Panic Disorder: Symptoms, Diagnosis, and Treatment Options

I am sick?

Hello Doctor: What are the diagnostic criteria for panic disorder? If someone has panic disorder, will palpitations be severe? Is it necessary to see a cardiologist for diagnosis? Does taking spirulina affect the condition? Thank you for your response.

A-Rong, 20~29 year old female. Ask Date: 2004/12/18

Dr. Tang Xinbei reply Psychiatry

Dear A-Rong,
Panic is an inexplicable state of emotional tension and anxiety.
When this state occurs repeatedly and affects the individual's daily life, functional performance, and interpersonal relationships, causing distress in various aspects of life and emotions, it is termed "panic disorder." Generally, panic disorder is episodic, with each episode lasting from 10 to 30 minutes, rarely exceeding one hour.
The primary psychological symptoms include extreme fear or a feeling of impending death.
Patients often cannot articulate what they are afraid of; they experience confusion and difficulty concentrating.
Physiological symptoms include: rapid heartbeat, palpitations, shortness of breath, and sweating.
According to the diagnostic criteria outlined in the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV), published by the American Psychiatric Association in 1994, a patient must experience intense fear or discomfort during a specific period, suddenly manifesting at least four of the following symptoms, reaching their peak within ten minutes: palpitations or accelerated heart rate, sweating, trembling or shaking, feelings of shortness of breath or choking sensations, feelings of choking, chest pain or discomfort, nausea or abdominal distress, dizziness or unsteadiness (feeling faint), feelings of unreality (feeling detached from reality) or feelings of depersonalization (feeling disconnected from oneself), fear of losing control or going crazy, fear of dying, abnormal bodily sensations (numbness or tingling), chills or hot flashes.
If you are experiencing similar distress and a cardiologist has determined that there are no cardiac issues, please seek consultation with a psychiatrist as soon as possible.
As for whether consuming spirulina will affect your condition, I cannot provide an answer as I have not researched this matter.
Wishing you peace and joy!

Reply Date: 2004/12/18

More Info

Panic disorder is a type of anxiety disorder characterized by recurrent and unexpected panic attacks, which are sudden periods of intense fear or discomfort that peak within minutes. Understanding the symptoms, diagnosis, and treatment options for panic disorder is crucial for effective management and recovery.

Symptoms of Panic Disorder
The symptoms of panic disorder can vary from person to person, but they typically include:
1. Panic Attacks: These are the hallmark of panic disorder. A panic attack can include symptoms such as:
- Rapid heart rate (palpitations)
- Sweating
- Trembling or shaking
- Shortness of breath or a feeling of choking
- Chest pain or discomfort
- Nausea or abdominal distress
- Dizziness, lightheadedness, or feeling faint
- Chills or heat sensations
- Numbness or tingling sensations
- Feelings of unreality or detachment from oneself
- Fear of losing control or "going crazy"
- Fear of dying
2. Persistent Worry: After experiencing panic attacks, individuals often develop a persistent fear of having more attacks, which can lead to significant changes in behavior, such as avoiding situations where they fear an attack might occur.

3. Physical Symptoms: Many individuals with panic disorder may also experience physical symptoms that can mimic other medical conditions, leading them to seek medical attention for heart issues or other concerns.

Diagnosis of Panic Disorder
The diagnosis of panic disorder is typically made by a mental health professional based on the following criteria:
1. Recurrent Panic Attacks: The individual must have experienced recurrent and unexpected panic attacks.

2. At Least One Month of Worry: Following the attacks, there must be at least one month of persistent concern about having additional attacks or the consequences of the attacks (e.g., losing control, having a heart attack).

3. Exclusion of Other Conditions: The symptoms must not be attributable to the physiological effects of a substance (e.g., drug abuse, medication) or another medical condition (e.g., hyperthyroidism, heart disease).

Treatment Options for Panic Disorder
Treatment for panic disorder often involves a combination of psychotherapy and medication:
1. Cognitive Behavioral Therapy (CBT): This is one of the most effective treatments for panic disorder. CBT helps individuals identify and change negative thought patterns and behaviors that contribute to panic attacks.

2. Medications: Antidepressants (such as SSRIs like Prozac) and anti-anxiety medications (such as benzodiazepines like Xanax) can be effective in managing symptoms. It is essential to work closely with a healthcare provider to find the right medication and dosage.

3. Lifestyle Changes: Incorporating regular physical activity, practicing relaxation techniques (like deep breathing or mindfulness), and avoiding caffeine and alcohol can help reduce anxiety levels.

4. Support Groups: Connecting with others who have similar experiences can provide emotional support and coping strategies.

Addressing Specific Concerns
Regarding your specific questions:
- Severity of Palpitations: Yes, palpitations can be a severe symptom of panic disorder. However, they can also be caused by other medical conditions, so it is essential to consult with a healthcare provider to rule out any underlying heart issues.

- Consulting a Cardiologist: If you are experiencing significant heart-related symptoms, it is advisable to see a cardiologist to ensure that there are no underlying cardiac issues. Panic disorder can coexist with other medical conditions, and a thorough evaluation is essential.

- Impact of Green Algae: While dietary supplements like green algae (spirulina or chlorella) are generally considered safe, they can interact with medications or exacerbate anxiety in some individuals. It is best to discuss any supplements with your healthcare provider to ensure they do not interfere with your treatment plan.

In conclusion, panic disorder can significantly impact an individual's quality of life, but with appropriate treatment and support, many people can manage their symptoms effectively. If you suspect you have panic disorder, seeking help from a mental health professional is a crucial first step toward recovery.

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