Panic
Panic
What Are Panic Attacks and Panic Disorder?
What Are the Symptoms of a Panic Attack?
What Are the Symptoms of Panic Disorder?
How Is Panic Disorder Treated?
Panic (PA-nik) is a sudden surge of overwhelming fear that causes both psychological (sy-ko-LAH-je-kal) and physical symptoms. Panic disorder is a condition that leads to repeated attacks of panic that can strike often and without warning.
KEYWORDS
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Agoraphobia
Anxiety disorders
Panic attack
Carla was riding her bicycle to school when a speeding car ran a stop sign. The driver slammed on the brakes, but the car kept skidding toward Carla with a sickening squeal. As Carla watched the car bearing down on her, she felt her heart racing, she broke into a sweat and couldn’t catch her breath, and everything seemed to be moving in slow motion. For a moment before the car finally came to a stop, Carla feared she was going to die.
What Are Panic Attacks and Panic Disorder?
Carla was feeling panic, a sudden surge of overwhelming terror that causes both psychological symptoms, such as feeling that things are unreal or fearing that death is approaching, and physical symptoms, such as a racing heart, sweating, trembling, shortness of breath, chest pain, upset stomach, and dizziness. These feelings are the body’s natural response to danger or stress. For some people, though, the feelings seem to arise from nowhere. They can occur in seemingly harmless situations, such as while taking a quiet walk or sitting in class. Panic attacks are bursts of intense fear or discomfort that happen, often for no obvious reason. They are part of many anxiety (ang-ZY-e-tee) disorders, in which needless fear becomes so intense and long-lasting that it causes problems at home, in school, at play, or elsewhere.
Panic disorder is a particular type of anxiety disorder in which people have panic attacks that strike often and usually without warning. The attacks are so unpleasant that many people live in constant dread of the next one. People may develop phobias (FO-bee-as), intense, unrealistic fears of certain objects or situations, about things linked to past panic attacks. For example, a boy who has had a panic attack during basketball practice might develop a phobia of the gym. As the problem gets worse, people may start to avoid situations where they believe they might have another panic attack. This avoidance may even turn into agoraphobia (a-gor-a-FO-bee-a), a condition that makes people find it hard to go beyond familiar places or even leave their homes. People with agoraphobia are terrified of having a panic attack in a situation where it would be hard to escape or get help.
How Common Is Panic Disorder?
About 1 in every 63 adults in the United States will have panic disorder at some point in his or her life. The problem usually begins during the late teen or early adult years, but children and older adults can have panic disorder, too. Women are affected twice as often as men. People with panic disorder often have other conditions as well, such as other anxiety disorders or depression.
What Causes Panic Disorder?
Genetics
There are probably several causes of panic disorder. Genetics* may play a role in some cases, since panic disorder and other forms of anxiety can run in families. Also, research has shown that twins are more likely both to have panic disorder if they are identical twins rather than fraternal* twins.
- * genetics
- (je-NE-tiks) is the branch of science that deals with heredity (traits inherited from parents), including the ways in which genes control development and behavior.
- * fraternal
- twins are born at the same time but develop from two separate fertilized eggs. Unlike identical twins, who develop from only one fertilized egg that splits into two and who look exactly alike, fraternal twins may not look the same at all or be the same gender. Identical twins have the same genes, but fraternal twins are no more likely to share genes than non-twin siblings.
Physical factors
People with panic disorder may not be able to use the natural substances made by the body to reduce feelings of anxiety. Such people may have flaws in nerve cell structures in the nervous system* that bind to these substances.
- * nervous system
- is a network of specialized tissue made of nerve cells, or neurons, that processes messages to and from different parts of the human body. The brain and spinal cord are part of the nervous system.
