A feeling of complete terror, an overwhelming and unreasonable fear, heart palpitations, shortness of breath, excessive sweating-these are some of the common symptoms more than 3 million Americans may experience when having a panic attack.
This 3 million represents 1.2 percent of the 1990 U.S. population of 248,710,000, according to the National Institute of Mental Health. Though local figures aren`t available, in Du Page County, with a 1990 population of 781,666, that same percentage would figure out to close to 8,000 residents.
Confusion over the diagnosis of this debilitating malady, commonly described as a ”flight or fight” response, had once created a flurry in the medical profession when many patients were thought to be having a heart attack. But research has given legitimacy to the panic syndrome, and those who suffer from it are getting help and support not only from medical experts but also from the community at large.
Limited income or insurance restrictions often prevent sufferers of panic disorder from seeking professional counseling. For those who find it necessary to tackle this alone, self-help in the form of reading books on the subject of panic disorder is a viable alternative.
Area libraries are alert to the needs of patrons who seek information from periodicals and books. In addition, public libraries serve as information centers, giving specifics regarding support groups that meet in their communities.
Other relatively inexpensive forms of self-help are classes in relaxation techniques offered at local park districts and community education programs available through local high school districts.
Recently the National Institute of Mental Health in Washington, D.C., announced the beginning of a public education campaign to reach both physicians and those who suffer from the disorder but have not been treated.
Studies indicate that the possible causes of panic attacks may be a chemical or hormonal imbalance, enzyme deficiencies or emotional trauma. In addition, the disorder has been linked to mitral valve prolapse-a heart disorder-hyperthyroidism, anemia and other physical disabilities.
Many who suffer from panic disorder are both embarrassed and reluctant to discuss it openly. Said Sandra (a pseudonym): ”My first attack came on several years ago in late winter during a very stressful time. It began with a sleepless night and escalated into a pounding heart, desire to jump out of bed and run and then continued with hyperventilating and was followed by a severe feeling of depresssion. I wanted to die.
”The next morning I called a physician friend who prescribed a mild tranquilizer. Everything was fine for several weeks and then out of the blue I was struck again and again. I felt like I was drowning and couldn`t see my way out. Each attack left me physically and mentally fatigued. It was then that I reached out for help.”
Dr. Robert Marozas, a psychiatrist in private practice and faculty member of Loyola University Medical School in Maywood, said 20 percent of his patients suffer from panic disorder.
”There is some biological predisposition,” Marozas said. ”But in many cases there is a surge forward during periods of great stress.”
Professionals cite several alternatives in the treatment of panic disorder. For some, individual counseling in the form of psychotherapy is the recommended way to identify and explore the problem. Marozas, who also serves on the staff of Good Samaritan Hospital, Downers Grove, describes the treatment of panic disorder as a threefold process.
”First, we must determine how severe the symptoms are and decide if medication management is desirable. Then we identify the forces leading to the panic,” Marozas said.
The final step in treatment through psychotherapy is behavior modification. This step is critical because patients with panic disorder often adjust their lifestyles to avoid situations that might lead to an attack.
For example, Marozas explained that sufferers may choose not to shop, drive or travel. Soon they find themselves near-prisoners of their own homes. ”We attempt to cut into this limitation of activity as quickly as possible,” Marozas said.
Even though it is believed that men and women suffer from the syndrome equally, Marozas said he sees more women than men ”on a ratio of three-to-one. Historically, men are reluctant to admit to it, because it implies a sense of helplessness,” he said.
Many men use alcohol to mask symptoms, he said, when they refuse to seek treatment. When medication management is advisable, Marozas said the most effective drug is Xanax, because it has an anti-panic agent.
”Typically a patient will use Xanax to control panic for three to nine months, at which time he or she will be removed from the medication gradually,” Marozas said.
Twenty-five percent of his patients are totally free of medication within one year, due to successful behavior modification. One of the most accepted forms of behavior modification is through biofeedback therapy.
Biofeedback, according to Richenel Ellecom, a psychologist and preventive care specialist in Willowbrook, is the use of instruments to measure biological conditions, such as brain waves, heart rate, sweat glands and blood flow to the surface of the skin.
”These measurements are a barometer for diagnostic purposes,” said Ellecom. ”And they enable the individual to be an active participant in bringing these conditions, such as elevated blood pressure, under voluntary control.”
For many who experience panic attacks, a support group offers comfort and shared information. Usually organized and hosted by either a psychologist, hospital social worker or trained counselor, these groups meet weekly. Their purpose is to give a chance to learn from one another how to confront and cope with the problem. Information and education are tools available to all who suffer from panic attacks or who have a loved one struggling with the disorder. Many area hospitals offer classes in coping with stress, thought to be a factor in establishing a vulnerability to panic attacks.
Maureen Undine teaches stress management classes at Hinsdale Hospital, where six-week classes are offered continually from August through June.
”Some people are addicted to their stress, particularly male executives,” said Undine. ”Mine is a holistic approach. We talk about concepts and how to change your thinking in the first two classes. Then we move on to the physical aspects of stress: relaxation, the diet and exercise.”
Undine encourages a whole-grain, high-fiber diet, adding that the highly processed foods rob the body of nutrients. She warns her students to avoid nicotine, caffeine, sugar and alcohol.
”There are three parts to the relaxation that I teach,” Undine said.
”They are breathing, imagery and progressive muscle relaxation.” She emphasized the importance of exercise, either running, an aerobic workout or walking.
”With exercise the brain releases endorphins, which make you happy,”
she said.
”People with panic disorder frequently isolate themselves. I encourage support systems. We all need people to talk to. It`s a coping method,” Undine said.
Help for sufferers of panic disorder is available from:
Publications: Lewis Engel, Ph.D. and Tom Ferguson, M.D., ”Imaginary Crimes: Why We Punish Ourselves and How To Stop,” Boston, Houghton Mifflin, 1990. Robert Handly and Pauline Neff, ”Anxiety and Panic Attacks: Their Cause and Cure,” paperback, Fawcett, 1987. Mort Orman, M.D., ”The Fourteen Day Stress Cure,” Houston, Breakthru Publishing, 1991. David V. Sheehan, ”The Anxiety Disease,” paperback, Bantam, 1986. R. Reid Wilson, ”Don`t Panic,”
paperback, Harper Collins, 1987.
Videos: ”Hatha Yoga Series,” Volumes 1-14, with Kathleen Hitchcock. Produced by WMVS-TV, Milwaukee, 29 minutes each. BETA and VHS. ”Less Stress in 5 Easy Steps,” with Ed Asner and Dr. David Gross, Produced by Market W Productions, Inc., 45 minutes, BETA and VHS.
