Panic disorders Flashcards
Panic attack is
an episode of acute and overwhelming apprehension or terror. During a panic attack, the person feels certain that something dreadful is about to happen. This feeling is usually accompanied by such symptoms as heart palpitations, shortness of breath, perspiration, muscle tremors, faintness, and nausea.
Where do symptoms of panic attacks come from
from excitation of the sympathetic division of the autonomic nervous system – the same as when someone is extremely frightened. During severe panic attacks, the person fears that he or she will die.
Percentage of people with panic attacks and the severity/ How someone may receive panic disorder diagnosis
As many as 40% of young adults have occasional panic attacks, especially in times of stress. For most of these people, the panic attacks are annoying but isolated events that do not change how they live their lives. When panic attacks become a common occurrence and the individual begins to worry about having attacks, he or she may receive a diagnosis of panic disorder, which is relatively rare. Without treatment, panic disorder tends to become chronic.
People with panic disorders may believe
People with panic disorder may believe that they have a life-threatening illness, such as heart disease or susceptibility to stroke, even after such illnesses have been ruled out by medical examinations. They may go from one doctor to another, searching for the one who can diagnose their ailments. They may also believe that they are “going crazy” or “losing control.” If their symptoms go untreated, they may become depressed and demoralized.
Relation of agoraphobia to panic disorders/attacks
About a third to one half of people with panic disorder also develop agoraphobia. People with agoraphobia fear any place where they might be trapped or unable to receive help in an emergency. The emergency they most often fear is having a panic attack. People with agoraphobia fear being in a busy, crowded place such as a mall. They may also fear being in tightly enclosed spaces from which it can be difficult to escape, such as a bus, elevator, or train, or being alone in wide open spaces such as the savannah or a deserted beach. All these places are frightening for a person with agoraphobia because if a panic attack or some other emergency occurred, it would be very difficult for them to escape or get help. They may also fear that they will embarrass themselves when others see that they are having a panic attack.
On agoraphobia
People with agoraphobia avoid all the places they fear. They significantly curtail their activities, remaining in a few “safe” places, e.g. close to home. Whenever they venture into “unsafe” places, they are usually accompanied by a trusted family member or friend. If they attempt to enter an “unsafe” place on their own, they may experience a great deal of general anxiety beforehand and a full panic attack when at the place.Although people can develop agoraphobia without panic attacks, the vast majority of people with agoraphobia do have panic attacks or panic-like symptoms in social situations. Agoraphobia usually develops within a year of the onset of recurrent panic attacks. The symptoms of agoraphobia can severely interfere with the ability to function in daily life. People with this condition often turn to alcohol and other drugs to cope with their symptoms.
Understanding panic disorder and agoraphobia
Many people who develop panic disorders probably have a genetic or other biological vulnerability to the disorder. Panic disorder runs in families. This does not mean that panic disorders are entirely hereditary, however, the results of twin studies provide firm evidence for an inherited predisposition for panic disorder. An identical twin is twice as likely to suffer panic disorder if the other twin does, than is true of fraternal twins
How can panic attacks occur
One characteristic that may be inherited in people who are prone to panic attacks is an overactive fight-or-flight response (Mc Nally, 2001). A full panic attack can be induced easily by having such individuals engage in activities that stimulate the initial physiological changes of the fight-or-flight response. For example, when people with panic disorder purposely hyperventilate, breathe into a paper bag, or inhale a small amount of carbon dioxide, they experience an increase in subjective anxiety, and many will experience a full panic attack
Fight or flight response
The overactive fight-or-flight response may be the result of deficiencies in areas of the brain that regulate this response, especially the limbic system. Some studies show that people with panic disorder have low levels of the neurotransmitter serotonin in the limbic system and other brain circuits involved in the fight-or-flight response(Bell & Nutt, 1998). Serotonin deficiencies cause chronic hyperactivation of these areas of the brain, putting the individual on the verge of a panic attack most of the time.
Cognitive-Behavioural Theories of Panic and Agoraphobia
They argue that an overactive fight-or-flight response may not be enough to create a full panic disorder. They suggest that people who are prone to panic attacks tend to pay very close attention to their bodily sensations, misinterpret them in negative ways, and engage in catastrophic thinking.Misreading bodily sensation, leads to catastrophic thoughts, which increase emotional symptoms of anxiety which make physiological symptoms even worse. This constant vigilance causes the autonomic nervous system to be chronically aroused, making it more likely that the individual will have another panic attack.
How can these people have less anxiety
Also, people with panic disorder remember vividly the places where they have had attacks. They greatly fear those places, and that fear generalizes to all similar places. By avoiding those places, they reduce their anxiety, and their avoidance behavior thus is highly reinforced. They may also find that they experience little anxiety in particular places, such as their own homes, and this reduction in anxiety is also highly reinforcing, leading them to confine themselves to these “safe” places.
Classical and operant conditioning related to agoraphobia
Therefore, through classical and operant conditioning, their behaviours are shaped into what we call agoraphobia. Several laboratory studies support the contention that cognitive factors play a strong role in panic attacks and that agoraphobic behaviours may be conditioned through learning experiences (McNally, 2001). The biological and cognitive-behavioural theories of panic disorders and agoraphobia can be, and have been integrated into a Vulnerability-Stress Model.