The Mythological Roots Of Panic
The word “panic” comes from the Greek term “panikos,” which means “of Pan.” Pan, the son of Hermes, was the Greek god of nature, of shepherds and their flocks (both goats and sheep), and of music. He was not an especially handsome example of a Greek god, having the upper body of a man and the hindquarters and horns of a goat. Nonetheless, within the woods where he made his home, Pan was known for chasing the ladies. The beautiful nymph Syrinx, in an effort to escape him, was changed into a stand of reeds. Pan plucked one of the reeds and made a musical instrument called a panpipe. When lonely travelers wandered through the wild woods at night, it was said that they heard the pipes of Pan in the wind whistling through the trees and were struck with dread and deep fear. This fear of Pan came to be known as panic.
Psychological factors
Other research suggests that it takes very little to set off the body’s danger alarm in people with panic disorder. These people may have learned to overreact to normal body changes, giving rise to frequent false alarms. Some scientists believe that the faulty learning may be the result of repeated stress. Once people have learned to react this way, a stressful life event may trigger full-blown panic disorder.
Calming Yourself Down
Three things to do if you panic:
- Remind yourself that your feelings and symptoms, though very frightening, are not really dangerous.
- Rate your fear from 0 to 10. Notice how it begins to fall from the highest level after just a few seconds or minutes.
- Distract yourself from your panicky feelings. Count backward from 100 by threes, or snap a rubber band on your wrist. Distracting yourself from the panic will allow the feelings to disappear on their own after a few seconds or minutes, while focusing on the panicky feelings intensifies them.
What Are the Symptoms of a Panic Attack?
Panic disorder starts with panic attacks that can seem to come out of the blue. People can be struck suddenly by scary and uncomfortable symptoms, often including terror, a sense of unrealness, or a fear of losing control. These symptoms usually last several seconds, but they may go on for several minutes or longer. Confused by the unexpected rush of symptoms, people may worry that they are going crazy or suffering from a disease. Even when the most intense symptoms of panic have stopped, other anxious or nervous feelings may last for a while.
Symptoms of a panic attack may include:
- pounding or racing heart
- sweating
- trembling
- shortness of breath
- a choking feeling
- chest pain
- upset stomach
- dizziness
- faintness
- feeling as if things are unreal
- fear of losing control
- fear of dying
- numbness or tingling.
First panic attacks may occur when people are under great stress, such as when they are trying to do too much or when they have just lost a loved one because of death, divorce, or a move. A panic attack also may follow surgery or a serious accident or illness. In addition, overuse of caffeine or abuse of cocaine and certain other drugs may trigger panic attacks. Whatever the situation, though, first panic attacks usually take people completely by surprise. This is one reason they are so terrifying and most often remembered.
What Are the Symptoms of Panic Disorder?
Some people have a single panic attack or occasional attacks, but they never have a problem serious enough to affect their lives. For others, however, panic attacks can continue and cause much misery. People with panic disorder have attacks so often that they start to live in constant fear of the next one. This “fear of fear” can become so intense and last so long that it greatly interferes with people’s lives. Panic disorder tends to get worse over time if it is not properly treated.
How Is Panic Disorder Treated?
Early treatment helps keep panic disorder from reaching the stage where people experience severe problems in everyday life. With proper care, 70 to 90 percent of people with panic disorder can feel much better. Before treatment starts, a medical checkup can determine if there are other possible causes for the person’s physical symptoms, such as an overactive thyroid gland*, certain types of epilepsy*, or problems with the rhythm of the heartbeat.
- * thyroid (THY-royd) gland
- is a gland located in the lower part of the front of the neck. The thyroid produces hormones, chemicals that regulate the body’s metabolism (me-TA-boli-zem), the processes the body uses to convert food to energy. Sometimes problems with the thyroid gland can cause symptoms similar to those of a panic attack.
- * epilepsy
- (EP-i-lep-see) is a condition of the nervous system characterized by recurrent seizures that temporarily affect a person’s awareness, movements, or sensations. Seizures occur when powerful, rapid bursts of electrical energy interrupt the normal electrical patterns of the brain.
Medications
Certain medications can prevent or lessen the severity of panic attacks. When people find that their panic attacks are less frequent or less severe, they may worry less about future attacks, and they may be able to face situations they have been avoiding. There are several different kinds of medications doctors may use to treat panic disorder, depending on the person’s age and condition.
