Your Father's Mental Health: Panic Disorder or Something Else?

Q: Your Father's Mental Health: Panic Disorder or Something Else?

Hello： Based on your letter, it seems that your father's symptoms cannot lead to an immediate diagnosis, but he may be experiencing psychological (emotional) distress. <br>Since he is considering seeking medical help and has a history of overcoming panic disorder, it would be ben

Panic disorder!? Depression? Or something else?

Hello Doctor: My father had a panic disorder ten years ago, which was treated successfully, but it has relapsed in the past two to three years.
However, I am uncertain if he is experiencing panic disorder again, as he does not seem to exhibit the typical symptoms.
Currently, he has several symptoms:
1.
He often feels unwell and believes he is sick (especially concerning his heart).
Whenever he starts feeling uncomfortable, he rushes to the hospital for emergency care or to see a cardiologist.
Despite numerous visits and tests, doctors have assured him that there are no issues, yet he still believes there is a problem with his heart.
2.
His daily routine has changed significantly.
For example, he often sleeps a lot.
On weekends, he wakes up early to complete tasks, but once he has nothing to do, he falls asleep in a chair.
He sleeps until lunchtime, eats, watches TV for a short while, then goes back to sleep until around 5-6 PM when he prepares for dinner.
After dinner, he goes to bed before 9 PM.
This is his weekend schedule.
On weekdays, he maintains a normal work routine, but after dinner, he also goes to sleep before 9 PM and sleeps until 5 AM the next day, repeating this cycle.
3.
He has become very anxious and often feels the need to complete tasks quickly, even if they are trivial or could be done by others.
For instance, when his children have classes, he insists on leaving before it’s time, or he rushes family members to take showers so he can wash and dry the laundry.
This behavior creates tension for the family as well.
4.
Although we have considered helping him find a focus in life, such as learning new things or taking him out on weekends, he quickly becomes anxious to return home after being out for a short time.
Additionally, if he knows in advance that he will be going out the next day, he tends to feel unwell and reluctant to leave the house.
Given these observations, I would like to ask the doctor what my father's condition might be.
How can our family help him?

Niming, 20~29 year old female. Ask Date: 2016/03/12

Dr. Qiu Junda reply Psychiatry

Hello: Based on your letter, it seems that your father's symptoms cannot lead to an immediate diagnosis, but he may be experiencing psychological (emotional) distress.
Since he is considering seeking medical help and has a history of overcoming panic disorder, it would be beneficial to assist him in consulting a psychiatrist or the original physician who treated his panic disorder.
This will allow for a discussion regarding his condition and facilitate learning appropriate ways for family members to provide support.

Reply Date: 2016/03/12

More Info

Understanding your father's mental health, especially in the context of his past panic disorder, is crucial for both his well-being and the harmony of your family. Based on the symptoms you've described, it seems that your father may be experiencing a combination of anxiety and possibly depressive symptoms, rather than a straightforward recurrence of panic disorder.

Firstly, the fact that your father frequently feels unwell, particularly concerning his heart, and seeks emergency medical attention despite multiple negative evaluations from doctors, suggests a condition known as health anxiety or hypochondriasis. This condition can lead individuals to become preoccupied with their health, often interpreting normal bodily sensations as signs of serious illness. This behavior can be exacerbated by past experiences with panic disorder, as the fear of experiencing panic attacks may lead him to misinterpret physical sensations as dangerous.

Secondly, the significant changes in his daily routine, such as excessive sleeping and a lack of engagement in activities he once enjoyed, could indicate depressive symptoms. Depression in older adults can manifest differently than in younger individuals, often presenting as irritability, fatigue, and withdrawal from social interactions. Your father's tendency to sleep excessively and his reluctance to engage in activities outside the home are concerning signs that he may be struggling with his mental health.

Additionally, his increased urgency to complete tasks, even those that seem trivial, could reflect an underlying anxiety disorder. This behavior may stem from a need for control in his environment, which can often be a coping mechanism for anxiety. The pressure he places on himself and others can create a tense atmosphere at home, which is understandably distressing for you and your family.

To help your father, consider the following steps:
1. Open Communication: Encourage open and honest discussions about his feelings and experiences. Approach the topic gently, expressing your concern and love. Let him know that it’s okay to talk about his fears and anxieties without judgment.

2. Encourage Professional Help: Given his history of panic disorder and current symptoms, it may be beneficial for him to see a mental health professional. A psychiatrist or psychologist can provide a proper assessment and recommend appropriate treatment, which may include therapy or medication.

3. Promote Healthy Routines: Encourage him to establish a more structured daily routine that includes physical activity, social interactions, and hobbies. Gentle encouragement to engage in activities he once enjoyed can help combat feelings of isolation and depression.

4. Family Support: As a family, it’s essential to support each other. Consider family therapy sessions where everyone can express their feelings and learn how to communicate more effectively. This can also help your father feel less isolated in his struggles.

5. Educate Yourself: Understanding anxiety and depression can help you empathize with what your father is going through. Resources such as books, articles, or support groups can provide valuable insights into managing these conditions.

6. Monitor Symptoms: Keep track of any changes in his behavior or mood. If his symptoms worsen or if he expresses thoughts of self-harm or suicide, seek immediate help from a mental health professional or emergency services.

In conclusion, your father's symptoms suggest a complex interplay of anxiety and possible depression rather than a simple recurrence of panic disorder. By fostering open communication, encouraging professional help, and promoting healthy routines, you can play a vital role in supporting your father's mental health journey. Remember, mental health issues are often best addressed with the help of professionals, and your family's support can make a significant difference in his recovery.

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