Panic Disorder. Dr. Muhammad Waseem Consultant Psychiatrist(Emergency) Punjab Institute of Mental Health. What is Panic Disorder?. Panic Disorder is a serious anxiety disorder.
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Dr. Muhammad Waseem
Punjab Institute of Mental Health
Panic Disorder is a serious anxiety disorder.
Sudden attacks of anxiety in which physical symptoms predominate and are accompanied by fear of a serious consequence such as heart attack.
Diagnosis is made when panic attack occur unexpectedly (not response to known phobic stimulus).& when more than 4 attacks have occurred in 4 weeks or one attack is followed by 4 weeks of persistent fear of another attack
A panic attack is a sudden episode of intense fear with symptoms that may include the following:
A person needs to have 4 or more of these symptoms, one of these symptoms does not mean that he/she is having a panic attack. Some of the above symptoms can also be indications of serious medical conditions that would require a physician's medical evaluation.
What happens next?
Individuals who suffer from panic attacks can frequently begin to:
Or may progress to:
Family members more likely to have Panic Disorder? Statistics show that there is a 6 to 8 times greater risk of Panic Disorder in family members of individuals with Panic Disorder.
For first time panic attacks need medical evaluation
The usual medical evaluation includes:
There are many medical problems that may sometimes cause symptoms of a panic attack or have symptoms that are similar to a panic attack, including:
Yes. There are some medications that may cause symptoms of a panic attack or have symptoms that are similar to a panic attack in some people, including:
Three main hypothesis about origin of panic disorders
1. Biochemical Abnormality
Some pts with panic disorders hyperventilate with the effect that
Note: in DSM IV PD can be diagnosed when these disorders are present but in UK it is custom not to diagnose in the presence of these disorders.
There are several common treatments for Panic Disorder including:
Mr.Ibrar is a 19 –year old unmarried resident of district Layya, educated up to 8th class, farmer by occupation presented to PIMH Emergency 3 months ago with the following complaints:-
Palpitation one month
Shortness of breath 15 days
chest discomfort 15 days
Fear of death 15 days
First episode occurred after hearing the death story of one of his relative. He woke up in the mid of night and started crying with accelerated heart rate. He was taken to district hospital and doctor on duty after attending him gave tablet propranalol and bromazepam.He remained in the hospital for 2 to 3 hours and then discharged.
Next morning his family consulted cardiologist at Bhakhar.After taking history, doing physical and systemic examination,ECG and some blood tests. He declared that he is not having any cardiac problem. However he prescribed tablet inderal and Lexotanil to the patient
Then he started having shortness of breath, chest discomfort, and fear of death.
Next day he presented to PIC.