M.D Choi, Hong
Department of Psychiatry
Psychiatry. Panic Disorder, Generatlised Anxiety Disorder
How To Deal With Panic Disorder
“On my way home, I suddenly had cold sweats, felt dizzy and felt my heart tighten. I felt like I might die. I also had difficulties breathing. I also had numbness in my hands and feet, and I could also felt my heart beating heavily.
It was intolerable. I was very nervous, filled with thoughts that such things might happen again.” Have you ever experienced these symptoms? Have you ever had these horrible and painful symptoms at an unexpected moment? Do you become nervous and fearful before you take the subway or go shopping in crowded department stores? These symptoms of sudden onset are referred to as a panic attack. Repeated panic attacks are collectively termed a panic disorder.
Prevalence of panic disorder
According to epidemiological studies, 1.5-5 percent of the population are diagnosed with a panic disorder at least once in their lifetime. It can therefore be inferred that the number of patients with panic disorders is estimated to be at least 700,000 in Korea. Also, panic disorders are two to three times more common in women than in men. Moreover, it tends to have a sudden onset, and occur most frequently during your 20s and 30s. Ever since a well-known comedian was hospitalized due to a panic disorder, people are paying more and more attention to panic disorders in general. Today, let us learn about panic disorders together with the Samsung Medical Centre.
Signs and symptoms of a panic attack
- Heart palpitations or a racing heart
- Sweating
- Trembling or shaking
- Shortness of breath or hyperventilation
- Feeling of suffocation
- Chest pain or discomfort
- Nausea or upset stomach
- Feeling dizzy, light-headed, or faint
- Feeling detached from your surroundings
- Fear of losing (mental/psychological) control
- Fear of dying
- Numbness or tingling sensations in the hands and feet
- Hot or cold flushes
If you have a sudden onset of more than four of these symptoms simultaneously (usually beginning abruptly and reaching a peak within 10 minutes), you are likely to have experienced a panic attack. However, not everyone who has experienced panic attacks is diagnosed with panic disorder. To be diagnosed with panic disorder, patients need to experience recurrent panic attacks as mentioned above, followed by a period of at least 4 weeks of significant behavioural change caused by the symptoms (e.g. not going out or not going to work), a persistent concern of more attacks, or anxiety about the attack's consequences (e.g. fear of losing control, having a heart attack, going crazy etc.).
Treatment of panic disorders
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1. Pharmacological treatment
- Selective serotonin reuptake inhibitors are the most widely used medication for the pharmacological treatment of a panic disorder. In addition, drugs such as anti-depressants and benzodiazepines are also useful. -
2. Cognitive-behavioral therapy
- Through cognitive-behavioural therapy (CBT) is a talking therapy where patients themselves actively participate in the treatment. Patients' false recognition of, and attitude towards panic attacks are improved, and their behaviour is corrected. -
3. Psychotherapy
- In-depth psychotherapy, including the psychoanalytic variety, can improve the symptoms of a panic disorder by analyzing their unconscious meaning. -
4. Biofeedback therapy
- Biofeedback therapy is a treatment program based on a physiological feedback mechanism, where patients train themselves to relieve tension by directly monitoring their own physiological signs on a computer screen.
The clinical characteristics of panic attacks are similar to cardiovascular conditions, such as myocardial infarction or angina pectoris. This means that there are some who will become worried that they might die of a heart attack, but in fact this is not the case. Due to a temporary derangement of the autonomous nervous system caused by the panic attacks, patients undergo a variety of symptoms. When panic attacks disappear however, the activity of the ANS return to normal.
It is apparent that a panic disorder makes patients both nervous and uncomfortable. But there are no cases where patients die of its symptoms, even though they feel that they are life-threatening. Nonetheless, there is a high possibility that patients might have recurrent episodes of a panic disorder if left untreated. Fortunately, with a systematic treatment, most patients no longer need to be afraid of or afflicted with a panic disorder. Through help from experts, I hope that patients can regain their natural healthy lifestyle.