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Panic Disorder Home Page

Panic Disorders all of my life. I have created this
page in the hope that I might help someone who suffers
as I do. This is the most concise and informative
site on panic disorders, that you will ever find on
the web.

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Panic disorder is an extreamly common and very important illness,but it is much misunderstood by the general public. The following are questions most commonly asked about this illness.

1.What is Panic Disorder? Panic Disorder is a medical disorder of the brain and body that is capable of causing some of the most agonizing feelings that a human can experience.It can totally disable a person.In fact,it is now known to be a cause of suicide.

2.Isn't it something that anyone would feel under great stress,like when you smell smoke in your house or when you can't find your ticket and your plane is leaving?Absolutely not.Panic Disorder is not a normal feeling under any circumstances.A person in the siuations you describe might certainly feel very tense,the way you feel when you see a policeman's blue flashing light in your rearview mirror. But someone having a panic attack feels something else altogether.Few people in ordinary tense life situations have ever experienced anything like a panic patient feels during one of his attacks.In order to understand what it's like,imagine yourself in a airliner.Suddenly an explosion is heard,the plane shakes violently,then starts to spiral downward out of control.What you would feel then is what a panic patient feels several times a week.

3.Are all Panic Attacks that bad?No.There are much milder versionof the illness,in which there is much less terrifed feeling,but more physical feelings like the heart pounding.This type of panic is harder to recognize because it mimics many other diseases.

4.What are the symptoms of Panic Disorder?A person with this disorder experiences what are called panic attacks,consisting of very terrifying symtoms for five or ten minutes.Usually these attacks are short.Probably no one could live through one that lasted for hours.But several can occur in the same day.The following are common symptoms of a panic attack: A smothering feeling as though your breath is being cut off. A racing,pounding heartbeat. Dizziness. Numbness,particularly in the hands or about the mouth and face. A hot stuffy feeling as though you have to get fresh air. Aclosed-in feeling,as though one is trapped. Chest pains. An empty or nauseated feeling in the stomach. A feeling of somthing terrible,about to happen,even when there is no sign of danger.

Not all panic attacks feature all of these symptoms,and they may not be severe.One thing in common about all these symptoms is that they develop rather suddenly,and for no apparent reason.

5.A PERSON HAVING SYMPTOMS LIKE THAT WHEN NOTHING IS REALLY WRONG SOUNDS CRAZY.DOES NOT SUCH A PERSON HAVE SOME KIND OF MENTAL HANGUP?No! Peoplewho have attacks like this are perfectly normal people in every other way. And there is somthing wrong with them!But it is not a mental hangup. Their body chemistry is not working properly when these attacks occour. The fact that there seems to be no reason to have such terrifying feelings causes other people to think that the panic victim may indeed be crazy.In fact the panic patient himself may even start to wonder if he is losing his mind. The fact that x-rays and other medical test do not show anything wrong makes him feel even more that way.When you suddenly feel the way a person would feel facing an onrushing tiger,and yet you know there is no tiger there,it's not surprising that you start to doubt your own sanity.

6.BUT IT STILL SOUNDS CRAZY.DOESN'T SOMEONE WITH THIS ILLNESS AT LEAST HAVE SOME SORT OF PSYCOLOGICAL WEAKNESS THAT MAKES HIM VULNERABLE TO IT? Again,NO!This is one reason why patients with panic disorder are often put through so many heart test,electrocardiograms,x-rays and other things: The patient is so normal and well-adjusted that the doctors can hardly believe he or she has a panic disorder either!They are convinced that such a normal person must have something "real",like heart disease.And of course,such a patient does have somthing real,just not what the doctor suspects.

7.YOU ARE TRYING TO TELL ME THAT SOMEONE WHO BECOMES COMPLETELY TERRIFIED FOR NO OBVIOUS REASON STILL HAS A MEDICAL DISORDER AND NOT A PYSOLOGICAL HANGUP.HOW DO YOU KNOW THAT? For the folling reasons:

A.When we do psycolgical examinations of panic attack patients we don't find any hangups or maladjusments. B.People who really do have all sorts of hangups,maladjudsted personalities,and troubled childhoods,people who are "chronic losers",etc.don't get panic attacks,or at least no more often than normal people do. C.We can stop the panic attacks by using medications that are not tranquilizers.If these attacks represented a mental hangup,such medicines would not be expected to work.
D.Pehaps most important of all:we can actually produce a panic attack by changing a persons body chemistry. We can take two people,one who has panic disorder and one who does not,and give them fluid called saline(salt water),a fluid commonly used in hospitals. Neither person will fell a thing as the salt water courses through his veins.Then unknown to the two people, we can substitute another commenly used type of IV fluid,lactate for the saline.The person without the panic disorder will feel nothing;he has no idea anything has been changed.The person with the panic disorder will also have no idea that we have changed the fluid,but he will develope a sudden and severe panic reaction,within seconds of recieving the second fluid.Medical science does not understand why a simple IV fluid should cause a panic patient to have one of his attacks. But the fact the fluid does do such a thing proves one point;panic disorder happens as a result of some sort of change in a persons body chemistry,and is not a figment of his imagination!If the patient was just putting on or simply has a psycoligical hangup there would be no way for him to have a panic attack when we make a change in his body chemistry that he doesn't even kmow about.

8.IT'STILL HARD TO BELIEVE.IF THIS IS A MEDICAL DISORDER,WHY DID MY OTHER DOCTOR TELL ME IT WAS JUST MY NERVES?Remember,even though panic disorder has always been with us,it's only in recent years that we have learned what it really is. we are basiclly scientist.We want lab evidence of diseases,and logical explainations for them,before we accept them as realBut unfortunatley,the body gives up secrets of it's chemistry very reluctantley,and only very recently have we begun to understand the secrets of panic disorder. In the past there have been so many disorders we blamed on imagination or neurosis because we didn't understand them.Migraine headaches,menstrual cramps,and certain types of epilepsy are examples.But the important thing is not what people used to think.The only important thing is that we make them stop

9.BUT YOU SAY PEOPLE WITH PANIC DISORDER ARE NORMAL EXCEPT WHEN THEY ARE HAVING THEIR ATTACKS,I KNOW SOME PEOPLE WITH PANIC DISORDERS,AND THEY ARE MISERABLE ALL THE TIME.THEY EVEN STAY LOCKED UP IN THEIR HOUSE,AFRAIDTO GO ANYWHERE.HOW CAN THAT BE NORMAL? This is what happens when panic disorder goes untreated.The condition you describe is called agoraphobia.As a patient has attack over and over again who do not understand,he feels not only frightened but humilated.It is bad enough to have one of these terrifiying attacks,but to have it in a supermarket;or in church,is simply intolerable. Everyone looks at you as though you are some kind of nut.There is a feeling of loss of control during a panic attack,and to lose that control while driving down a Los Angeles Freeway is horrible.Thus as a patient has the attacks over and over again,and realizes he can't predict or stop them,he decides to never again be caught in a situation where his attacks will bring humiliation or danger Thus he sticks close to home and only around people whom He knows and trusts.Now the unfortunate patient has a more complicated problem.Even though medicines can can stop his panic attacks rather easily,it may be many weeks or months before he can bring himself to believe that they are really gone,and trust himself on the freeway or supermarket again.

10.SO WHAT DO DOCTORS DO FOR PANIC ATTACKS?The basic treatment for this disorder is medication.There are three different excellent medications for panic.

11.IS THERE NOT SOME OTHER FORM OF TREATMENT I CAN TAKE,SO THAT I DON'T HAVE TO TAKE PILLS?DOESN'T PSYCHOTHERAPY HELP?There are very capable and respected doctors who do report successes with some forms of therapy that do not involve medications.However these treatments fail far more often than does medication treatment.Also,these other treatments take far too long to work. Panic disorder is miserable and disabling.It should be eliminated by the quickest and most reliable means possible.It is my strong opinion that medication offers the best and quickest route to recovery

12.WHAT TYPE OF MEDICATIONS ARE THESE?Two types of antidepressants and one type of anti-anxiety drug.

FROM HERE ON OUT USE YOUR OWN JUDGEMENT AS I AM NOT A DR. THESE ARE JUST SOMETHINGS I LEARNED ALONG THE WAY!

