In panic Disorder, recurrent unexpected panic attacks occurs with or without a trigger. A panic attack is an abrupt surge (it can accrue from a calm state or anxious state ) of intense fear or intense discomfort, that reaches a peak within minutes, during which time 4 or more of the following symptoms accrue.
Symptoms of Panic Disorder
Persistent concern or worry about additional panic attacks and their consequences is because of anticipatory anxiety or residual anxiety. A patient with panic disorder is always on the edge, he never feels relaxed. A panic attack may come and go but he will be under constant fear of consequent panic attacks. After a panic attack, the patient feels weak, physically exhausted, and mentally drained.
Because of the recurrent panic attacks, the patient identifies the situation in which panic attacks can occur and tries to avoid such situations. One-third of the panic disorder patients get a panic attack at public places so they avoid visiting such places or even avoid going out alone. One-third of the panic disorder patients get panic attacks when they are alone in the house so they always prefer to be with someone.
frequency and severity of panic attacks vary widely
Some of the patients may avoid running, exercising, driving, lift, tunnels, or closed spaces as they fear that if they will have panic attacks in this situation, who will rescue them? The frequency and severity of panic attacks vary widely. In terms of panic attacks, it may be one per month, one per week, or even daily. One-third of panic disorder patients can get nocturnal panic attacks.
Because of the anticipatory anxiety, the patient keeps on spectating and spying the rhythm of the heart. If he finds his heart beating a bit fast, he will science that a fresh panic attack will come. Because of this, his anxiety will increase, because of this anxiety heart rate will increase, this will set a vicious cycle hence precipitating a panic attack.
In Panic Disorder, Panic Attack may come with or without trigger
In panic disorder, there is a cycle of panic attacks. After panic attacks, fear of panic attacks will increase, which will, in turn, increase the possibility of panic attacks. In panic disorder, panic attacks may come with or without triggers. At least 50% of panic attacks occur without triggers or occur in a situation where there is no fear or stress eg. Panic attack while taking lunch or dinner, panic attack while watching tv, panic attack while relaxing.
Life time Prevalence of Panic Attack
The life-time prevalence of panic attack (at least once in a lifetime) is 30-35% patients. Usually the median age of onset of panic attack is 20-24 years. A small number of cases begin in childhood or even after the age of 45 years. Individuals with panic disorder may be frequently absent from work or school. They visit specialists and emergency rooms frequently which can lead to unemployment and dropping out of school.