Anxiety Panic Disorder 

Nervousness when you're going to a party is normal,  panicking and anxiety at the thought of getting on an elevator is an entirely different matter.  

Is It Fear or Anxiety?

Fear is what you feel when a barking dog lunges at your bicycle. Anxiety is what you feel when you get on an elevator and break out in a sweat. Fear is a realistic response to a real threat. Anxiety is an unrealistic response to an imaginary threat.

Fear is a good thing to have. When you are facing a grizzly bear, you should be afraid. But when you are faced with getting on an elevator, you shouldn't have the same feelings. If you do, you may have an anxiety disorder--an intense, unrealistic fear of an object or an event. Your body sets off a false alarm that makes you panic.

What Is a Panic Attack?

People who have had panic attacks seemingly "out of the blue" report that they feel disconnected from reality. Their hearts pound, they can't breathe, their hands get sweaty. Panic attacks seem to happened for no particular reason. People who have had one panic attack spend a lot of time worrying that they will have another one.

People who have had one panic attack sometimes avoid the situation that caused it. A woman may get on an elevator one day and have her heart start beating about 150 beats a minutes. She can barely catch a breath; she feels as if she will die. As soon as the door opens, she gets off.

She's fine once she is out of the elevator, but she takes the stairs from then on to avoid another attack. A month later she's offered a promotion and an office on the 35th floor. Is she really going to climb 35 flights of stairs every day?

Panic attacks often begin in late adolescence or early adulthood. If not treated, the attacks can lead to avoidance of common, everyday objects or situations. In extreme cases, a person cannot even leave the house. Victims of panic attacks often become depressed and turn to drugs or alcohol.

Shyness or Social Phobia?

Another kind of anxiety disorder is social phobia, the extreme fear of being embarrassed in a social situation, such as going to a party. Donny Osmond wrote in his autobiography, Life Is Just What You Make It, "I'd lie in bed at night wondering `What if ...?' and then imagine a series of possible events that might unfold, all of them culminating in my being humiliated."

People with social phobia fear that others are judging them. They don't go to parties or give speeches because they might say something that would embarrass them. Sometimes a person with social phobia can't eat in public or use a public restroom. Symptoms of social phobia are blushing, sweating, trembling, nausea, and difficulty talking.

Fighting Off a Panic Attack In Social Situations

What if you have a panic attackin public? Here are some steps you can take to get rid of it:

    * Remind yourself that the attack will soon pass--usually in about 5-10 minutes, even though that may seem like a lifetime.
    * Take slow, deep breaths from your diaphragm.
    * Talk yourself through it. Osmond got through one attack by telling himself to "stay conscious."
    * Put a rubber band around your wrist, and every time you have a negative thought, snap it and say "stop" to yourself.
    * Tell someone--your family or a trusted friend--about your anxiety problems.

Professional Help for Anxiety Disorders

Some anxiety disorders are believed to be caused by defective neurotransmitters in the brain. The condition may be inherited or the result of a terrifying experience. To get over this type of anxiety disorder, professional help is often needed.

A doctor may prescribe certain drugs. Antidepressants called selective serotonin reuptake inhibitors boost the activity of serotonin, a brain chemical. Benzodiazepines relieve symptoms quickly but only can be used short term because they can become habit-forming. A beta-blocker may help in a specific situation.

Perhaps more effective than drugs is cognitive-behavioral therapy. In the cognitive part of the therapy, the therapist helps patients change their thinking patterns by asking the question, "What is the worst thing that could happen?"

In the behavioral part, the therapist works with the patient to change his or her reactions to anxiety-provoking situations. The more a person is exposed to the object of the phobia, the less he or she fears the object.

The woman who panics about riding an elevator might spend one session going up one flight in an elevator. The next week, she might go up two flights in the elevator. After about 12 weeks of conditioning, she should be able to do the trip alone.

The good news about anxiety disorders is that they respond very well to treatment. About 80 percent of people who are treated learn to live a normal life.