Michael G. Rayel, MD Jill is a 21 y/o college student who used to do well until about a hardly a months ago when she started to experience “weird” attacks almost daily. She described her experience as “horrible.” When she has the attack, she feels that she’s about to die or develop a stroke. One day while she was in a mall, she suddenly developed an “overwhelming” sensation all over her body. She was sweaty and tremulous and felt that her heart was pumping so fast. Within a few seconds, she also suffered from chest pain and shortness of breath. This episode lasted for about 10 minutes but she felt that this was her worst cardinal minutes of her life. Overwhelmed by her experience, she has stayed away from malls and has avoided being in a crowd of people. Because of the frequency of the attacks, Jill can’t anymore function normally. She is afraid to leave the house and go to work. Jill’s experience is regular of someone with Panic Disorder. A person with panic disorder develops anxiety attacks associated with the thought that he or she would die or develop a stroke or heart attack. Physical changes such as hurrying heart beat, shortness of breath, fainting episodes, sweating and tremulousness are some of the related symptoms. A typical episode usually comes “out of the blue” and not precipitated by some triggers. It can therefore happen any time and anywhere. An attack can last for a few to several minutes. One episode can make a person feel scared of having other one. In fact, a lot of people feel troubled anticipating the occurrence of other attack. So most individuals prefer to stay at home and isolate themselves from friends, co-workers, and even relatives. Eventually they become incapacitated. If you’re like-minded Jill, is there any treatment that can help? Yes, there is. Individuals with this condition are successfully treated with an antidepressant such as the serotonin-reuptake inhibitors. Usually, the dose should be started low, for instance 10 mg/day of citalopram. aft a few weeks, the dose should be gradually increased depending upon the person’s clinical status. Cognitive behavior therapy is likewise very effective. This type of “talk psychotherapy” helps the several to restructure his or her thinking. Negative cognition associated with the illness should be self-addressed in therapy because it creates more harm than good. Relaxation techniques such as breathing exercises should also help. During treatment, patience is very important because it takes a while before any intervention helps. However, don’t despair. After a few weeks, the medication should start employed and should give you a feeling of comfort. What’s the role of benzodiazepines (e.g. lorazepam or clonazepam) in the treatment of panic disorder? This type of drug can provide subacute relief but should be old only on a short-term basis because of its addiction potential. For long-term treatment, antidepressants and psychotherapy are still preferable. About The Author Copyright © 2005. Dr. Michael G. Rayel – author (First Aid to intellectual Illness–Finalist, Reader’s Preference Choice Award 2002) psychiatrist, and inventor of Oikos Game: An Emotional Intelligence or EQ Game. For much information, please visit www.oikosgame.com and www.soardime.com. mrayel@soardime.com