Wednesday, March 26, 2008

Anxiety & Panic Disorder

By: James Schaus, MD - UCF Health Center Doctor

Severe anxiety sometimes manifests as physical symptoms. These very real and frightening symptoms are known as “panic attacks,” and the syndrome, “panic disorder.”

Panic disorder is a common condition, affecting approximately three out of every one 100 people. These episodes of intense fear or anxiety often occur suddenly without warning or provocation and the cause or trigger of these attacks may not be obvious. These attacks can last from minutes to hours, and can occur only once in a while or they may occur quite frequently. People have a built-in “alarm system” that goes off when they feel threatened. This alarm starts physical and emotional changes that prepare us to flee or fight the danger that triggered the alarm. In some people this alarm may go off unexpectedly, creating a very strong sense of threat when no danger is present. It is often a terrifying experience associated with several physical signs including:

  • Shaking or tremors

  • Heart pounding or racing

  • Sweating

  • Chest pain

  • Shortness of breath

  • Tight throat or choking sensation

  • Nausea

  • Cramping

  • Dizziness

  • Out of body feeling

  • Tingling or numb feelings in the hands

  • Chills or hot flashes

A person may also have an extreme fear of losing control, going crazy or dying during a panic attack. Many of the symptoms are the same as the symptoms of diseases of the heart, lung, intestines, or nervous system. Just a fear of having a panic attack is often enough to trigger the symptoms. This is the basis for a condition called Agoraphobia. About two thirds of those who have panic attacks have some degree of Agoraphobia. A person who has Agoraphobia finds it difficult to leave home, because he or she is afraid of having a panic attack in public or not having an easy way to escape.

If you think you might have panic attacks, it is very important to see a provider at the UCF Health Center. Several medications can make panic attacks less severe or prevent them altogether. SSRI antidepressant medications such as Paxil and Zoloft are FDA approved to treat panic attacks, and can be used for as long as necessary, sometimes for years. Short-term use of tranquilizers such a Xanax and Klonopin are also FDA approved to treat panic attacks, but they should be used only for short periods of time unless you absolutely cannot function without them. Several kinds of stress reduction counseling are available at the UCF Counseling Center, and are very effective for treating panic attacks. The combination of both counseling and medication is most effective. About 90% of people who receive a form of counseling known as cognitive behavioral therapy experience at least some relief of their panic symptoms. Biofeedback is also effective at preventing and treating panic disorder. There is no need for a person to continue to suffer these terrifying symptoms and we can help you live a more stress-free and secure life.

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