NO.127 . Anxiety and Panic

Anxiety and Panic

Panic attacks are intense periods of fear or feelings of doom developing over a very short time frame -- up to 10 minutes -- and associated with at least four of the following:

• Sudden overwhelming fear
• Palpitations
• Sweating
• Trembling
• Shortness of breath
• Sense of choking
• Chest pain
• Nausea
• Dizziness
• A feeling of being detached from the world (de-realization)
• Fear of dying
• Numbness or tingling in the limbs or entire body
• Chills or hot flushes

Panic attacks and panic disorder are not the same thing. Panic disorder involves recurrent panic attacks along with constant fears about having future attacks and, often, avoiding situations that may trigger or remind someone of previous attacks. Not all panic attacks are caused by panic disorder; other conditions may trigger a panic attack. They might include:

• Mitral valve prolapse
• Hypoglycemia
• Hyperthyroidism
• Heart attacks
• Social phobia
• Agoraphobia (fear of not being able to escape, such as flying in an airplane or being in crowds)

How Do You Know When Worry Turns To Anxiety That Needs Treatment?

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Generalized anxiety disorder is excessive and unrealistic worry over a period of at least six months. It is associated with at least three of the following symptoms:

• Restlessness
• Fatigue
• Difficulty concentrating
• Irritability or explosive anger
• Muscle tension
• Sleep disturbances
• Personality changes, such as becoming less social

Phobic disorders are intense, persistent, and recurrent fear of certain objects (such as snakes, spiders, blood) or situations (such as heights, speaking in front of a group, public places). These exposures may trigger a panic attack. Social phobia and agoraphobia are examples of phobic disorders.

Post-traumatic stress disorder -- or PTSD -- was considered to be a type of anxiety disorder in earlier versions of the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders. But in 2013, PTSD was reclassified as its own condition. It describes a range of emotional reactions caused by exposure to either death or near-death circumstances (such as fires, floods, earthquakes, shootings, assault, automobile accidents, or wars) or to events that threaten one's own or another person's physical well-being. The traumatic event is re-experienced with fear of feelings of helplessness or horror and may appear in thoughts and dreams. Common behaviors include the following:

• Avoiding activities, places, or people associated with the triggering event
• Difficulty concentrating
• Difficulty sleeping
• Being hypervigilant (you closely watch your surroundings)
• Feeling a general sense of doom and gloom with diminished emotions (such as loving feelings or aspirations for the future)

Symptoms such as chest pain, shortness of breath, palpitations, dizziness, fainting, and weakness should not be automatically attributed to anxiety and require evaluation by a doctor.

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