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Panic disorder

Visit us (http://www.khanacademy.org/science/healthcare-and-medicine) for health and medicine content or (http://www.khanacademy.org/test-prep/mcat) for MCAT related content. These videos do not provide medical advice and are for informational purposes only. The videos are not intended to be a substitute for professional medical advice, diagnosis or treatment. Always seek the advice of a qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read or seen in any Khan Academy video. Created by Tanner Marshall.

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Video transcript

- [Voiceover] Someone with panic disorder has frequent and repeated episodes of something called panic attacks. These panic attacks are periods of intense fear and discomfort that something bad's gonna happen. These panic attacks can happen even in familiar places where no real threats exist. They usually come about suddenly and peak within the first 10 to 20 minutes. But sometimes symptoms can last for an hour or more. People having a panic attack feel like there's some real threat or danger. And when we feel this way, our bodies react accordingly, right. This reaction could be so severe and so intense that some people having panic attacks feel as if they're having a heart attack or some other life-threatening illness when they're actually not. Symptoms that might come about during a panic attack are things like chest pain or discomfort, dizziness, fear of dying, losing control, or impending doom, feelings of choking, detachment, or unreality, nausea or upset stomach, numbness or tingling in the hands, feet, or face, palpitations, which is like this feeling that your heart's pounding, a shortness of breath, sweating, chills or hot flashes, and trembling. If you experience four or more of any of these symptoms, you might be diagnosed with a panic disorder. Unfortunately, panic attacks can't be predicted and often happen without any particular trigger being involved. With that said, it's important to have treated as soon as possible before the patient starts to avoid places where they've happened in the past, which is called avoidance. And this is where a patient that's had a panic attack before stops doing activities that they think trigger the panic attacks. For example, if someone has a panic attack while they're in an elevator, they might think that that elevator triggered the attack. And so they'll start avoiding going on elevators. Although this might help temporarily with the fear of attack and loss of control, it makes normal daily life extremely difficult and doesn't usually even stop the attacks from happening. Along the same lines, somebody might develop anxiety just thinking about the possibility of having a panic attack. And this is called anticipatory anxiety. This can result in the person becoming reclusive and choosing to endure the attacks alone rather than in public, where they think there's no chance of escape and slight chance of help. Sometimes this can lead to the development of a specific phobia called agoraphobia, which is a fear of being in public or crowded spaces. Like I mentioned, though, the cause of each panic attack usually isn't linked to any specific trigger. And the cause of having panic disorder in general is unknown. Though it's been found to run in families, which hints at there being some sort of genetic component, also about twice as many women as men experience panic disorder, though there hasn't been found to be any differences between ethnic, economic, or geographic backgrounds. Usually panic disorder starts in the patient's 20s. And sometimes a stressful event comes before the disorder and triggers the first attack. But usually there aren't any specific events to associate with the attacks. Once it's been diagnosed by a mental health professional, many patients will seek treatment. And like most other mental disorders, this involves either psychotherapy, medication, or both, depending on what that particular patient responds best to. Now, cognitive behavior therapy, a form of psychotherapy, is typically very effective and consists of five fundamentals when applied to panic disorder. In the first stage, called the learning stage, the patient learns about panic disorder, including how to identify the symptoms. They also go over the treatment plan. And then in the second stage, which is called the monitoring stage, the patient will keep a diary to monitor the panic attacks and record any situations that might produce anxiety. In the third stage called the breathing stage, they'll learn relaxation techniques to control breathing and help combat the physical reactions of a panic attack. And the fourth stage is called rethinking where the therapist helps the patient change their beliefs about the physical symptoms from totally catastrophic to something more realistic and less harmful. And finally, in the exposing stage, the therapist helps the patient expose themselves to situations that cause frightening physical sensation and gradually increases the intensity level so that the patient starts to feel more and more comfortable being around whatever it is that produces the anxiety and hopefully will reduce the likelihood of having a panic attack in the future. Besides cognitive behavior therapy, though, there are also medications that can be prescribed. If these are chosen, antidepressants like selective serotonin reuptake inhibitors or SSRIs are the most commonly prescribed medications for panic attacks. Anti-anxiety medications can sometimes also be prescribed like benzodiazepines. And these will tend to have this calming and relaxing effect, although these are typically less preferred, since there's a higher risk of becoming dependent. Finally, anti-seizure medications can also be prescribed in very severe cases. Overall, between these treatment options, many patients that get appropriate psychiatric care can recover and return to normal life activities.