Panic Disorder, Treatment, and Therapy

Panic Disorder, Treatment, and Therapy


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QUESTION:  For the longest time we thought my wife had some undiagnosable
heart problem.  Every time she went into a stressful situation her heart
started pounding, she experienced chest pains, became off balance, sometimes
started choking and was out of breath.  Then a doctor told us it wasn't her
heart at all, but something called "panic disorder."  That was a relief, but
we don't know what to do about this disorder.  Is it treatable?  Please tell
me about it.  Right now my wife is just avoiding all stressful situations.

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ANSWER:  Panic disorder is a very treatable problem that may occur as
frequently as in 3% of American women and 1% of American men.  The symptoms of
the disorder include all of the ones you mentioned that your wife experiences,
plus many more.
     "Panic" patients may go through times of excessive sweating, a sensation
of rubbery legs, nausea, stomach problems, hot flashes and cold chills,
tingling or numbness, a strange, unreal or foggy feeling, trembling, diarrhea,
feeling tired and weak, difficulty sleeping, rapid mood swings, or the
recurrent feeling that they are dying or something terrible is about to
happen.  People who fall victim to panic disorder often suffer from many
phobias.  They'll naturally try to avoid the situations that bring on the
panic attacks, and therefore create a list of things they absolutely cannot
do.
     Treatment should be given by a doctor or psychiatrist who is experienced
in dealing with panic patients.
     To begin with, the patient should understand that the condition is a
malfunction of certain central nervous system receptors.  The patient is not
crazy--but merely experiencing panic responses at inappropriate times.
     The treatment begins with medications which can bring the attacks under
control--that is, by bringing the autonomic nervous system under control.  The
patient must know that having this problem is not life-threatening and that
she will not die during an attack.
     Once the medication kicks in, the panic attacks will subside.  Then it's
time to begin behavioral therapy.
     The doctor may ask you to help your wife in the behavioral therapy.  She
must be gradually reintroduced to the situations she has been avoiding because
of her attacks.  You can provide her with the emotional support she needs and
gently press her to continue to face the difficult situation.
     For example, some panic patients have developed phobias about using
elevators.  Your assistance could be enlisted to help.  You might take your
wife to an elevator bank, and just stand there with her, watching people
getting in and out.  When she no longer experiences any symptoms while
standing there, it may be time to get in the elevator, but keep the doors
open.  If she can stand in the elevator for a few minutes without becoming
phobic, she may be ready to try a one or two flight elevator ride.  If the
panic symptoms occur while she is taking the short ride, go back to the step
before of just standing in the open elevator.
     With such behavioral therapy for this and other phobias, your wife should
be able to overcome her anxieties and eventually resume a normal life.

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The material contained here is "FOR INFORMATION ONLY" and should not replace
the counsel and advice of your personal physician.  Promptly consulting your
doctor is the best path to a quick and successful resolution of any medical
problem.