Panic Disorder

Everybody feels stressed and anxious from time to time. In the face of a threatening situation, it is normal to panic and feel symptoms such as a tightening in the chest, faster heart rate and cold sweat. However, if someone suffers from recurrent severe panic attacks even in unexpected situations, he or she may be suffering from panic disorder.


Because of the recurrent and unexpected nature of panic attacks, sufferers of panic disorder are perpetually concerned about having another attack and consequences of such an attack. These worries work only to increase the likelihood of an attack, thus trapping the sufferer in a vicious cycle. People with panic disorder may also avoid places or situations in which they feel that escape will be embarrassing or help would be unavailable if a panic attack occurs. The constant worry and fear of public places may lead to low mood and also makes it difficult for individuals to carry out normal daily activities.


About 3-5% of people are likely to suffer from panic disorder in lifetimes. Women (5%) are more likely to be affected than men (2%). Among Singaporeans, 2% are likely to experience panic disorder within the duration of a year. Panic disorder usually affects people between 15-24 years of age, but it may also develop for people in their thirties and forties.


WHAT CAUSES PANIC DISORDER?
It is not uncommon for people to experience at least 1 panic attack in their lifetimes, but most do not develop panic disorder following their first panic attack. What then are the factors that cause some people to develop panic disorder?


Genes
Research has found that if one twin has panic disorder, the other twin has a 33-43% chance of developing panic disorder.


Biological
Differences in the levels of chemicals in the brain such as serotonin and norepinephrine have been found to be related to the development of panic disorder. Increased activity in the amygdala has also been found to contribute to panic disorder.


Personality
People who are more likely to develop panic disorder tend to interpret ambiguous situations as harmful. They are also more likely to believe that their bodily sensations indicate serious illnesses.

 

HOW DO YOU KNOW IF SOMEONE IS SUFFERING FROM PANIC DISORDER?
A person may suffer from panic attacks characterized by episodes of chest discomfort, dizziness, sweating, tremors and shortness of breath. He may think that he is having a heart attack or think that he is going crazy.


HOW DO YOU HELP SOMEONE WITH PANIC DISORDER?
If the person is having a panic attack, it is useful to sit with him or her quietly and remain calm while speaking in quiet tones. If you are in a public environment, move him or her into a quiet and peaceful environment and ask him or her to breathe deeply and slowly. Do reassure the person that he or she is safe from harm.

If the person is suffering from panic disorder, it is important to recommend that he or she see a mental health professional and you can offer to accompany him or her for the appointment.


IF YOU ARE SUFFERING FROM PANIC DISORDER, HOW DO YOU HELP YOURSElF?
You can read up more about panic disorder from credible sources. When you feel a panic attack developing, engage in deep and slow breathing until you feel calmer. You can help yourself get better by seeking help from a mental health professional.

 

HOW IS PANIC DISORDER TREATED?
Both medications and psychotherapy have been to be effective in the treatment of panic disorder.


Drug Treatment
Medications from the benzodiazepine category are effective in reducing panic symptoms and work quickly. However, they have been found to cause adverse side effects at moderate and high dosages. Long term use of benzodiazepine may lead to severe side effects such as drug dependence, and only licensed doctors are allowed to prescribe such medications.

Research has found that antidepressant medications are effective in the treatment of panic disorder and the improvement of quality of life


Psychotherapy
Cognitive-behavioural therapy (CBT) involves a combination of behavioural techniques such supervised exposure to panic-inducing situations, and cognitive-restructuring techniques aimed at altering negative thinking patterns that cause and maintain panic attacks.

Researchers have found that CBT is effective in reducing panic symptoms and improving the daily functioning ability of the patient.

Khoo Teck Puat Hospital Department of Psychological Medicine provides comprehensive treatment and management of anxiety disorders. We have a dedicated multidisciplinary team of psychiatrists and psychologists that can provide assessment and treatment for your psychological and emotional distress.


It is never too late to seek help. If you would like to obtain an assessment, please obtain a referral from your doctor or call 65558828 for an appointment.