Panic Disorder

Question 1

def panic attack

Answer 1

Panic attack: abrupt surges of intense fear or extreme discomfort → peak in minutes, accompanied by physical, and cognitive symptoms like palpitations, sweating, SOB, fear of going crazy, or fear of dying

Question 2

def panic disorder

Answer 2

Recurrent, unexpected panic attacks in the absence of triggers, and experience persistent concern and worry about having another panic attack

hallmark: attacks occur without warning

Question 3

RF for panic disorders

Answer 3

• Adverse childhood experiences
• Smoking for both panic attacks and panic disorder
• Chronic medical conditions – thyroid disease, cancer, chronic pain, cardiac disease, IBS, migraine, allergic and resp diseases
• Use of substances: specifically caffeine
• psychiatric comorbidities: other anxiety disorders, substance use disorders, other mood disorders

Question 4

criteria for a panic attack

Answer 4

> = 4 of STUDENTS FEAR the 3 Cs

S - Sweating
T - Trembling
U - Unsteadiness, dizziness
D - Depersonalization, derealization
E - Excessive heart rate, palpitations
N - Nausea
T - Tingling
S - Shortness of breath
FEAR of dying
FEAR of losing control
FEAR of going crazy
C - Chest pain
C - Chills
C - Choking

Question 5

how to tx panic disorders?

Answer 5

firstline: CBT + breathing training ➔ helps to decrease hyperventilation episodes by capnometry biofeedback

consider: pharmacological
- firstline: SSRI
- 2nd: benzodiazepines
- for panic attack ➔ benzo

lifestyle changes:
- avoid triggers
- avoid stimulants – caffeine, meth, cocaine
- sleep hygiene
- box breathing
- grounding techniques
- exposure therapy ➔ phobia tx

Question 6

how do benzodiazepines work?

Answer 6

enhance GABA action (binds to GABA receptors) ➔ suppresses nerve activity ➔ sedative