Medication.Effective treatment for panic disorder is available. Most people are able to overcome the disorder with the help of medication, specialized psychotherapy, or a combination of both. The first step is to block the attacks with the help of medication. There are several options, but the anxiolytics, particularly alprazolam make a good choice. Taken in high doses, the medication benefits quickly and provides relief within a day or two. It has few physical side effects, but it can be highly addictive and can impair mental ability in the long run, leading to deficient concentration and loss of memory.
Antidepressant medications are another good option. They eliminate panic symptoms and provide relief in 80 to 90 per cent cases. The tricyclic antidepressants, amitryptline and clomipramine work well, but must be taken for at least four to six weeks. They also may cause side effects such as a dry mouth, constipation, blurring of vision, dizziness and drowsiness. The selective serotonin reuptake inhibitors (SSRIs), including paroxetine and fluvoxamine, usually have fewer side effects and are quite effective. The biggest difficulty, however, with any medication is the high rate of relapse once a person stops using the medication.
Psychotherapy. Psychotherapy, particularly cognitive-behavioural therapy, helps control panic attacks. Under this method therapists help people reconstruct the physical symptoms of the panic attack and teach them to think rationally about the situation. Most people feel better with just eight to ten sessions. Physical relaxation techniques, such as deep breathing, yoga and muscle relaxation also ease the stress and prove useful in developing a sound coping mechanism to control the panic attacks.
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The current thinking regarding the origin of panic disorders is that they result from the interplay of multiple biological and psychological factors. The main contributory factor may be some genetic vulnerability, leading to a biological illness. Over time, panic attacks may also get associated with some environmental events that evoke stress and anxiety. The constellation of such stimuli could be an outcome of the past experiences or a psychological conflict. These particular conflicts arise from suppressed painful thoughts, impulses, or desires, either from the past or present. Sometimes no cause may be present at all, and the body just seems to react to stress. As such, the panic response is seen as an attempt to mobilize inner resources and ward off danger to the self. Some psychologists also believe that an early childhood experience of separation from important people, such as parents, increases the risk of panic disorder.
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It can happen any time. Your inner self presses the panic button for no rhyme or reason. All of a sudden, an attack of terror and apprehension overwhelms you. Your heart begins to race, your face flushes, and you have trouble breathing. You feel dizzy, queasy, out of control-some people even feel they are going crazy or are about to die.
Every year, millions of people across the world go through an experience like this. Many, fearing the worst, think they’re having a heart attack and rush to an emergency room. Others, though overtaken by fear, try to ignore it. But the story is much the same. Each of them just had a panic attack. Call it panic disorder, if you like. Once dismissed as ‘nerves’ or stress, a panic attack is now recognized as a potentially disabling but treatable condition. Typically, the attack lasts from a few seconds to several hours. Most attacks, however, peak within ten minutes and exit within 20 or 30 minutes, leaving its sufferer sometimes with a vague sense of exhaustion. They may come back any time and the unpredictability regarding their reappearance perturbs the victim with persistent anxiety. Life is laden with fear and one simply does not know what to do. Some people feel so inundated with fear that they stop stepping out of their homes.
The disorder is fairly common. It affects about two per cent people during their lives and twice as many women as men. The attacks typically begin in young adulthood-late teens and early twenties-and can recur throughout life. While some people experience panic attacks frequently, almost daily or every week, others suffer the attack less often. The condition tends to run in families; possibly heredity plays a role. If somebody has a diagnosed panic disorder, up to 18 per cent of his or her first-degree blood relatives may also suffer similarly. Studies done on identical twins also corroborate the genetic factor. If the disorder affects one of a pair of identical twins, the second twin runs a high risk of being similarly affected. But this kind of risk does not affect non-identical twins.
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