I can’t… I have Panic Disorder
The real consequences of a real disorder
A sudden rush of crushing, paralysing fear. With no warning, no apparent reason, it hits and you’re powerless to stop it. This is not just stress or nervousness – it’s a panic attack and can have very real and serious consequences.
Physical symptoms like heart palpitations, dizziness, nausea, tingling, and chest pains seem to come out of nowhere, from harmless situations like driving or sitting in a movie theatre, even while sleeping. Some researchers believe that when our brain's normal mechanism for reacting to a threat - the "fight or flight" response - becomes inappropriately aroused, the result is a panic attack. “Nausea, jelly legs, irritability… I didn’t know what was happening”, says Peter Matlahaela, a panic sufferer and now a Support Group leader.
There is such misunderstanding around panic attacks and panic disorder, and stigma and shame involved, that the South African Depression and Anxiety Group (SADAG) has a day on the national health calendar dedicated to raising awareness of this debilitating, yet treatable, condition. Preventing Panic Day is on Friday the 10th July and SADAG encourages anyone who suffers from panic, or thinks they might, to get in touch with them. “Panic is terrifying and so many people are still ashamed and believe it is due to person weakness”, says SADAG’s Cassey Amoore. “This is not true. Panic is an illness - and can be treated.” SADAG offers telephonic counselling, referral to experts and support groups, as well as talks to communities, schools, and corporates. For more information, please contact SADAG on 011 262 6396 or 0800 20 50 26, or visit www.sadag.co.za.
The panic attack itself is not dangerous, terrifying definitely, but not physically dangerous. “Most people who experience panic attacks feel as if they are going crazy or are out of control”, says Johannesburg-based anxiety expert psychologist Dr Colinda Linde. “Most people feel anxious about the possibility of having another panic attack and avoid situations in which they believe these attacks are likely to occur.” And this is where the danger comes in - anxiety about having another attack, and the avoidance it causes.
Phobias that people with panic disorder develop from fear of having another attack, and they often avoid certain situations because they fear it will trigger another attack. For example, someone who has had a panic attack while driving may be afraid to get behind the wheel again, even to drive to the local supermarket. Panic attacks may occur at night resulting in disturbed sleep as the person awakes in a state of terror. The experience is so distressing that some people who have nocturnal panic attacks become afraid to go to sleep and suffer sleep deprivation and exhaustion. “People who develop these panic-induced phobias tend to avoid situations they fear will trigger a panic attack, and their lives may be increasingly limited as a result”, says Dr Linde. Some people with extreme cases of panic develop agoraphobia – a fear of going outdoors – due to the belief that by staying inside, all panic-provoking situations can be avoided.
When people who suffer from panic disorder try to avoid situations that may trigger an attack, the consequences can be far-reaching. Their work may suffer because they can't travel or get to work on time. Relationships may be strained or marred by conflict as panic attacks, or the fear of them, rule the affected person and those around them.
“I had my first attack during a movie. I wanted to get out – fast – but being male and proud I didn’t want to admit anything was wrong”, says panic sufferer James. “I stopped going out with friends, and the thought of a movie made me cringe. I isolated myself out of fear of people finding out that I was ‘weak’ and had these attacks that I believed no-one would understand.”
And he’s not alone. A recent American study showed that people who suffer from panic disorder are more prone to alcohol and other substance abuse, spend more time in hospital emergency rooms and feel less emotionally and physically healthy than non-sufferers, spend less time on hobbies or sports, tend to be financially dependent on others, are afraid of driving more than a few miles away from home, and have greater risk of attempting suicide. One panic sufferer gave up a R300 000 a year job so she wouldn’t have to travel or drive far from home.
SADAG says that panic disorder does not need to disrupt your life in any way. “None of these dreadful effects of panic need to happen”, says Amoore. “Panic disorder can be treated, and even people who have suffered regular attacks can lead full lives.”
Fear... heart palpitations... terror… a sense of impending doom... dizziness... These are the words used to describe Panic Disorder. But there is hope: treatment can benefit everyone. SADAG has an extensive referral list of expert psychologists and psychiatrists who will develop a specific treatment plan for you.
Treatment of course is often holistic, and it won't work overnight, but if you stick with it, you should start noticing improvements within a few sessions. James admits that in the beginning he was in denial of the problem completely and when an attack hit he was “totally surprised”. Cognitive Behavioural Therapy focuses on identifying, confronting and testing negative and automatic thoughts and assumptions with reality, and brings about a more realistic way of thinking about fearful situations, and challenges anxiety-provoking thoughts and feelings. “Thanks to SADAG and CBT, I know that I can feel the fear, but I remember it’s just a panic attack and tell myself that I am safe”, says Peter. CBT generally requires at least 8 to 12 weeks, although some people may need a longer time in treatment to learn and implement the skills. This therapy has a low relapse rate and is effective in eliminating panic attacks or reducing their frequency.
Symptoms of a panic attack include:
· Racing heartbeat
· Difficulty breathing, feeling as though you 'can't get enough air'
· Dizziness, light-headedness or nausea
· Trembling, sweating, shaking
· Chest pains
· Hot flashes, or sudden chills
· Tingling in fingers or toes ('pins and needles')
· Fear that you're going to go crazy or are about to die
“When I was having a panic attack, I felt short of breath and I’d try to get in as much air as possible”, says James. “The one really important part of therapy was teaching me to breathe out.”