Surviving Panic Disorder

In 1836 after finishing a 5-year scientific excursion to South America and the Pacific, Charles Darwin, returned to England to find himself almost housebound.  Doctors could not find a diagnosis for Darwin’s problems that included an overwhelming sensation of fear, palpitations, weakness and muscle tremor that overcame him whenever he left home.  After making a rare speech at a scientific meeting he was reported to have had 24 hours of vomiting.  Remarking on his response to stress, The Life and Letters of Charles Darwin, cites Darwin having written, " ... of late anything which flurries me completely knocks me up afterwards, and brings on violent palpitation of the heart."

Darwin probably had panic disorder.  Today, he would not have had to suffer as he did, however it is likely that he would need to be an informed consumer of healthcare to get proper treatment.

I am a board certified psychiatrist who specializes in panic disorder.  Over the last twenty years I have personally examined and treated well over 2,000 patients with panic disorder.   In 1996 I put up the Panic Disorders Institute (PDI) web site.  Besides presenting basic information on panic disorder, the web site has a bulletin board where people can post questions.  The people who post these questions are usually under the care of physicians, but in addition their physician’s advice they are seeking to become as educated as possible about panic disorder.  Self-education is an essential part of any treatment for panic disorder.  This is particularly true for the confusing psychosomatic aspects of panic disorder.

In addition to my clinical experience the years of reading and answering the questions on the bulletin board has helped me to understand what information is needed most by people with panic disorder.  In this book I will share my knowledge and experience with patients and their physicians.  Panic disorder is an increasingly popular diagnosis.  The actual incidence of panic disorder is probably rising but it is also progressively more popular with medical and mental health practitioners and often given out casually to people who do not have it. 

“Panic attack” is a label used to describe almost any episodic medical condition that is frightening and otherwise difficult to explain.  It is part of our common vocabulary and people commonly describe themselves as having a panic attack whenever they have intense anxiety.  People may go to their doctors and tell them that they have had a panic attack, and the doctor may initiate treatment for panic disorder taking them at face value.  Even so, a panic attack is not in itself always abnormal.  Sometimes a panic attack is just an uncomfortable part of being human and sometimes it is part of a larger condition that requires medical attention.

Because the diagnostic features of panic disorder are completely descriptive one is technically correct to call a wide variety of physical sensations and emotional fears panic disorder.  The disorder exists on a spectrum, with patients experiencing scary thoughts on one end and seizure-like neurological events on the other.  For this reason, people who are told that they have panic disorder or think that they might have panic disorder find it bewildering when they try to get more information.