$Unique_ID{BRK00035} $Pretitle{} $Title{Panic Disorder, Treatment, and Therapy} $Subject{panic disorder disorders stress anxiety phobia Mental Emotional Condition Conditions stressful psychiatric psychological central nervous system autonomic life-threatening behavioral behavior behaviors panic stresses anxieties phobias} $Volume{E-23} $Log{} Copyright (c) 1991-92,1993 Tribune Media Services, Inc. Panic Disorder, Treatment, and Therapy ------------------------------------------------------------------------------ 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. ------------------------------------------------------------------------------ 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. ---------------- 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.