13.ANTIDEPRESSANTS?WHY SHOULD THEY HELP?DOES THAT MEAN A PERSON WITH PANICDISORDER IS REALLY DEPRESSED?No.many times in medical history a medicine has been developed for one disease and then discovered to work for several others.For example,a drug invented to treat fast heartbeat has turned out to be one of the best drugs for high blood pressure and tremors.The antidepressants turned out to be great for several totally different diseases,such as ulsers,sleep disorders,and chronic pain conditions.Like a baseball player,many drugs are good enough to play in several different postions

14.HOW QUICKLY DO THESE DRUGS WORK?When using our best drug,Alprazalom(formerly known as xanax),you can tell the panic attacks are less severe and less frequent almost immediately.The antidepressants take conciderably longer to work.It's common to elimanate the panic attacks compleatly withhin three weeks.After then a patient may experience an "almost panic" type of attack, as though the panic attack was trying to happen,but was blocked from fully developing.

15.ONCE MY PANIC ATTACK STOP COMPLETELY,AM I CONCIDERED CURED?CAN I STOP THE MEDICATION?Unfortunately NO.Medicatiions do not "cure" panic disorder,they only prevent the attacks from happening.Thus you are like a diabetic who's taking the correct dose of insunlin.Or like an asthmatic patient whose disease has been completely controlled by medication.You will be fine as long as the medication is continued,however if it is stopped,the panic attacks are likely to return,just as would be the case with diabetic patient who stopped his insulin.

16.DOES THAT MEAN I WILL BE TAKING THIS MEDICATION THE REST OF MY LIFE?Not necessarily.Panic disorder does tend to fade away over the years,so that someday the medication will become unnecessary.However,you should not count on this happening very soon.Generally speaking,Panicdisorder lasts for many years.Fortunately,the medication can be taken safely for many years,or even for a lifetime if needed.

17.WON'T THAT MEAN I'M "HOOKED" ON THE MEDICATION?No more so than a diabetic patient is hooked on his insulin,or a man with arthritis is hooked on his arthritis pills.

18.WHAT ARE THE MEDICATIONS,AND HOW ARE THEY DIFFERENT FROM EACH OTHER?Taking them one at a time,the most effective drug we have is an antidepressant called Nardil(generic name phenelzine),but it takes a couple of weeks to work,and there are several foods and drugs that must not be taken if it is used.

The second type of drug is called a tricyclic antidepressant.There are about a dozen of these,but the most commco used for panic is Tofranil(imipramine).These compounds may not be as effective as Nardil,but they can work well for some people.They are safer in that there are no foods you have to avoid.They do generally have more annoying side effects,such as dry mouth and constipation.Addiction to either the tricyclic antidepressants or to Nardil does not occur,and need never be worried about.Some new antidepressants have far fewer side effects than imipramine,such as Prozac,Zoloft and Paxil.These also may help panic.

I feel that the best,quickest,and surest drug is Xanax(alprazolam).This drug is one of eight fairly similar drugs for anxiety known as benzodiazapines.However,it is especially effective against panic disorder.The other seven are equally effective against the ordinary type of anxiety,but require too much dosage to be useful for panic.Xanax has virtually no side effects unless the dosage is too high.In that case,the patient will start to feel sleepy.The problem is easily solved by reducing the dose.Xanax has the advantage of working both for ordinary anxiety and panic disorder,whereas the two antidepressants help only the panic type.The one major disadvantage of Xanax is that it can be abused.This is not a problem for the majority of people,only for the approximately 5% of us who suffer from the disease of alcoholism/addictive disorder.This is a chronic disorder,probably inherited,in which a person can't control certain drugs they take.People with this disorder recieve gratifacation(often called a buzz,a trip,a lift, etc.)that no one else recieves or understands.Unfortunatly in order to continue to get this "buzz" an alcoholic or drug addict has to constantly increase his dose,and this leads to all the difficulties in his life that we know so well.An alcoholic or an addict will not abuse the antidepressants,but if given Xanax,he finds himself in trouble,unable to keep from taking ever-increasing amounts of the drug.For people who don't have alcoholism or addiction,this problem does not occur.One other disadvantage of Xanax that applies to all people is once the drug is given steadily for a long period of time(as is always necessary in treating panic disorder)the drug must never be discontinued suddenly.To do so can result in a severe reaction,even a convulsion.Fortunatly it is never necessary to discontinue Xanax suddenly or "cold turkey".

