Panic disorder

There has been much discussion about panic disorder in the past years. Panic disorder is fairly recent as a specified illness; in Finland, the diagnosis was not introduced until the 1980s. However, in view of its symptoms, it clearly belongs to anxiety disorders and has long been known as one of them.

Symptoms | Development of panic disorder | Students and panic disorder | Treatment |

Symptoms

A panic attack means a sudden state of intense anxiety. Anxiety occurs without warning, without any clear and sensible reason, right out of the blue. The sensation of fear is intense, to which the word panic originally refers. Anxiety also involves strong fears of death, of "going crazy" and of losing control. When an attack of panic anxiety occurs, the feeling of terror is almost paralysing. If the attacks occur repeatedly we talk about panic disorder.

Even though the feeling of fear is in principle a psychological occurrence, an event inside the mind, a panic attack is problematic due to its sensitive and direct connection with bodily reactions. Intense panic anxiety excites the nervous system; this leads to pounding of the heart, trembling and sweating, tremor of the hands, laboured breathing, shortness of breath, dizziness and nausea.

The sensations associated with anxiety, transmitted by the autonomous nervous system, are so intense and unpleasant that the person begins to fear them. The consequences are twofold.

Even though the feeling of fear is in no rational proportion to the situation in which it first occurs, it easily becomes associated with that situation. Later on, a similar situation or stimulus can trigger a new attack. People who have experienced a panic attack easily begin to avoid places in which an attack might occur. Cinemas, lecture halls and buses are among the most common places for such avoidance behaviour. Another problem associated with the close connection between the feelings of anxiety and fear and the nervous functions is that the fear of an attack itself may sensitise, make the nervous system susceptible to the experience of panic anxiety. Thus the fear of an attack may, in itself, trigger a new anxiety attack.

This easily leads to a vicious circle of repeated attacks and thereby to an ever-worsening situation. Recurring panic attacks accompanied by unpleasant bodily sensations and fears gradually cause such additional symptoms as anxiety and depression. Different phobias, such as social phobia and agoraphobia (fear of being in public places) are common in panic disorder.

Development of panic disorder 

It is a central characteristic of panic disorder that the panic attack occurs quite unexpectedly, right out of the blue. However, it seems to have some kind of a connection with the current situation in life. Many people have had a stressful life situation prior to the attack, for example an intense work or study period. Sometimes the attack may occur just as this demanding period eases. Some people have gone through major changes in their lives, such as moving away from home, moving to a new neighbourhood or to another country. Personal relationships may also involve stress factors which even add to subconscious anxiety, for example getting engaged or married, the birth of a child, breaking up with your girl- or boyfriend, etc.

The predisposition to panic disorder seems to be, to a certain extent, hereditary. It has been discovered that panic disorder is more common in the immediate family of people suffering from this disorder. It is also a well-known fact that different behavioural patterns and ways of reacting are acquired partly through social heredity: members of a family living under the same roof learn to act and experience things in the same way. On the other hand, research has indicated that biologically inherited traits could also be involved in panic disorder.

Despite being frightening, a panic attack is usually not dangerous; you do not die of it, you do not go crazy or even lose control during it. A panic attack is over quickly; it usually lasts from a couple of minutes to 15 minutes, although sometimes an attack may last up to half an hour. Individual panic attacks are relatively common. It has been estimated that up to 10-30 per cent of people may experience an attack at some stage in their lives.

Students and panic disorder

Students' life situation is highly favourable for the onset of panic disorder. Studies have shown that the disorder often originates in your late teens or early adulthood - exactly at that stage of life when you study. The life situation of a student, with all the major changes, is also otherwise highly prone to crises. Moving away from home, starting a life on your own, pressures associated with studying and dating, coping with your peers, etc. are factors which may create and accumulate conflicting requirements and tension deep inside the mind, making the student uncertain, anxious and tense. Add to this a possible hereditary predisposition and a suitable situation (which is usually not even anticipated to be oppressive), and the preconditions for a panic attack are there.

The consequential symptoms of panic disorder make it problematic and therefore an illness to be taken seriously. Recurring attacks may leave intense feelings of fear in your mind, which can lead to the avoidance of certain situations, a fear of social situations, isolation and depression. Therefore it is always advisable to consult a professional (doctor, nurse, psychologist) if the panic attacks continue.

Treatment

Nowadays, panic disorders can be treated successfully, and the anxiety of people suffering from it can be alleviated. The most important treatment is medication combined with psychotherapy.

Some of the features of panic disorder make it problematic for self-care. The attacks often occur unexpectedly, so at least at first it can be difficult to prepare yourself for them in any way. The attacks are emotionally so intense that almost all mental energy is consumed in bearing the feelings of fear, anxiety and terror and coping with them.

Another difficulty derives from the psychological contents and underlying factors of panic attacks. It can be thought that the attacks speak of possible internal conflicts, hidden sources of anxiety, subconscious hatred, fears or disappointments. The problem is that, being subconscious, these feelings cannot easily be seen and there is not much you can do about them on your own. In a situation like this, you often need somebody else with whom you can try to deal with these matters.

Panic disorder or an acute panic attack may be related to the current stressful life situation. You should try to stop and think what kind of forces affect your life at the moment. Many methods related to stress management are certainly helpful in trying to get a better hold of your life:

  • think about the current pressures associated with your work or your studies
  • what kind of demands do you set for yourself
  • what kind of demands are set for you from outside (home, university, workplace) 
  • can you say "no" or is it in your nature to accept all tasks that are offered
  • do you get enough rest
  • do you have a chance of leisure and recreation, having a good time with your friends
  • do you have hobbies to counterbalance work and studies, do you get enough exercise

Remember, however: If panic attacks recur and you do not get them under control, seek professional help. Panic disorders can be treated.

NOTE
Even though various disorders are often discussed on a very general level, each person's problems are highly individual and have their background in the person's life history. For this reason, the symptoms and difficulties of anybody seeking help should be considered in relation to their background and life situation. Treatment must also always be planned individually. There are various psychotherapies and a multitude of medicines designed for mental health care. A treatment suitable for the person concerned should be discussed with a professional.

 

This article is made by:
Phychotherapist Lauri Yli-Pohja