Diagnosis and Treatment

Healthcare professionals should distinguish panic disorder from everyday anxiety and stress. To help confirm a panic disorder diagnosis, consider the following approach:

1. To differentiate panic disorder from other medically important conditions the patient should, of course, have a thorough physical examination. Panic disorder symptoms mimic other conditions such as myocardial infarction, cardiac arrhythmias , hyperthyroidism, and certain types of epilepsy.

2. It is important to probe the emotional components of the patient's symptoms. Patients may focus on only one or two symptoms as they describe the attacks to you, concentrating only on their physical sensations and not on the fears they experience. By asking patients to describe their feelings about the attacks you may be able to more quickly identify panic disorder. You will also be more likely to identify depression or other concurrent conditions that should be considered in the treatment plan.

3. It can be constructive to probe for environmental factors that trigger panic attacks in some people. For example, in susceptible persons attacks may occur during or within six months of such stressful life events as the death of a loved one, divorce, geographic relocation, childbirth, or surgery. Panic attacks can also be triggered by large doses of caffeine, some cold medicines and cocaine and marijuana. If someone has a substance abuse problem it will have to be treated before panic disorder can be addressed effectively.

Research shows that panic disorder can coexist with other disorders, most often depression and substance abuse. About 30% of people with panic disorder abuse alcohol and 17% abuse drugs, such as cocaine and marijuana, in unsuccessful attempts to alleviate the anguish and distress caused by their condition. Appropriate diagnosis and treatment of other disorders such as substance abuse or depression are important to successfully treat panic disorder.

Facts:

• About 1.7% of the adult U.S. population ages 18 to 54 - approximately 2.4 million Americans - have panic disorder in a given year.
• Panic disorder without agoraphobia is equally common in men and women. However, agoraphobia occurs more often in women than men. Approximately 80% of severe agoraphobics are women.
• Panic disorder typically strikes in young adulthood. About half of all people who have panic disorder develop the condition before age 24.
• Panic disorder may coexist with other disorders, most often depression and substance abuse. Appropriate diagnosis and treatment of other disorders are important to successfully treating panic disorder.