Confronting the Storm Within: Understanding and Conquering Panic Disorder
Panic disorder is a serious condition marked by repeated, sudden surges of overwhelming anxiety, fear, and terror called panic attacks. These attacks cause distressing physical and psychological symptoms that strike repeatedly and seemingly without warning. Panic disorder causes intense suffering and disruption to people’s lives, as they live in dread of when their next attack may hit. However, with understanding, proper treatment, and self-care, it is possible to manage panic disorder effectively.
What is Panic Disorder?
Panic disorder is a type of anxiety disorder characterized by recurrent panic attacks and persistent worry or concerns about future attacks. According to the DSM-5 diagnostic manual, to meet the criteria for panic disorder, someone must experience at least two unexpected panic attacks followed by at least one month of concern about additional attacks, worry over the implications of the attacks, or self-defeating changes in behavior related to the attacks.
Panic attacks themselves involve sudden surges of intense fear, apprehension, and terror that reach a peak within minutes. Attacks are accompanied by physical symptoms like a racing heartbeat, shortness of breath, dizziness, trembling, hot flashes or chills, numbness or tingling, and sensations of unreality. Attacks feel extremely frightening and even life-threatening while occurring. Following an attack, people often experience ongoing anxiety, fatigue, muscle tension, insomnia, and impaired concentration.
Panic disorder affects around 4% of the global population at some point during their lifetime. As per the survey in 2019, 301 million people had anxiety disorder. It commonly begins in late adolescence or early adulthood, though onset can occur later as well. Women are diagnosed with panic disorder about twice as often as men. The disorder also tends to run in families. Environmental factors like trauma, grief, stress, or major life changes can serve as triggers for the emergence of panic disorder in those predisposed.
Causes and Contributing Factors
Researchers don’t yet fully understand what causes panic disorder, though both genetic and environmental factors appear to play a role. There are higher rates of panic disorder among close biological relatives of people with the condition. Certain gene variants also show links. The exact genes and mechanisms have not yet been definitively identified.
At the same time, major life stress often precedes first panic attacks. Stressful events during childhood, like abuse, parental loss, family instability, or poverty increase risk. Environmental conditions probably interact with genetic vulnerabilities in complex ways to produce panic disorder.
Panic attacks themselves arise from misfiring of the nervous system’s natural alarm and fear responses. These systems are meant to activate in the presence of actual threats to trigger fight-or-flight reactions. In panic disorder, they seem to get triggered at innocuous times for unclear reasons. Key regions of the brain like the amygdala and hippocampus which process fear appear overly reactive in people with panic disorder when faced with triggers like stressful events.
The body’s fight-or-flight system includes the sympathetic nervous system and release stress hormones like adrenaline and cortisol. Outpourings of stress chemicals likely drive many of the physical sensations of panic by increasing respiration, heart rate, blood pressure while decreasing digestion and blood flow to extremities. Altered breathing patterns characterized by shallow, rapid breaths may also contribute to lightheadedness while hyperventilating. Panic attacks feel terrifying largely due to an interplay between bodily sensations and fearful misinterpretations about what those sensations mean.
Treatments That Can Help
Panic disorder tends to be very responsive to treatment through scientifically-supported psychotherapy, medications, or both. With adequate treatment, 70 to 90% of people with panic disorder experience substantial or complete resolution of symptoms. Many different treatment avenues exist. Working with a mental health professional to develop an integrated treatment plan tailored to one’s needs is recommended.
Psychotherapy
Cognitive behavioral therapy is one of the most effective forms of talk therapy for panic disorder. It teaches ways to alter catastrophic thought patterns during panic attacks to improve coping abilities. Breathing retraining helps clients normalize respiration to mitigate troubling physical symptoms. Stress management and relaxation techniques like mindfulness meditation can reduce anxiety sensitivity. Gradually exposing oneself to feared sensations in a supported way can also help override alarmist associations.
Medications
Various medications are FDA approved treating panic disorder. Selective serotonin reuptake inhibitors like Zoloft, Lexapro, and Prozac are first-line treatments. Serotonin-norepinephrine reuptake inhibitors like Effexor work similarly. Anti-anxiety benzodiazepines like Klonopin, Ativan, and Xanax can provide rapid relief during attacks but carry risks of dependency when used long-term. Betablockers, mood stabilizers, and tricyclic antidepressants offer additional options.
Holistic Lifestyle Changes
Regular exercise, sleep, and healthy eating habits help manage anxiety. Avoiding smoking, excess caffeine, alcohol abuse, and illicit substances prevents exacerbating attacks. Relaxation practices like yoga, deep breathing, massage, mindfulness, or meditation counterbalance stress. Maintaining social supports aids coping abilities. Seeking counseling after traumatic events can help prevent issues from snowballing. Keeping an anxiety journal allows for self-monitoring. Setting small, achievable goals creates confidence.
The Path Forward
Panic disorder stems from complex interactions between genetic risks and environmental triggers. Though attacks feel intensely frightening in the moment, they cannot actually harm someone when no underlying medical issue exists. Implementing evidence-based treatments, lifestyle changes, support networks and self-care allows for managing symptoms successfully long-term. While confronting panic requires courage and perseverance, sustainable healing is within reach. With better understanding of the condition combined with compassion towards oneself and others similarly struggling, it becomes possible to weather the stormy phases while appreciating the calmer ones.
