Panic disorder mimics heart attack

By Michael Ceo

04/29/2003

 

The attack comes without warning. A person may be online buying groceries, sitting in a movie theater or asleep in bed, when suddenly chest pains, difficulty breathing and a pervasive sense of impending death grips him or her.

 

The person may experience weakness in the legs and tingling or tightness in the arms -- other telling signs of a heart attack. But when the individual seeks urgent medical care, the nightmare may become even worse.

 

Batteries of diagnostic tests prove negative for heart attack, and the person is told that the problem is mental. The isolation that comes when no one seems to understand that the pain is real can send the individual into an abyss of depression and hopelessness -- or worse, into drugs and alcohol.

 

Welcome to the world of those who struggle with a condition called panic disorder.

 

Statistics on panic disorder are mind-boggling:

 

One in five of the 26 million people with panic disorder has attempted suicide.

 

Women are twice as likely as men to have this condition.

 

One third of people with panic disorder also have major depression.

 

Thirty-six percent have a history of alcohol and drug problems because they try to self-medicate their symptoms.

 

When people with panic disorder pursue medical care, the statistics get even crazier. Whereas the average American visits the doctor a total of five times a year, people with panic disorder visit doctors 37.3 times per year. In terms of misused medical resources, panic disorder takes a significant toll.

 

Typically, someone with panic disorder sees 10 doctors before getting a correct diagnosis. Fewer than 23 percent of patients get appropriate treatment, even though 90 percent of panic disorders can be effectively treated. Overall, the estimated cost of panic disorder combined with other anxiety disorders costs the public $46 billion in lost wages, sick days, missed career opportunities and misused medical resources.

 

In response the National Institute of Mental Health has established a research protocol to study panic disorder and is actively recruiting individuals who struggle with it. With this push to explore the causes and find more effective treatments, help may well be on the way.

 

Unlike other anxiety disorders, which may be both psychological and biological in nature, panic disorder is strictly physical. The condition is regarded as a “brain disease,” in that there is a disorder in the brain's neuro-circuitry. The “fight or flight” response, integral to survival, triggers randomly.

 

Patients often describe the symptoms associated with these episodes in dire terms. I have heard panic attacks described as similar to being in combat or inducing the gut-wrenching fear of an impending car wreck. There is a pervasive fear of dying and a feeling of being completely out of control.

 

The current thinking is that individuals have a genetic predisposition to panic disorder; it may run in families. The average age of onset is 24 years.

 

People with this condition may become more vulnerable to episodes when they consume caffeine products. Otherwise, symptoms occur randomly.

 

For those seeking treatment, the first step is to rule out certain thyroid problems as the cause of the panic symptoms. If the diagnosis is indeed panic disorder, the proven treatment protocol involves brief cognitive behavioral therapy combined with anti-anxiety medication and education about the condition.

 

The goal is to assist the person to function despite the disorder.

 

Clarifying misunderstandings about what is happening in the body can be quite helpful. For example, people often fear that they will lose consciousness during a panic episode, yet because of the increases in blood pressure and heart rate, fainting is almost out of the question.

 

In my own psychotherapy practice, treating anxiety disorders has become something of a special interest. I have coached people through panic episodes by correcting the distortions in thought processes. I have assisted them in learning to “ride the wave” of panic sensations.

 

A useful tool in treating panic disorder is yoga breathing. By learning breath-control exercises, an individual can reduce the frequency and severity of panic episodes. Yoga breathing is an age-old practice that has direct physiological benefits for people struggling with panic disorder, other anxiety disorders and chronic pain.

 

Anxiety disorders are one of the reasons why students drop out of college. It is important, therefore, for teachers and schools to make treatment available and to teach students how to manage their anxiety.

 

Because you – parents, teachers, friends, co-workers and siblings of people with anxiety disorders – are the true first responders, learning about these disorders will empower you to be better caregivers.