Panic Disorder

Explain the diagnostic criteria

• recurrent unexpected panic attacks

  • sudden surge of intense fear/discomfort

  • packs within minutes

  • not initially tied to a specific trigger

• physical symptoms during attacks in which 4 or more symptoms must occur:

  • racing heart

  • sweating

  • trembling

  • shortness of breath

  • chest pain

  • dizziness

  • choking sensations

  • fear of dying

  • fear of losing control / “going crazy”

• at least one of the attacks has been followed by 1 month of one or both:

  • persistent concern or worry about other panic attacks or their consequences

  • a significant maladaptive change in behaviour related to the attacks (ex. avoiding having panic attacks, such as avoidance of exercise or unfamiliar situations)

• not due to a substance, medical condition, or another mental disorder

What is the course of the disorder?

• recurrent panic attacks + anticipatory anxiety + avoidant behaviours = panic disorder

• sometimes continuous, sometimes with many remissions, reoccurrence is common

What is the onset?

• usually in the early 20s

• often in a stressful period of life

• after some negative life events

What are the gender differences?

Much more common (2x) in women.

What is the comorbidity?

• other anxiety disorders esp. agoraphobia

• depression and suicidality

• substance abuse

What are the psychological causes?

1. Catastrophic misinterpretations (normal body sensations are interpreted as dangerous)

2. Anxiety sensitivity (belief anxiety symptoms themselves are dangerous)

3. Classical conditioning (certain sensations or situations become associated with panic attacks)

4. Cognitive biases — attention becomes focused on signs of danger

5. Safety Behaviours