas that control the “fight or flight” response. According to psychological theories, one psychological approach to the cause of panic disorder is cognitive theory. In this, individuals who suffer from panic disorder build their own fear and anxiety through negative thought patterns by focusing on physiological feelings and ascribing their own meaning to them (APA). Some of this is majorly caused by the stresses of life, such as the death of a loved one, can sometimes trigger panic attacks, which can potentially re-occur and go on to become panic disorder.

 Another common approach is Cognitive-Behavioral treatment, which allows for a more psychological perspective in helping people suffering from panic disorder.  Cognitive-behavioral treatment is based on the idea that people suffering from panic disorder cognitively misinterpret normal physiological responses, such as a rapid heartbeat or heavy breathing. Cognitive-behavioral treatment may consist of five fundamentals that ultimately help fulfil its goal. In the first stage of learning, the therapist explains the illness, identifies the symptoms, and outlines the treatment. The therapist encourages the client to monitor the attacks, and finally helps the patient expose the disorder by encountering situations that evoke and frighten physical sensations at levels of increasing intensity (APA). According to the American Psychiatric Association, earlier detection significantly reduces the complications of untreated panic disorder. In the end, we could all love each other better when we listen, and not hear. 

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