Margaret is 38 years old, married and the mother of two children, Ethan, 13, and Sara, 16. It is 5:20 p.m. on a Friday and she is in the grocery store which is crowded, noisy and hot. (“Is the air conditioning working,” she wonders.) Her son’s birthday party is at 7:30 p.m. (pressure - 12 guests coming) and she is picking up Ethan’s cake as well as cold cuts, soft drinks and balloons. Margaret tells the woman 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 (“What’s up with this,” she asks). She next begins to experience an increase in her heart rate and the heavy pounding in her chest frightens her (“Heart attack,” she wonders).
To calm herself, she begins to breathe faster and faster. 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 — “That doesn’t look like me.” Her body feels strange and detached. Then, without warning, a tidal wave of terror and doom washes over her, knocking her to her knees. Sobbing, she mutters, “What’s wrong with me?” 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 has just had her first, full blown panic attack, and she will be told by physicians in the emergency room that she will require treatment for a condition called panic disorder. The purpose of this column is to give readers information about panic disorders, so family members, loved ones or close friends can better understand and help those with this disorder find the courage to seek treatment. So, 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. The “without warning” part means that you cannot predict when an episode of anxiety will occur. This, in turn, means that Margaret, from this point forward, 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 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.
Let’s end this column on a positive note: 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.
The content of this article is for educational purposes only, and should not be used as a substitute for treatment by a professional. The characters in this story are not real. Names and details have been changed to protect confidentiality.
Dr. Richard Elghammer contributes his column each week to the Journal Review.
