Anxiety Disorders (Panic Disorder)

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• Panic Disorder is the fear of having a spontaneous panic attack. It was first recognised and included in the American Psychiatric Association's Diagnostic& Statistical Manual (DSM) 111 in 1980. Ongoing research has greatly increased the knowledge and understanding of this Disorder. 
• Spontaneous panic attacks comes without any apparent warning warning, day or night, irrespective of what the person is doing. Many people report that panic attacks happen when they are relatively 'calm' or 'relaxed' eg when they are watching TV or reading a book. 
• A research study we undertook in 1993 regarding spontaneous panic attacks showed that 78% of Panic Disorder participants reported experiencing a panic attack when relatively 'calm'. 69% of Panic Disorder participants report they experience a panic attack while going to sleep and 86% report that the panic attack wakes them from sleep at night.

Three internationally recognised experts in Panic Disorder describe a panic attack as follows:

• "An intense recurring spasm of panic that start ... just below the breastbone and seem to spread like a white hot flame .. passing through the chest, up the spine, into the face, down the arms and even down into the groin to the tips of the toes"  
  (C. Weekes (1962): Self Help for your Nerves. London: Angus & Robertson pp33)
• "The attacks start with a tingling feeling going up my spine which enters my head and causes a sensation of faintness and nausea"  
  (J. Hafner (1986). Marriage and Mental Illness. New York: The Guildford Press pp 39) 
• "A rushing sensation of a hot flash through the body .. sometimes associated with a sick feeling and a sensation of fading out from the world but this faintness is more like a 'white out' than a 'black out' and that the head may literally feel light." 
  (Sheehan (1983). The Anxiety Disease. Charles Scribner's Son NY.)

Our own research into the subjective experience of the spontaneous panic attack, found that many people with Panic Disorder can experience various sensations moving through their body - either before or during the actual panic attack. These sensations can change from one 'attack' to the next which only adds to the confusion people feel. These sensations can include:

• Electric current moving through the body
• Hot prickly sensation moving through the body
• Intense heat or burning pain moving through the body
• "Unusual" intense flows of energy throughout the body
• Rushes of 'energy' shaking the body
• Tingly sensation moving through the body
• Creeping sensation moving through the body
• Wave-like motion of energy moving through the body
• Vibration moving through the body
• White hot flame through the body
• Ice cold sensation through the body
• "Ants crawling" sensation over the body

Our research also found many people can dissociate first and then panic as a result. Symptoms of dissociation can include :

• Derealisation (a feeling that you and/or your surroundings are not real)
• Depersonalisation (a feeling that you are detached from your body)  
• Sensitivity to light and/or sound   
• Dizziness

As with the other anxiety disorders, people with panic disorder also experience other symptoms which can include : 

• Racing heart beat   
• 'Missed heart beats  
• Palpitations  
• Difficulty breathing   
• Chest pain  
• Left arm pain   
• Jaw pain   
• Nausea Shaking and trembling  
• Choking sensation  
• Perspiration   
• Headache  
• Neck pain
• Churning / burning stomach

The major fears associated to the experience of spontaneous panic attacks are

• Fear of having a heart attack  
• Fear of dying from a panic attack  
• Fear of going insan
• Fear of losing contro

Many people who experience spontaneous panic attacks do feel as if they are dying and / or having a heart attack, or feel as if they are going insane or will lose control during the panic attack. As a result people become frightened of having another one. It is this fear that leads to the development of panic disorder.
This is turn can lead to the secondary conditions associated to panic disorder which include avoidance behaviour (agoraphobia), major depression and/or prescribed drug addiction and/or alcohol abuse. 

While the experience of spontaneous panic attacks can be minimised to a large degree, the development of panic disorder, and the secondary conditions can be prevented.