ANXIETY DISORDERS (WITH OR WITHOUT AGORAPHOBIA) Brian Bexton, M.D., Psychiatrist and Psychoanalyst, Vice-President of Revivre

What is panic disorder? A reaches its peak quickly – quent among women as men. Panic disorder usually in less than 10 minutes – and is limi - with agoraphobia is three times as frequent ted in duration. It is frequently associated among women. Biological and psychosocial A panic attack is a sudden episode of very with the feeling that a disaster is about to factors are believed to play a role in this intense fear, accompanied by at least four of happen, and the person often feels an urgent disorder. Traumatic events, separation the following symptoms: need to flee. It can happen anywhere at any - during childhood, and learning time. through observation may increase the likeli - • Palpitations or accelerated heart rate; hood of occurrence. From a biological pers - Panic attacks can occur with other anxiety pective, certain neurotransmitters may be • Dizziness, light-headedness, or feeling disorders, such as social or specific involved, such as norepinephrine, serotonin, faint; phobia. For example, for someone who has a and GABA. phobia involving spiders, seeing a spider can • A sensation of suffocating or shortness trigger a panic attack. On the other hand, 50% to 60% of people who suffer from of breath; even though people who suffer from panic panic disorder also suffer from , disorder sometimes have panic attacks that and one-third of these people suffered from • Nausea or upset stomach; are associated with or made more likely by a depression before they developed panic particular situation, the diagnosis of panic disorder. People often have other anxiety • Tingling or numbness; disorder requires that panic attacks occur disorders as well. unexpectedly. • Chills or hot flashes; Panic disorder may or may not be accompa - • Fear of dying; nied by agoraphobia, which is a condition Warning signs that causes an individual to make an effort • Fear of going crazy or losing control; to avoid places or situations where it would be hard to escape or find help in the case of For some people, panic disorder begins or • Sweating; a panic attack (e.g.: avoiding pools, crowds, intensifies when there’s a break in or loss of and mass transit, being afraid of traffic jams, a significant relationship. Signs that panic • Trembling or shaking; etc.). When these situations can’t be avoi - disorder may be developing include the fol - ded, it causes severe distress or intense fear lowing: an individual has experienced more • Chest pain or discomfort; of a panic attack. than two unexpected panic attacks and the fear of having a panic attack has lasted for a • A feeling of choking; Panic disorder affects between 1.5% and month or more; the individual experiences 3.5% of the population, and although there significant distress and has problems perfor - • Feeling detached from oneself or a fee - is a great deal of variation in terms of the ming daily activities and getting work done; ling of unreality. age when it first appears, it is often between the individual does not take advantage of late adolescence and the mid-thirties. Panic interesting opportunities because of a fear of disorder without agoraphobia is twice as fre - having a panic attack.

Support • Information • Referral 514 REVIVRE (738-4873) • Toll free: 1 866 REVIVRE • Revivre.org Symptoms Treatment Where to go for help

The symptoms of panic disorder can mani - The two main forms of treatment for this If you think you have panic disorder and you fest as concerning the possible disorder are psychotherapy and medication. want to learn more about the available consequences or implications of a panic treatments, one of the first steps may be to attack. For example, people who suffer from Psychotherapy helps to alter certain beliefs talk to a doctor. For psychological help, you panic disorder may be afraid that their symp - and thoughts that can intensify the symp - can consult a psychotherapist who is reco - toms are caused by a serious illness (heart toms of panic attacks. One form of therapy gnized by a professional association, such as problems, etc.) or that they will lose control that has been recognized as effective for a psychologist or a social worker. permanently and go insane. Many people panic disorder consists of gradually exposing may even go to the emergency room or call the person to problematic situations in order an ambulance. to replace avoidance behaviours with more appropriate behaviours. People who suffer from agoraphobia may become more and more isolated, to the point In terms of medication, that where they significantly limit their activities act on serotonin are often recommended for and social life. panic disorder. may also be prescribed, but should be used in modera - The frequency of panic attacks among those tion, because they can lead to addiction and who suffer from panic disorder varies signifi - dependency. cantly from one person to another. Some people have several per day, while others Self-help groups – such as those at Revivre – may only experience them once per month. can help to break the isolation by bringing They also vary in severity. people who are going through similar situa - tions together. They provide a place where SUPPORT, INFORMATION, REFERRAL you can talk about your feelings and anxie - 514 REVIVRE (738-4873) ties without fear of being judged. It can also Toll free: 1 866 REVIVRE be helpful to hear the stories of other people Revivre.org who have learned to live with the disorder.

The printing of this sheet was made possible by a grant from the health improvement program