Margaret is 38 years old, married and the mother of two children, Ethan,13, and Sara,16. It is 5:20 p.m. Friday, and she is in the grocery store which is crowded, noisy and hot. Her son’s birthday party is at 7:30 p.m. and she is picking up Ethan’s cake as well as cold cuts, soft drinks and balloons. Margaret tells the lady in the bakery she is here to pick up her son’s cake, and as she lowers the cake into her cart, she notices that both of her hands are shaking. She next begins to experience an increase in her heart rate and the heavy pounding in her chest frightens her.
Suddenly, without warning, she feels like she is choking and dizziness slams her. She tells her kids to stay by the cart while she runs to the restroom. Inside the restroom, her image in the mirror is wrong. Her body feels strange and detached. Then, without warning, a tidal wave of terror and doom washes over her, knocking her to her knees. Her children find her, sitting on the restroom floor, crying. They call their father, who comes and takes Margaret to the emergency room.
This story gives you a taste of what it is like to experience a panic attack. Margaret will be told by physicians in the emergency room that she will require treatment for a condition called panic disorder.
Let’s discuss what panic disorder is all about. First, there is a difference between panic attacks, and panic disorder. A panic attack is not a formal diagnosis. It is used to describe the symptoms Margaret had while in the grocery store. A panic attack is defined as a period of intense fear, lasting 5 to 30 minutes, with the symptoms peaking at 10 minutes. There are 13 symptoms of panic attacks, and Margaret experienced most of them.
Panic disorder, on the other hand, is a specific diagnosis, and it includes the occurrence of panic attacks. The distinguishing feature of a panic disorder is that the panic attacks occur without warning. This means that you cannot predict when an episode of anxiety will occur. This, in turn, means that Margaret will carry the fear of “what if I get a panic attack while driving, or on vacation or on an airplane?” The persistent anxiety caused by the “what if” factor, is like a dog chasing its tail, a circular pattern of uncertainty which causes many people to stop activities; they quit work, or school, or driving, and restrict themselves to the safety of their home.
Here are some key facts about panic disorder:
1. Panic attacks can happen while asleep. They cause you to wake up and can destroy sleep patterns.
2. Panic disorder is common — 3% of the population, and due to genetic factors, it runs in certain families.
3. Panic disorder starts around age 16-25, but can begin in childhood.
4. 20% of all emergency room visits are due to panic attacks.
5. 70% of patients with panic disorder lose or quit their jobs.
6. 50% of patients cannot drive more than 3 miles from home.
My experience in treating patients (from children to age 75) who have panic disorder, has revealed a disturbing pattern: Almost 100% of these patients reported being dismissed, ignored or told that their anxiety was trivial. These statements are especially troubling when another fact about panic disorder is discussed — suicide. Rates for people with this disorder are high -— 20-40% report having a suicide attempt.
Margaret’s panic disorder is capable of being treated with powerful and effective new methods which allow her to live a full life. If you have a friend or relative like Margaret, help them find good professional care.
Dr. Richard Elghammer contributes his column each week to the Journal Review.