Therapy
A treatment that often works well for panic disorder is cognitive-behavioral (COG-ni-tiv-bee-HAY-vyor-al) therapy, which helps people change specific unwanted behaviors and faulty thinking patterns. People are taught that thoughts such as “I am going to have a panic attack” can be replaced with thoughts like “This is only uneasiness. It will pass.” They also may learn to use slow, deep breathing to help ward off the rapid, shallow breathing that many people experience during panic attacks. In another technique, the therapist may have people intentionally bring on some of the sensations of a panic attack. For example, people may exercise to raise the heart rate. Then the therapist can teach them how to cope better with these physical sensations. For example, instead of thinking, “I am having a heart attack,” a person may be taught to think, “It is only my heart beating fast. I can handle it.”
In this way, cognitive-behavioral therapy focuses on helping people learn to relax when they feel panic. People are taught to understand the thought processes behind their panicky feelings and the way the body physically reacts to stress. Then the therapist can help the person find ways to respond better when they feel the symptoms of a panic attack.
See also
Agoraphobia
Anxiety and Anxiety Disorders
Fears
Phobias
Resource
Organization
Anxiety Disorders Association of America, 11900 Parklawn Drive, Suite 100, Rockville, MD 20852. This nonprofit group promotes public awareness of panic disorder and other anxiety disorders. Telephone 301-231-9350 http://www.adaa.org
Panic
Panic
PANIC AS A SUBTYPE OF ANXIETY DISORDER
PANIC FLIGHT AS A FORM OF COLLECTIVE BEHAVIOR
The term panic is used with a vast variety of meanings by the population at large, as well as by professionals and research scientists in different disciplines. For example, economists talk of financial or stock market panics, scholars of popular culture discuss moral panics or widespread public anxieties about deviant behaviors, and journalists sometime refer to certain kinds of hoarding or buying activities as an expression of panicky behavior. However, this entry confines itself to the two major usages of the term in the scientific and professional literature, which have little to do with the examples just given.
Even the two major usages differ. Along one line, there is an identification of panic with certain kinds of overt behavior by a number of people, such as rapid physical flight from a situation perceived as highly and personally dangerous to individuals in the collectivity involved. Sociologists have primarily used the term this way, and to a lesser extent so have psychologists. The other use of the term has reference to a mental state characterized by a sudden and extreme anxiety attack, with the person being unable to perceive any obvious reason for the reaction. Psychiatrists and other mental health professionals, who have been the primary students of this phenomenon, call it panic disorder.
Apart from using the same term, panic, there is otherwise very little in common between the two approaches. Interest in and study of the phenomena have had radically different origins and have involved different kinds of research by different specialties. In addition, the end goal of the research has differed. Those looking at panic disorder have increasingly come to believe that the mental problem can be dealt with through therapeutic and other measures. Those interested in flight behavior initially thought that understanding such behavior would be useful for disaster planning and crisis management purposes. However, as more empirical studies of disasters have been undertaken, many researchers have increasingly argued that the very concept of panic should be abandoned as a useful concept for scientific research. They argue that what occurs can be much better understood through other concepts, such as social roles and social relationships.
PANIC AS A SUBTYPE OF ANXIETY DISORDER
Panic disorder involves unexpected and repeated episodes of intense anxiety attacks accompanied by physical symptoms that may include chest pain, shortness of breath, heart palpitations, abdominal distress, trembling, dizziness, and a sense of unreality. An attack generally peaks within ten minutes, although some symptoms may last much longer. Many of those suffering from the disorder develop intense anxiety between episodes because they worry when and where the next one will strike. Routines of everyday life can be totally disrupted.
According to the U.S. National Institute of Mental Health, in any given year 1.7 percent of the American population will have a panic disorder. Females are twice as likely as males to develop panic disorders. Panic disorder usually occurs in early adulthood. Roughly half of all people who have panic disorder develop the condition before the age of twenty-four. Such statistics ought to be treated with caution, however; panic attacks are sometimes misdiagnosed and missed because many of the symptoms resemble heart attacks. Also, not everyone who experiences a panic attack will develop panic disorder; people can experience one attack but never have another.
