Panic Disorder: Symptoms, Diagnosis, and Management
Panic Disorder
Cases
•
Imagine you've just stepped into an elevator and
suddenly your heart races, your chest aches, you
break out in a cold sweat and feel as if the
elevator is about to crash to the ground. What's
happening?
•
Imagine you are driving home from the grocery
store and suddenly things seem to be out of
control. You feel hot flashes, things around you
blur, you can't tell where you are, and you feel as
if you're dying. What's happening?
Panic Disorder
panic attacks as abrupt surges of intense fear or
discomfort that peak within minutes. People
with the disorder live in fear of having a panic
attack.
Presenting Complaints
One or more physical symptoms
chest pain, shortness of breath, dizziness,
feeling of suffocation, fear of having a heart
attack
Diagnostic features
•
3-4 attacks of sudden onset of anxiety or fear
•
racing heartbeat or palpitations
•
shortness of breath
•
feeling like you are choking
•
dizziness (vertigo)
•
lightheadedness
•
nausea
•
sweating or chills
•
shaking or trembling
•
changes in mental state, including a feeling of derealization (feeling
of unreality) or depersonalization (being detached from oneself)
•
numbness or tingling in your hands or feet
•
chest pain or tightness
•
fear that you might die
Differential Diagnosis
•
Similar symptoms like coronary artery disease
(CAD) and asthma.
•
These attacks occurs only in specific feared
situations like phobias
•
If low or sad mood also occurred considered
depression
Management
1.
Provide Information Care
–
Anxiety produces frightening physical symptoms
–
Symptoms are not dangerous
•
Mental and physical anxiety reinforce each
other (concentrate physical symptoms)
•
Don’t withdraw from or avoid situation it
strengthen anxiety
2. Counseling
•
concentrate on controlling anxiety
•
Practice to calm your self
•
Identify aggregated fear / discuss how to
challenge it
•
Patient must be left alone if symptoms are
being scary
3. Medication
•
Many patients may not need medication
•
Antidepressants
•
imipramine
•
Anti-anxiety
•
Lorazepam
•
benzodiazapine
Panic disorder is characterized by sudden, intense surges of fear or discomfort known as panic attacks. Individuals with this disorder may experience symptoms like chest pain, shortness of breath, dizziness, and a fear of having a heart attack. Differential diagnosis includes conditions like coronary artery disease and asthma. Management involves providing information, counseling to control anxiety, and medication if necessary.
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Presentation Transcript
Cases Imagine you've just stepped into an elevator and suddenly your heart races, your chest aches, you break out in a cold sweat and feel as if the elevator is about to crash to the ground. What's happening? Imagine you are driving home from the grocery store and suddenly things seem to be out of control. You feel hot flashes, things around you blur, you can't tell where you are, and you feel as if you're dying. What's happening?
Panic Disorder panic attacks as abrupt surges of intense fear or discomfort that peak within minutes. People with the disorder live in fear of having a panic attack. Presenting Complaints One or more physical symptoms chest pain, shortness of breath, dizziness, feeling of suffocation, fear of having a heart attack
Diagnostic features 3-4 attacks of sudden onset of anxiety or fear racing heartbeat or palpitations shortness of breath feeling like you are choking dizziness (vertigo) lightheadedness nausea sweating or chills shaking or trembling changes in mental state, including a feeling of derealization (feeling of unreality) or depersonalization (being detached from oneself) numbness or tingling in your hands or feet chest pain or tightness fear that you might die
Differential Diagnosis Similar symptoms like coronary artery disease (CAD) and asthma. These attacks occurs only in specific feared situations like phobias If low or sad mood also occurred considered depression
Management 1. Provide Information Care Anxiety produces frightening physical symptoms Symptoms are not dangerous Mental and physical anxiety reinforce each other (concentrate physical symptoms) Don t withdraw from or avoid situation it strengthen anxiety
2. Counseling concentrate on controlling anxiety Practice to calm your self Identify aggregated fear / discuss how to challenge it Patient must be left alone if symptoms are being scary
3. Medication Many patients may not need medication Antidepressants imipramine Anti-anxiety Lorazepam benzodiazapine