19.BUT I KNOW SOME PEOPLE WHO HAVE BEEN GIVE ALL THREE OF THESE DRUGS,AND IT GOT THEM "HOOKED".THEY HAVE BEEN TAKING THE DRUG FOR YEARS,AND EVERYTIME THEY TRY TO GET OFF THEY GET REAL NEARVOUS AND HAVE TO GET BACK ON IT.ISN'T THAT ABOUT AS BAD AS HAVING THE PANIC DISORDER?No!They are not hooked.What you are seeing is what happens with any chronic disease when you take away the treatment.Panic Disorder usually last for many years.Fortunatly,you don't have to suffer from it,thanks to these medications.However if you take away the drug that has been controling the illness,the symptoms of the illness will come right back,just like diabetes or other chronic diseases.If you have arthritis,you will need your arthritis pill for many years.If you were to stop taking your arthritis pill,your arthritis would surely flare up again.But you would not be "hooked" on the arthritis pill.You simply still need them.Diabetic people who stop their insulin will surely get sick,but not because they're hooked on their insulin.In the case of panic disorder,sooner or later it goes away,but that may take many years.If and when it goes away,then the antidepressant or the Xanax would be discontinued by slowly and gradually reducing the dose over a period of time.

20.BUT WHAT MIGHT THESE DRUGS DO IF YOU TAKE THEM FOR MANY YEARS?Nothing.Provided that they are taken properly,we have never been able to discover any long-term damage to an individual from using any of the antidepressants or Xanax.Of course,if the person taking Nardil foolishly eats the forbidden foods,or if the person taking Xanax suddenly stops it,harm may come to him.But overall,these drugs are among the safest in all medicine.

21.BUT I DON'T LIKE THE IDEA OF BEING DEPENDENT ON THESE DRUGS.Of course not.The diabetic does not like being dependent on his insulin either.I don't really like to wear my glasses either,but it beats not being able to read!People with ulcers,arthritis,or high blood pressure don't want to have to take these pills.But the disease gives them no choice.And they realize this.So they take their pill,not because they like,but because they like suffering even less.But people are bothered about taking anti-panic drugs because they don't fully understand that panic is a real disease.Some doctors are bothered about prescribing these drugs for the very same reasons.

22.MY FAMILY AND FRIENDS TELL ME THAT BY TAKING THESE DRUGS I AM DOING THE SAME THING THAT "HIPPIES" DO WITH THEIR DOPE.ISN'T THAT TRUE?No there is a big difference.The pill popping hippie is looking for a way to escape life's troubles,or to find some sort of thrill.A panic patient is taking anti-panic drugs to control a disease.That is the great safty of the antidepresants.You can't hide from life's problems with them.They won't elevate your mood or give you a thrill.Niether will Xanax,unless you have the alcoholism/addiction disease.These medications should be viewed in the same manner as penicillin,namely,a drug used to fight disease!

23.BUT MY FAMILY SAYS I NEED TO TRY TO FIGHT THIS DISEASE MYSELF AND NOT DEPEND ON DRUGS. That simply means they have never had panic disorder. It shows that they have no idea what panic disorder really is. They would not tell you that you should fight pneumonia yourself and not take Penicillin. Therefore be certain that anyone close to you, anyone who is aware of your taking medications, anyone who has seen you have your attacks and wondered what it was all about, reads this paper also.

24.WILL I HAVE TO BE TAKING THIS STUFF AND SEEING A DOCTOR FOREVER, LIKE A DIABETIC PATIENT? Most of the time panic disorder fades out, but it may indeed take years. Therefore you may be needing to take the medication for years. Fortunately, if that be the case, you can safely take it for years.

As for coming to doctors, as soon as we have the medications adjusted correctly and have eliminated the panic attacks, then visitors to the doctor can be very infrequent. You will need to see us every several months for refrills of medications and just to touch base. But you will not be faced with having a medical bill to pay every two weeks. Besides, the chance to lead a normal life that is not ruined by these miserable episodes is well worth the cost of medications and doctors. A person with panic disorder shoould be able to lead a normal, productive, and happy life.

don't give up on this page as there is still more to come.



Disclaimer: I am not a doctor. While some opinions offered on this site are offered by medical professionals, not all are. This site is simply meant to help people understand what panic disorders are. Any advice that you take from this site, you take at your own discretion. I can not be held responsible for your medical, and mental welfare. If you believe that you have a medical, or mental health issue please see a licensed professional.

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