Keys to the management of panic disorder include appropriate use of psychotropic medication and psychotherapy predicated on an understanding of the disorder's biopsychosocial underpinnings. Here, Stephen V. Sobel, MD, focuses on treatment options.
Keys to the management of panic disorder include appropriate use of psychotropic medication and psychotherapy predicated on an understanding of the biopsychosocial underpinnings. More in this podcast.
According to the CDC's latest published report, there were 38,364 suicides in the US in 2010—an average of 105 each day. Globally, an estimated 1 million suicides occur annually.
The issue of context and its relationship to disorderness extends well beyond panic attacks: it arises in nearly all psychiatric diagnoses not explicitly defined contextually.
Panic attacks are nearly always pathological and disordered states, even when they occur in an understandable context.
After scoring high on the Panic Disorder Severity Scale, this patient sought panic-focused psychodynamic therapy.
The cardiovascular properties of serotonin (5-HT) have been known for some time—its name reflects its presence in serum and its action in increasing vascular tone. Serotonergic medications are routinely used to treat depressive and anxiety disorders, and the association of depression with cardiovascular disease has become well established.2 Recent studies have confirmed the colloquial wisdom that anxiety (especially panic) and hypertension are linked.
The 2 most common anxiety disorders are generalized anxiety disorder (GAD) and panic disorder. Approximately 5.7% of people in community samples will meet diagnostic criteria for GAD in their lifetime; the rate is about 4.7% for panic disorder (with or without agoraphobia).1 GAD—which is characterized by excessive and uncontrollable worry about a variety of topics (along with associated features such as trouble sleeping and impaired concentration)—is often chronic and is associated with significant costs to the individual and to society.
One minute she's breathing room air and the next you're barking orders at a team wheeling in a crash cart. You review signs and symptoms you missed, the rough rhythm of her heart before she coded. You want to believe your reasoning was as elegant as a glass filled with cabernet, and you want to forget the bottle you imagine resting on a tray table at forty thousand feet, ready to tumble when the captain announces the plane is diving for an unscheduled stop. But I don't need images of air disasters to convince you doctors live somewhere between reason and panic: just flip open your laryngoscope, visualize the vocal chords, and forget you have fifteen seconds to thread the tube before the breathless body on the bed turns blue.