For most of this century, generalized anxiety disorder and phobias received much more attention from clinical practitioners and researchers than did the other anxiety disorders-panic, obsessive-compulsive, and stress disorders. The latter appeared to be less common, explanations for them more inclusive, and treatments less effective. This situation has changed drastically in the past 10 years.
Recent studies have revealed that panic, obsessive-compulsive, and stress disorders are more common than previously believed, although they still seem to be less prevalent than generalized anxiety disorder and phobias Moreover, researchers have uncovered very promising clues concerning the origins of these disorders, and therapists have developed treatments for them that are very helpful indeed.
Accordingly, this is where investigators of anxiety disorders are now focusing much of their attention.
As with generalized anxiety disorder and phobias, anxiety plays a key role in panic, obsessive-compulsive, and stress disorders. As we noted in the previous chapter, people with panic disorders have recurrent attacks of terror Those with obsessive-compulsive disorder are beset by recurrent and unwanted thoughts that cause anxiety or by the need to perform repetitive actions to reduce anxiety.
And people with acute stress disorder and posttraumatic stress disorder are tormented by fear well after a traumatic event has ended.
Panic Disorders
Sometimes an anxiety reaction accelerates into a smothering nightmarish panic. When that happens to people, they lose control of their behaviour, are practi cally unaware of what they are doing, and feel a sense of imminent doom.
Anyone can react with panic if a situation is provocative enough Some people, however, experience panic attacks-periodic, discrete bouts of panic that occur abruptly and reach a peak within ten minutes Such attacks consist of at least four symptoms of panic, the most common of which are palpitations of the heart, tingling in the hands or feet, shortness of breath, sweating, hot and cold flashes, trembling, chest pains, choking sensations, faintness, dizziness, and a feeling of unreality.
Small wonder that during a panic attack many people fear they will die, go crazy, or lose control.
People suffering from any of the anxiety disorders may experience a panic attack when they confront the objects or situations they dread. Some people, however, experience panic attacks without apparent provocation, and do so recurrently and unpredictably. They may receive a diagnosis of panic disorder.
According to DSM-IV, a diagnosis of panic disorder is warranted if after one or more unexpected panic attacks a person spends a month or more worrying persistently about having another attack, worrying about the implications or consequences of the attack (such as fear of going crazy or having a heart attack), or changing his or her behavior markedly in response to the attack.
In any given year, as many as 23 percent of adults in the United States suffer from a panic disorder. Around half of them receive treatment. Most people develop the disorder between late adolescence and the mid-thirties and the diagnosis is at least twice as common among women as among men.
Many other people experience panic attacks that are not severe or frequent enough to be diagnosed as panic disorder.In one survey percent of 534 Australian adolescents reported having experienced at least one panic attack.
Many people mistakenly believe that they have a general medical problem when they first experience panic attacks. Conversely tain medical problems, such as mitral valve prolapse cardiac malfunction marked by periodic episodes of heart palpitations, and thyroid disease, may initially be misdiagnosed as panic attack.
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