Recognizing and Diagnosing Panic Attacks

Reduce & prevent panic attacks

How to Know When You've Had A Panic Attack  Diagnosis Of Panic Attacks

It's easy for most of us to advise someone in a tizzy not to panic over something, and probably almost as easy for that person to calm down with a bit of time, advice, or conversation with a friend.

But for 2-3 million Americans - the majority of them women - "panic" is far more disabling and difficult to resolve than the occasional feeling of being overwhelmed by responsibilities or events. Panic, for them, means a panic attack, a sudden, inexplicable feeling of terror accompanied by a barrage of physical symptoms and a fear or dying or going crazy.

Recurring panic attacks are the hallmark of panic disorder, one of a family of anxiety disorders estimated to affect as much as one-quarter of the U.S. population. Panic disorder can be psychologically, physically, and socially debilitating, often leaving relationships in ruins and making it impossible to keep a job.

Depression accompanies more than half the cases of panic disorder. The rate of attempted suicide is 20 times higher among individuals with the disorder than among the general population. Untreated, panic disorder tends to get worse with time.

Why more women than men are diagnosed with panic disorder is unclear. Hormones may play a role: the disorder often worsens premenstrually. But women also are more likely than men to seek help for anxiety.

Because panic attacks mimic other medical conditions, such as heart attacks, strokes, neurological problems, and gastrointestinal disorders, people with panic disorder often visit a lot of emergency rooms and doctors' offices before getting a proper diagnosis.

Once diagnosed, however, the condition is highly treatable. Medications and cognitive-behavioral therapy, alone or in combination, can effectively reduce or prevent panic attacks in 70 - 90% of those suffering from the disorder.

RECOGNIZING A PANIC ATTACK

Although it might feel like an eternity, a panic attack generally reaches its greatest intensity in 5 -10 minutes and subsides within an hour. People report that during this time they feel doomed, as if they're going to die or lose control, and as if they urgently need to escape.

Several physiological symptoms characterize panic attacks and differentiate them from other types of anxiety. Also, the anxiety that accompanies panic attacks is unlike more generalized anxiety. It tends to come on suddenly, almost like a spasm, is intense while it lasts, and recurs intermittently.

Panic attacks are rather common. An estimated 20% of the general population has had a panic attack in the recent past, and 35% say they've had a single panic attack at some point in their lives. Clearly, not everyone who has an attack goes on to develop panic disorder. But when panic attacks recur and lead to constant worry, they can become chronic and disabling.

DIAGNOSING PANIC DISORDER

A diagnosis of panic disorder is suggested when panic attacks occur with no apparent or immediate trigger (situational cue) to touch them off, such as seeing a dog or a snake, or being in a crowded place. Someone with panic disorder may have situationally cued panic attacks, but for a diagnosis to be made, at least two "out of the blue" attacks need to have occurred. In addition, medical conditions such as cardiovascular disease, asthma, hyperthyroidism, and supraventricular tachycardia, as well as drug and alcohol use, need to be ruled out as underlying causes.

Not surprisingly, having a panic attack can foster fears about having another one. After one or more panic attacks, some people become agoraphobic: they don't want to leave their homes for fear another panic attack will occur in a situation from which they can't escape, or where they won't be able to get help, such as in traffic or a crowd. About 70% of panic disorder sufferers develop agoraphobia. Women are three times more likely to be diagnosed as agoraphobic than are men.