Panic Disorder

A Brief Introduction to Clinical Panic Disorder

According to the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders, fifth edition, clinical Panic Disorder is determined by the presence of recurrent and unexpected panic attacks. Recurrent means that the individual experiences more than one panic attack. Unexpected refers to the panic attack being seemingly unprovoked, that is, not as a result of a predictable time, place, or set of circumstances the individual knows to be particularly anxiety provoking for them such as driving on high mountain roads. Another type of unexpected panic attack is one that wakes an individual from sleep, called a nocturnal panic attack. Half of those with Panic Disorder experience expected panic attacks in addition to unexpected panic attacks.

What complicates living with this disorder is that panic increases in anticipation of yet another panic attack. Individuals with Panic Disorder generally accumulate concern about future panic attacks because of the physical implications, social implications, and cognitive implications. Individuals may worry that the physiological symptoms of their panic attack may indicate a true medical issue, such as a heart attack; or they may be concerned about other’s perceptions of them in a social situation because of the outwardly noticeable physical signs of the panic attack; or, they may worry about their own inability to regulate using their rational mind, as in, “Why can’t I calm myself down?” Self-imposed restrictions and constrictions are common as the individual with Panic Disorder attempts to forestall the onset of a panic attack by avoiding places, circumstances, and situations they fear may provoke a panic attack. 

What is a Panic Attack?

A panic attack often begins as an abrupt experience of mounting fear or inexplicable sense of discomfort. Due to this stress, particular areas in the human brain become hyperactive. The brain begins to experience fear and pain. These instances happen simultaneously as the body’s sympathetic nervous system arms the body to defend itself, signaling the need for “fight or flight.”

In normal circumstances, the parasympathetic nervous system is then activated to guard the body against consuming all its energy. The parasympathetic system is a “rest and digest” system that helps relax the muscles in the gastrointestinal tract and slow the body’s heart rate. This helps the body reach a calm state so its functions can again continue normally.

But during a panic attack, the increase of stress interrupts the body’s parasympathetic nervous system and it stays at an elevated peak instead of helping the body regain calm. The lack of response of the parasympathetic nervous system can cause a person to feel like they are slipping out of control.

Next, the unchecked need for a defensive stance affects the brain and sympathetic nervous system . The heightened agitation due to worry or a prolonged agitation that arises is from what is referred to as a Panic Disorder.

Signs and Symptoms of Panic Disorder

There are a distinct set of physiological and psychological symptoms experienced by individuals suffering with Panic Disorder. A panic attack caused by Panic Disorder must meet the following criteria:

• A fast paced surge of fear that reaches its peak within minutes.
• It includes four of the following symptoms:
  • Accelerated heart rate
  • Sweating
  • Trembling
  • A feeling of shortness of breath
  • A feeling of choking
  • Chest pain
  • Nausea
  • A feeling of being dizzy or light-headed
  • Feeling the temperature at extremes (hot or cold)
  • A feeling of numbness or tingling
  • A feeling that things around you are not real or feeling detached from yourself; feeling that your own self as other; feeling outside of yourself 
  • A fear of not being in control
  • A fear of dying
• One month of more of at least one of the following behaviors:
  • An overwhelming fear of having another panic attack
  • Develop new behaviors designed to avoid a panic attack such as avoiding people or places in your normal life.
• The panic attacks cannot be better explained as a reaction to substance use, a prescribed medication, or as part of another mental illness or medical condition. 

Panic Attack vs Anxiety Attack

Anxiety can be a symptom of a panic attack. However, panic attacks and anxiety attacks differ from each other. Some specific differences that can distinguish a panic attack from attack linked to anxiety are:

An attack of anxiety:

• Can develop slowly but increase as a person begins to feel anxious.

• Frequently can occur from a specific trigger, such as a health-related event, a problem in a relationship, or a situation in a work-based role.

• May be related to other mental illnesses, such as OCD, PTSD, phobias or other Anxiety Disorders.

• May or may not exhibit physical responses (tightening in the chest or belly, shortness of breath, or extreme discomfort).

• Has a lesser volatility or severity than an attack of panic.

A panic attack:

• Develops as a surge of fear that reaches its peak within minutes.

• May happen independently of when an individual is calm or anxious.

• Does not occur from a specific stressor (pressure from an event, likelihood or worry) or trigger.

• Don’t arise as a symptom of another diagnosable mental illness, physical condition, or use of a medication or substance.

• Can demonstrate as physical experiences and emotions of fear or terror so pronounced there is a feeling of unconquerable loss or death.

• Symptoms may range from intense to increasingly severe.

Additional Facts About Clinical Panic Disorder

• Half of the individuals diagnosed with Panic Disorder experience expected and unexpected panic attacks
• The frequency of panic attacks varies for individuals with Panic Disorder: for some, they will experience a panic attack once a week over a series of months; for others, they may experience daily panic attacks during a short period of time followed by a respite of months; some may experience a few panic attacks every month over a span of years. 
• The likelihood of developing Panic Disorder increases for individuals who have experienced physical abuse and sexual abuse in childhood
• Most individuals with Panic Disorder can identify circumstances that led up to their first panic attack, for example, stressors such as disease, the death of a loved one, and interpersonal stressors

Panic Disorder Treatment at Silicon Beach Treatment Center

Recovering from a Panic Disorder, as any holistic process involving healing, is a restorative and gradual process. While there are advancements in panic attack treatment modalities, it can take time to find the treatment style or treatment combination that works best for you.

At Silicon Beach Treatment Center, we can treat Panic Disorder. Our task when treating any area of client suffering is to identify the nature of your experience with it, explore the underlying causes, and work together to usher in resiliency, foster a more hopeful outlook, and restore equilibrium. Our caring, trained professionals will work diligently to bring you the support, interventions, and treatment you need.

General Disclaimer

Please note, the information on this page is based on the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders, fifth edition, however, it is in no way exhaustive on the subject of each disorder discussed. This text is not intended to be the basis of self-diagnosis of any disorder. Only a trained mental health provider can provide you with an accurate diagnosis based on a myriad of factors and details specific to your particular case.