Panic Disorder

Diagnostic Criteria and Prevalence

Panic Attack

• An abrupt surge of intense fear or discomfort that reaches a peak within about 10 minutes

• Feel like there is something physically wrong with them

Attacks include at least 4 of the following:

•Palpitations, pounding heart

•Sweating

•Trembling/shaking

•Shortness of breath/smothering

•Feelings of choking

•Chest pain/discomfort

•Nausea/abdominal distress

•Feeling dizzy, unsteady, light-headed or faint.

•Chills or heat sensations

•Numbness/tingling sensations

•Feeling detached from oneself or like things aren’t real

•Fear of losing control or “going crazy”

•Fear of dying

Panic Disorder Symptoms:

• Recurrent, unexpected panic attacks

  • With > 1 month of:

    • Worry about future panic attacks

    • And/or

    • Change in behavior due to the attacks

• Fear of fear itself

• Distress and/or impairment

Panic Disorder by the #s, Prevalence

• One-year: 2.4%; Lifetime: 3-4%

• W:M = 5:2

• Age of onset - 15-35

Agoraphobia

Persistent, excessive, Irrational fear of places where escape is difficult

• (e.g., public transportation, parking lots/bridges/other open spaces, shops/theatres/other confined spaces, lines or crowds, away from home unaccompanied

  • Avoid situations that may trigger panic attack

Agoraphobia by the #s… Prevalence

• One-year: 1.7%

• W:M = 2:1

• Age of onset - 15-35

Cognitive Perspective

High degree of anxiety sensitivity

Anxiety Sensitivity

A tendency to focus on one’s bodily sensations, assess them illogically, and interpret them as harmful.

Worry about symptoms—>

increased symptoms/panic attack

• does not explicitly rule out biological factors

Treatments

CBT:

C = addresses catastrophic thoughts/beliefs

B = exposure

• Relaxation techniques, Breathing Exercises

• Exposure to bodily panic symptoms/physical cues

Treatments for Panic Disorder

Drug Therapy

• Antidepressants

• Benzodiazepines (work quickly)