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Panic

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Information about Panic
Science-Technology

Published on December 17, 2008

Author: aSGuest7001

Source: authorstream.com

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Panic Disorder : Panic Disorder Dr. Vishwamohan Thakur, MD What is Panic Disorder? : What is Panic Disorder? Panic Disorder is a serious anxiety disorder. Individuals who suffer from Panic Disorder experience "panic attacks." This attack is extremely intense and people who have such experiences describe them as "horrible and unforgettable." Commonly a person suffering from this disorder remembers the time, day and events occurring at the time of this powerful and overwhelming set of symptoms. When does someone experience a Panic Attack? : When does someone experience a Panic Attack? Panic attacks happen unexpectedly.Individuals who experience a panic attack usually say that they were not experiencing anything stressful, or doing anything unusual, when the attack "just happened out of the blue." It may occur in sleep. It is common that people who have panic attacks report significant stresses in their lives but the attack itself is generally perceived as unexpected. What is a Panic Attack ? : What is a Panic Attack ? A panic attack is a sudden episode of intense fear with symptoms that may include the following: chest pain increased heart rate a feeling that the heart is beating harder (called a palpitation) shortness of breath or smothering feeling or a sensation of choking sweating dizziness tingling in the hands or feet chills or hot flashes nausea or stomach pain a feeling that things seem unreal fear that you are going to die or that you "are going crazy" A person needs to have 4 or more of these symptoms, one of these symptoms does not mean that he/she is having a panic attack. Some of the above symptoms can also be indications of serious medical conditions that would require a physician's medical evaluation. What the patient believes : What the patient believes People with panic believe very strongly that the "attack" they experienced means that something is physically wrong with them. The central point is that people with panic fear that they have a physical, medical disease. What happens when someone experiences a Panic Attack? : What happens when someone experiences a Panic Attack? Panic attacks last 20-30 minutes No lasting effects In healthy individuals, the medical evaluation is usually normal, except for a mildly elevated heart rate and a mildly elevated breathing rate during the attack What happens next? What happens next...? : What happens next...? Individuals who suffer from panic attacks can frequently begin to: Worry about having another attack (Panic attacks + fears about having more attacks = Panic Disorder) Or may progress to: Avoid situations where they experienced an attack in the past (out of fear of having another attack) Avoid going anywhere alone Avoid leaving home (Panic Disorder + avoiding situations that may cause panic = Panic Disorder with Agoraphobia) Who experiences Panic Disorder? : Who experiences Panic Disorder? Usually: Healthy people in their 20's or 30's (but any age may be affected) Females more than males Lifetime prevalence of panic attacks in the general population is 3 to 4% Lifetime prevalence of Panic Disorder in the general population is 1 and 1/2% How does Panic Disorder affect the family? : How does Panic Disorder affect the family? Panic Disorder is also very difficult on the individual's family. Are family members more likely to have Panic Disorder? The answer is Yes. Statistics show that there is a 4 to 8 times greater risk of Panic Disorder in family members of individuals with Panic Disorder. Untreated Panic Attacks : Untreated Panic Attacks ?distress ? breathlessness ? GP visits ? ambulance calling ? hospitalisation ? medications and medical interventions ? distress in middle of night Therefore ? costs to the person and to the health services How to Identify Panic Disorder : How to Identify Panic Disorder The Diagnostic Criteria to Diagnose Panic Disorder are laid down. They can be obtained from me as separate handout. What should be done when someone has a panic attack? : What should be done when someone has a panic attack? For first time panic attacks or for a change in usual symptoms: Medical evaluation The symptoms of a panic attack are very similar to the symptoms of several serious medical illnesses including: Heart attack (myocardial infarction), stroke (cerebrovascular accident), and bloot clot in the lung (pulmonary embolism). These illnesses are life-threatening medical emergencies and individuals suffering from these illnesses need to receive medical treatment immediately. In a healthy individual, if a complete medical evaluation is normal, a diagnosis of panic attack is considered. If a complete medical evaluation is normal, an individual with panic attacks is not at any greater risk of developing a medical illness than an individual without panic attacks. What is the medical evaluation? : What is the medical evaluation? The usual medical evaluation includes: physical examination blood tests ECG (electrocardiogram of the heart) sensors are placed on the chest to record the electrical current in the heart. Further medical testing may be required including: further tests of heart function MRI (test for abnormalities in brain structure) EEG (test for seizures) What medical problems can sometimes cause a panic attack? What medical problems can sometimes cause a panic attack? : What medical problems can sometimes cause a panic attack? There are many medical problems that may sometimes cause symptoms of a panic attack or have symptoms that are similar to a panic attack, including: myocardial infarction (heart attack) congestive heart failure high blood pressure pulmonary embolism (bloot clot in the lung) cerebrovascular accident (stroke) epilepsy Parkinson's Disease multiple sclerosis thyroid disease diabetes Can medications sometimes cause a panic attack? : Can medications sometimes cause a panic attack? Yes. There are some medications that may cause symptoms of a panic attack or have symptoms that are similar to a panic attack in some people, including: cold and allergy medications, cough medicine appetite suppressants "herbal remedies" containing ephedrine motion sickness and nausea medications asthma inhalers Nicotine, coffee, tea Alcohol – withdrawal, Opium-withdrawal, sedative-withdrawal Panic Disorder Causes : Panic Disorder Causes What Causes Panic Disorder? We don’t really know; many factors. But: Strong evidence that norepinephrine is involved. Norepinephrine: neurotransmitter especially active in Locus ceruleus part of the brain. Models of Abnormality : Models of Abnormality Biological model How the brain’s anatomy & physiology affect emotions, cognitions & behavior Models of Abnormality : Models of Abnormality Biological model: Anatomy (structures) Neo-Cortex Corpus callosum Amygdala Locus ceruleus Amygdala : Amygdala Models of Abnormality : Models of Abnormality Biological model: Physiology (processes) Nerve impulse Panic Disorder : Panic Disorder Anti-depressant drugs that regulate norepinephrine successful in treating panic When Locus ceruleus stimulated in monkeys ? panic like behavior Locus ceruleus rich in norepinephrine carrying neurons Hypothesis: Norepinephrine dysregulation may well be implicated in Panic Disorder What is the treatment for Panic Disorder? : What is the treatment for Panic Disorder? There are several common treatments for Panic Disorder including: Anti-anxiety medication Anti-depressant medication Psychotherapy Relaxation training Any Questions? : Any Questions?

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