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Panic Disorder: Description, Diagnosis, and Treatment 
 
by Jimmy McShean July 21, 2005

An Attempt to Define Panic

Many different people have defined panic disorder in many different ways over the years. Sigmund Freud wrote the first clinical definition:

"… an anxiety attack… may consist of the feeling of anxiety, alone, without any associated idea… or else some kind of paresthesia… may be combined with the feeling of anxiety, or, finally, the feeling of anxiety may have linked it to a disturbance of… bodily functions- such as respiration, heart action, vasomotor innervation or glandular activity."

A panic, or anxiety, attack, as described by the American Psychological Association, is defined as a "…sudden surge of overwhelming fear that comes without warning…". The symptoms listed by the APA include a racing heartbeat, difficulty breathing, paralyzing terror, hot flashes, and a fear of impending death or insanity. The first 2 editions of the DSM defined only one kind of anxiety disorder, as mentioned earlier. By the time of the DSM-III publication in 1980, it was broken up into 2 different diseases: panic disorder and general anxiety disorder (GAD). The major difference between the two is that panic disorder sufferers experience anxiety only during the panic attacks, while GAD sufferers experience anxiety all day, every day.

Non-Psychological Symptoms and Side Effects

Panic disorder is unlike other mental disorders in that it causes physical harm and side effects as well as psychological harm. Because of the cardiovascular symptoms of the disorder, such as heart palpitations and irregular heartbeat, panic disorder sufferers are 30-40% more likely to suffer from mitral valve prolapse, a serious heart condition, than members of the general population. Panic patients also tend to go in for expensive surgeries, mainly coronary and abdominal in nature, more often than non-panic sufferers do.

They make up 20-30% of patients who go in for coronary arteriography surgery, even though they tend to not need it. They also have a higher risk for migraines and severe headaches. According to a recent study, nearly 28% of all individuals between 24 and 29 years of age who visited a physician for headache had a history of panic disorder. The cause for these migraines is usually not discovered by the medical doctor, because his training is in a different area. Generally, because of these superfluous visits to the doctor, people who suffer from panic disorder visit the doctor or hospital much more frequently than people without it do. This not only ties up the doctor from dealing with patients who need medical help (as opposed to psychological help), but it also makes the panic sufferer’s medical bill much higher than the average person’s.

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