Anxiety Disorders: Panic Disorder

Panic Disorder

Person has recurrent, sudden, intense panic attacks of short duration

Seems to come out of nowhere with no identifiable feared object

Often accompanied by agoraphobia

5% prevalence rate

1/3 people will have a panic attack

More common in women than men

Description of Panack attack

Petrified with fear, everything gets black, thought they would faint, felt like heart would jump out, couldn’t stand up, icy hands, shooting pains, head felt tight, out of breath, weak and no strength

Sadata’s Panic Disorder

Was doing well in life until she had a break up and unwanted pregnancy, she had a broken leg and could not dance, then her grandfather dies.

This leads to a panic attack and later agoraphobia which she is confined to her bedroom

Receives exposure therapy and does really well

The Diathesis-Stress model of panic disorder

Biological vulnerability (diathesis) and psychological factors (stress) combine to cause disorder

Diathesis

Genetically something causes them to be more susceptible

31% concordance rate (if twin has it the other has a 31% chance)

What exactly is inherited

Dysregulation of neurotransmitters norepinephrine which makes person more physiologically responsive

Does not necessarily mean they will get panic disorder, just more physiological prone to feeling anxiety and feeling it more

Stress

Panic reaction is due to cognitive factor, a misinterpretation of anxiety related bodily events (I’m having a heart attack")

Person gets anxious but does not think “I’m anxious” they will think “something bad is happening to me”

Drug Therapy

Antidepressants (SSRIs) and antianxiety drugs (Xanax)

Helpful in more than 2/3 cases

Reduces anxiety and reduce attacks but high relapse rate when off drugs

Why does drug therapy help

Lowers the biological feeling of panic

There is nothing to misinterpret, no anxiety to make you feel biological factors

Cognitive Behavior Therapy (CBT)

Type of therapy Sadata had

Exposure therapy and Reattribution therapy

ex: Sadata’s fear of elevators

2/3 success rate however there is a lot of work and detail put in this therapy

90% of people do not relapse (better than drugs)

Reattribution Therapy

Teach the person that what they are feeling is just anxiety

There is nothing to fear

ex: Sadata’s education about anxiety

Why is CBT better than drugs

It gives person lesson and reason of to why they are feeling the way they are feeling

Drug does not remove tendency to misinterpret physical symptoms of anxiety

Final thoughts about Sadata’s Case

Have her learn about anxiety and have her face her fears

Then go back and say what was the root of the problem, She likely has a problem with grief or loss