What exactly causes the disorder is unknown. Heredity is probably involved, since the disorder seems to run in families. But there is also evidence that very stressful life events are a factor.
Fortunately, two types of treatment are available for panic disorder. There are medications that can keep symptoms under control as long as the prescribed medication is used. There are also specific kinds of psychotherapy that can teach sufferers how to view panic attacks differently, as well as ways to deal with the anxiety between attacks. Reports on success rates vary considerably, but it appears that a majority of those treated are helped. However, since panic disorder often coexists with other disorders and physical ailments, restoration to a less stressful life is also dependent on treatment of these other problems. Information on panic disorder and its treatment is available on the Internet, but care should be taken to insure that such reports are from legitimate medical sources.
PANIC FLIGHT AS A FORM OF COLLECTIVE BEHAVIOR
In the 1920s, sociologists interested in the study of collective behavior (which looks at nontraditional or emergent behavior) began discussing instances of panic in certain risky situations, such as a fire in a crowded theater. The prevailing idea was that panic involved extreme and groundless fear that spread in a contagion-like way, resulting in irrational flight behavior, with individuals trampling one another. This view of panic is still commonly depicted in disaster movies and television shows.
However, the emergence of systematic disaster studies in the mid-twentieth century led to some reformulations about the nature of panic and the conditions necessary for its emergence. Research has shown that panic flight, while not unknown, is extremely rare in disasters and similar kinds of crises. The notion that panic behavior spreads through contagion has been widely discredited. The behavior is not irrational from the viewpoint of those involved. There is no evidence that certain kinds of people are more likely to flee in panic. At worst, panic is asocial rather than antisocial in that people do not regress to an animal-like response.
Panic flight also occurs only under specific conditions. Potential participants must believe that there is an immediate and certain risk to their own life. Contrary to stereotypic views, flight will not be attempted if there is a belief that one is completely trapped. In other words, there must be hope that escape is possible. Persons who break in panic know what they are afraid of, and they are moving away from a specific location (in contrast to a stampede, which involves convergence). It is fear, not anxiety, that prevails. Finally, what others are doing around a person is crucial. This social interaction can work both ways, but usually reinforces a tendency not to flee.
SEE ALSO Anxiety; Psychotherapy; Psychotropic Drugs
BIBLIOGRAPHY
Aguirre, Ben. 2005. Emergency Evacuations, Panic, and Social Psychology. Psychiatry 68 (2): 121–129.
Johnson, Norris. 1987. Breakdown of Social Order: Popular Myth, Social Theory, Empirical Evidence. Sociological Focus 20: 171–183.
National Institute of Mental Health. 1999. Facts About Panic Disorders. http://www.nimh.nih.gov/publicat/panicfacts.cfm.
National Institute of Mental Health. 2000. Anxiety Disorders. http://www.nimh.nih.gov/publicat/anxiety.cfm.
Quarantelli, Enrico. 2001. Sociology of Panic. In International Encyclopedia of the Social and Behavioral Sciences, eds. Neil Smelser and Peter Baltes, 11020–11023. Oxford: Elsevier.
Enrico L. Quarantelli
panic
pan·ic1 / ˈpanik/ • n. sudden uncontrollable fear or anxiety, often causing wildly unthinking behavior: she hit him in panic | [in sing.] he ran to the library in a blind panic. ∎ widespread financial or commercial apprehension provoking hasty action: he caused an economic panic by his sudden resignation | [as adj.] panic selling. ∎ inf. a frenzied hurry to do something: a workload of constant panics and rush jobs.• v. (-icked, -ick·ing) [intr.] be affected by panic: the crowd panicked and stampeded for the exit. ∎ [tr.] cause to feel panic: talk of love panicked her.DERIVATIVES: pan·ick·y adj.pan·ic2 (also panic grass) • n. any of a number of cereal and fodder grasses (Panicum and related genera) related to millet.
panic
Hence panicky (-Y1) XIX.