Wendel Abel - I AM WHAT I THINK 
I realised that my friend was in a state of panic. I calmed her down. I listened for another 30 minutes as she related a long list of symptoms she was experiencing: terror - a feeling that something terrible is going to happen to her racing heart chest pains difficulty breathing sweating, trembling tingling or numbness in the hands and feet flushes or chills fear of losing control, going crazy fear of dying heaviness in the head, crawling sensation on top of head
This was surely another case of panic attack. And these are common symptoms associated with panic attacks. A panic attack usually arises out of the blue and is usually unrelated to any real danger. The symptoms usually last a few seconds and disappear over an hour. People who experience these symptoms often complain of great distress.
"I was going to work one morning and I suddenly had this sudden onset of chest pain and a choking sensation. My heart started to race rapidly and I had a terrible sensation like lightning going through my body," said Mary a mother of four. "I was so scared, so scared I thought I was having a heart attack. I went to several doctors and though they told me it was not a heart attack. I did not believe."
Many persons only experience one panic attack but when it recurs and begins to affect an individual's life it is referred to as a panic disorder. These recurrent panic attacks may affect an individual's ability to function and their relationships.
"The panic disorder ruined my marriage. It consumed every moment of my life. My husband could not deal with it anymore. It was difficult for us to have a normal relationship. It even affected our sex life," reported one distressed woman to her doctor.
Miriam who lives in the United States, said that she had great difficulty working. "I couldn't leave my home or travel on the bus. I always had this intense fear that another panic attack would occur." And an elderly man complained that: "despite reassurance from my doctor that I had a panic disorder. I was still concerned about having a heart condition. As a result I saw about ten doctors in one year. I was spending all my money on doctors' fees".
A lot of individuals with panic disorder become preoccupied with the distressing symptoms that they visit many doctors over a short period of time, often requesting expensive and sometimes unnecessary investigations. Sometimes doctors also miss the diagnosis.
Panic disorder may progress to an advanced stage where individuals are afraid to be in places that may trigger an attack or in which they worry about new attacks. Common situations that are usually avoided by these individuals are shopping malls, the market, buses and elevators. These individuals often avoid leaving their homes alone or if they travel outside of their homes they usually require the company of someone close.
Can it be treated?
This condition is treatable and if you or anyone has what appears to be a panic disorder you should consult your family doctor. Before starting treatment, a person should undergo a complete medical condition to rule other disorders that can mimic a panic disorder.
If a diagnosis of panic disorder is made discuss the treatment options with your doctor. Tranquillisers are used to manage these symptoms but we discourage their continued use as they are addictive. The newer antidepressants have proven to be very effective in the treatment of panic disorder. Therapy is effective but should be done by a trained therapist. A lot of focus in therapy is placed on countering negative thoughts for example, "what if I lose control on the bus," or "what if I have another attack in the elevator".
There are number of things you can do to manage these distressing symptoms for example, breathing exercises, relaxation techniques and regular exercise. Avoid using drugs and alcohol to treat these symptoms -- this is a mistake persons often make.
Those closest to the affected person usually recognise its symptoms first. Be supportive and understanding and encourage the person to seek professional help.
Dr. Wendel Abel is a Consultant Psychiatrist and Senior Lecturer, University
of the West Indies.
