Panic Disorders
Hazel’s symptoms suggest that she experienced a panic attack – an episode of acute and overwhelming apprehension or terror. During panic attacks, the individual feels certain that something dreadful is about to happen. This feeling is usually accompanied by such symptoms as heart palpitations, shortness of breath, perspiration, muscle tremors, faintness, and nausea. The symptoms result from excitation of the sympathetic division of the autonomic nervous system (See Chapter 2) and are the same reactions that an individual experiences when extremely frightened. During severe panic attacks, the person fears that he or she will die.
As many as 40 % of young adults have occasional panic attacks, especially during times of stress (King Gullone, Tonge, & Ollendick, 1993). For most of these people, the panic attacks are annoying but isolated events that do not change how they live their lives. When panic attacks become a common occurrence and the individual begins to worry about having attacks, he or she may receive a diagnosis of panic disorder. Panic disorder is relatively rare: Only about 1.5% to 3.5% of the population will ever develop a panic disorder (American Psychiatric Association, 2000). Usually panic disorder appears sometime between late adolescence and the mid 30s. With out treatment, panic disorder tends to become chronic (Weiss & Last, 2001).
Panic-like symptoms may take a different form across cultures. People from Latino cultures, particularly in Caribbean, sometimes experience a sudden rush of anxiety symptoms known as ataque de nervios. The symptoms of ataque include trembling, feelings of out of control, sudden crying, screaming uncontrollably, verbal and physical aggression, and sometimes seizure-like or fainting episodes and suicidal gesture (Lopez & Guarnaccia, 2000). When ataque de nervios comes out of the blue, it is often attributed to the stresses of daily living or to spiritual causes. A study of Puerto Ricans after the 1985 floods found that 16% of the victims reported experiencing an ataque (Guarnaccia Canino, Rubio-tipec, & Bravo, 1993).
People with panic disorder may believe that they have a life-threatening illness, such as heart disease or susceptibility to stroke, even after such illnesses have been ruled out by medical examinations. They may go from one physician to anther, searching for the one who can diagnose their ailments. They may also believe that they are “going crazy” or “losing control”. If their symptoms go untreated, they may become depressed and demoralized.
About a third to half of people with panic disorder also develop agoraphobia (American Psychiatric Association). People with agoraphobia fear any place where they might be trapped or unable to receive help in an emergency. The emergency they most often fear is having a panic attack. The term agoraphobia comes from the ancient Greek words meaning “fear of the marketplace.” People with agoraphobia fear being in a busy , crowded place such as a mall. They may also fear being in tightly enclosed spaces from which it can be difficult to escape, such as a bus, elevator, or subway, or being alone in wide-open spaces such as a meadow or a deserted beach. All of these places are frightening for people with agoraphobia because if a panic attack or some other emergency occurred, it would be very difficult for them to escape or get help. They may also fear that they will embarrass themselves when others see that they are having a panic attack, even though other people usually cannot tell when a person is having a panic attack.
People with agoraphobia avoid all the places they fear. They significantly curtail their activities, remaining in a few “safe” places, such as the area within a few blocks of home. Sometimes they can venture into “unsafe” places if a trusted family member or friend accompanies them. If they attempt to enter “unsafe” places on their own, however, they may experience a great deal of general anxiety beforehand and have a full panic attack when in the unsafe place. Hazel, whom we met earlier in the chapter, provides an example:
Hazel continued to have panic attacks every few days sometimes on the same street where she had the first panic attack, but increasingly in places where she’d never had a panic attack before. It seemed she was especially likely to have a panic attack if there were lots of people standing around her, and she became confused about how she would get out of the crowd if she began to panic. The only place Hazel had not had any panic attacks was in her apartment. She began to spend more and more time in her apartment and refused to go any place she had previously had a panic attack. After a few months, she had called in sick to work so often that she was fired. Yet, Hazel could not bring herself to leave her apartment at all. She had here groceries delivered to her so she wouldn’t have to go out to get them. She would see friends only if they would come to her apartment. Hazel’s savings were becoming depleted, however, because she had lost her job. Hazel began looking for a job that she could do from her apartment.
Although people can develop agoraphobia without panic attacks, the vast majority of people with agoraphobia do have panic attacks or panic-like symptoms in social situations (Craske & Barlow, 2001). Agoraphobia usually develops within a year of the onset of recurrent panic attacks. Obviously, the symptoms of agoraphobia can severely interfere with the ability to function in daily life. People with agoraphobia often turn to alcohol and other drugs to cope with their symptoms. Fortunately, we have learned a great deal about the causes of panic and agoraphobia in recent years.
Chapter 14
Psychological Reactions To Stress
Panic Disorders
Atkinson & Hilgard’s
Introduction To Psychology
14th Edition
Psychology Article Marketing
http://psychologyarticlemarketing.blogspot.com/
http://psychologyarticlemarketing.blogspot.com/2011/04/panic-disorders.html