What Causes Panic Disorder?
There seems to be about a 40% genetic contribution to developing panic disorder in twin studies. Having another family member with panic disorder is also increased between 8 and 20 times. People usually have their first symptoms somewhere between their mid-teen years and their mid-thirties. One to two percent of people will have Panic Disorder in their lifetime with its involvement in women twice to three times as often.
Are there Specific Tests for Panic Disorder?
No, but it is extremely important that we rule out medical problems before we assume someone is having a panic attack. Also, once a person has panic attacks they may visit the emergency room frequently as they continue to feel something is ‘really wrong’ with them. The problem this causes is that, at times, staff in an emergency room may not consider the person’s complaints seriously assuming they are having another panic attack. In these cases it may be advisable for the person to call their clinician who can assess the situation and if a person needs to be assessed in the emergency have the clinician call first with their concern. Psychological screens and tests for panic disorder may be helpful for initially screening in professional assessments and to help follow the results of a person’s efforts. In the end, nothing is better than someone taking the time to get to know you, your personal and family history and how you presently see your world.
How is Panic Disorder a Family Illness?
Panic disorder varies quite a bit in severity. It can be mild and last for only a few months or it can be severe, all life encompassing, waxing and waning for a life time. The person feels the anxiety as real. This may cause distortions in how children are raised. It can cause a person to leave school or lose a job. Employers may try to make accommodations but frequently the person can’t reliably leave the home. The illness can be unpredictable or predictably oppressive. Other family members, friends and acquaintances will respond in predictable ways depending on whether they feel the disorder is ‘real or an excuse’. Compassionate response of family members is critical.
Panic Disorder Treatment
When it comes to Panic Disorder treatment, Cognitive Behavioral therapy is an excellent place to start. If the panic and anxiety are initially moderate or severe medications can be helpful. I suggest starting any medication at a low dose for safety and to make sure that panic disorder is all we are treating. At times Bipolar Disorder can present as a string of panic attacks and the off again, on again response to an antidepressant can be very confusing.
As an aside, it is very interesting that people with such anxiety usually really dislike taking any medication. I often joke that a person with panic disorder licks one side of the pill one night and then the other side the next night. The good thing about this, is that this dislike of medication makes medication abuse much less likely.
If medication is used up front it is highly advisable that they see a person very familiar with CBT and Panic Disorder as soon as possible. Often people struggle to see someone new and the therapy is likely the longer term answer. Know that family issues abound when agoraphobia predominates. Please consider having family members come in early to provide their viewpoint and to make sure that the person’s overall support is not being compromised by the illness.
Where can I find Help?
- Many online SITES like the National Institute of Mental Health, NIMH
- Several books have helped others:
Peace for Nervous Suffering by Clair Weekes, Ph. D.
The Anxiety Disease by David Shehan, MD
- Support Groups like National Alliance on Mental Illness, NAMI, have web sites (NAMI.org) and local support groups.
- Friends who have successfully dealt with Panic Disorder themselves or in a family member may have information about local resources.
- Many church communities have resources or know of local resources.
- Your family doctor can review any medical issues and likely has suggestions about local resources.
- Local therapists, psychologists or psychiatrists who specialize in Panic Disorder can provide asssessments and help you develop a plan of action.
- When needed, you can go to a nationally recognized center for treatment or a second opinion.