Enough sleep, regular exercise and avoiding stimulants among the effective treatments available for panic disorder

Dr. Paul Latimer: Coping with panic attacksPanic. Your heart races, palms sweat and body shakes. You feel as though you’re choking and losing your breath as a bout of dizziness overtakes you. This is out of control.

Imagine feeling this way on a regular basis. People with an anxiety disorder called panic disorder experience recurring panic attacks – brief but intense periods of fear throughout their adult lives.

Physical symptoms such as the few described above are common and the individuals often believe they are either experiencing a heart attack or going crazy.

Everyone has probably felt intense fear at some point in life. The body’s natural fight or flight response kicks in to help keep us out of danger. When in a threatening situation, this response is a good thing, but not when it happens for little or no reason.

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Panic attacks come on suddenly with no warning and no way to stop them. The level of fear is not appropriate to the situation and is often completely unrelated or unprovoked.

Usually, panic attacks subside in a few minutes, but repeated attacks can go on for hours. They are terrifying and physically exhausting.

In order to be diagnosed with panic disorder, the panic attacks must be recurrent. Also, at least one attack should be followed by a month or more of either concern about having more panic attacks, worry about the implications of the attack or a significant change in behaviour (such as avoiding activities) because of the panic attacks.

This frightening illness affects approximately one in every 75 individuals and is usually a chronic illness that lasts throughout a person’s adult life. Although it is treatable, the physical symptoms that mimic other serious illnesses often cause delays in diagnosis and it can take several years before the proper diagnosis is made.

To date, there is no known single cause of panic disorder, but genetic and environmental factors both play a role. If there is already anxiety or depression in a family, it is more likely for an individual to develop the disorder. Also, environmental situations such as stressful transitions like exams, marriage or moving can be triggers for panic disorder.

Although panic attacks are not dangerous, they are extremely frightening and make it nearly impossible to function in certain situations. Also, individuals with panic disorder often develop phobias (such as agoraphobia), depression, substance abuse and other complications.

Fortunately, effective treatment is available for panic disorder. Newer anti-depressant medications or anti-anxiety medications such as benzodiazepines can all help to relieve anxiety and prevent panic attacks.

It is very important that these medications be taken on a regular basis rather than when a panic attack is occurring or anticipated. The latter strategy encourages a psychological dependency on the pills when what is desired is the ability to continue a daily routine regardless of the possibility of a panic attack.

Cognitive-behaviour therapy can also be useful at helping individuals understand the symptoms of a panic attack and learn techniques to lessen their effects. The most important element of this treatment is the elimination of avoidance behaviour. Often the avoidance behaviour becomes more disabling than the actual panic attacks.

Some lifestyle tips such as getting enough sleep and regular exercise and avoiding stimulants such as caffeine can also help to minimize anxiety. Alcohol should also be avoided and individuals experiencing panic attacks may find relaxation techniques helpful as well.

Although stress is often an unavoidable part of life, it is important to learn ways to cope with it effectively.

Dr. Latimer is president of Okanagan Clinical Trials and a Kelowna psychiatrist.

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