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Blue Mountains
Blue Mountains

Panic Attacks


Panic disorder is a real illness with both a physical and psychological component.

Q. I’ve heard people say they have had panic attacks. I’ve also heard the term Panic Disorder but aren’t these problems really just a case of nerves brought on by stress? Doesn’t the passage of time, rest and a little common sense usually fix the problem?

A. Sometimes the passage of time, along with rest and “common sense” can get a person over the anxiety hump and the panic attacks go away. Too often, though, they don’t. Who hasn’t had periods characterized by unsettling worries, fears, and stress. Our anxiety will increase during these times: our bodies feel anxious, we don’t sleep as well, we are constantly thinking about our problem, we may be more irritable, less goal oriented and so forth. When the situation has passed we begin to feel like ourselves again. But on the other hand, our life style may not “nurture” our nervous system so that a sense of well being returns. Americans have busy lives. We work hard and touch a lot of bases and the effects of stress can build up. Do we know how to maintain or restore wellness? Do we even think about it? If you are like most of us, you may take your body’s ability to bounce back for granted until it doesn’t bounce back.

Life events that can not be changed are the worst for setting up panic attacks: death of a loved one, a progressive illness, divorce with loss of income, children to raise and life style demands that by their nature endure, natural disasters, birth of a child, and so forth.

A panic attack is defined by the American Psychiatric Association as an unprovoked sense of fear accompanied by at least four of the following physical and emotional symptoms:

Shortness of breath
Dizziness or faintness
Accelerated heart beat
Nausea or abdominal distress
Feelings of detachment or unreality
Chest discomfort or pain
Numbness or tingling sensations
Hot flashes or chills
Fear of dying, going crazy or losing control

When panic attacks begin to occur with the frequency of about four or more in a four week period, or a person who has had fewer than four attacks in a month still has a persistent fear of an attack, then a diagnosis of Panic Disorder should be made.

What causes panic disorder? The debate persists. A first step is to schedule a physical examination to rule out an underlying medical problem. Taking medication may be extremely beneficial. For those professionals who lean towards the genetic and/or physiological orientation medication may be the intervention of choice. Correcting one’s nutrition, can be very helpful even key for some. Other professionals lean more towards psychological factors as the origin of panic disorder and specialized therapy is the treatment of choice. I think both the psychological and the biochemical issues must be addressed. Behaviors and attitudes are, in part, learned. We each have our own history and this history is made up of the people and experiences, that are unique to us. This is very important because our thoughts, life styles, as well as our behaviors, have biochemical consequences. So if I am worried and hassled for long enough and to a sufficient degree my body will begin to be constantly anxious. Thus, over time we unconsciously teach our bodies to be anxious. This incubation period can last for months even years before our body has that first panic attack that seemed to come out of the blue. In fact, though, the body became habituated to a biochemical state that sets up panic attacks. If the panic attacks persist we have panic disorder.

Q. Other than medication how can panic disorder be treated ?

A. Eighty-five to ninety percent of those who suffer from panic attacks can be greatly helped even cured of their attacks and a life of dread and avoidance. Treatment may or may not require medication. A well documented, successful, straight forward approach consists of in depth education about the nervous system, panic attacks and the development of phobias; body training so that the biochemistry of stress and anxiety is replaced by the biochemistry of relaxation and the skill to “let go” of body tension; extensive cognitive therapy to ferret out and unlearn those thoughts which have kept the body sensitized and on edge, panicky and reactive; learning new, rational, confidence building thoughts; training in behavioral strategies to replace non-specific even confusing reactions so that one begins to manage the anxiety rather than having anxiety victimize and overwhelm them; and, finally, a specialized form of behavioral therapy called in vivo desensitization through gradual and systematic exposure to feared situations.

Treatment is structured, and addresses the complex nature of panic attacks with phobic avoidance through progressive steps that are designed to address those situations that must change for wellness to occur.

The Anxiety, Mood and Phobia Center uses a treatment program consistent with the protocol described.