Albertus S.AWinda A.LDwi E.S

PANIC DISORDER

oPanic disorder happens when person experiences panic attack, complication in life because of them, when there is no danger

oSudden

oUnexpected

oUncontrollable panic attack for no reason

TRIAD OF PANIC DISORDERPanic Attack

Phobic Avoidanc

e

Anticipatory

Anxiety

+Functional impairment

SIGN & SYMPTOMS

PANIC DISORDER

NOTE: Some people with panic disorder find that caffeine (or other stimulants) makes things worse. They may even give up foods such as chocolate or drinks such as coffee, tea, cola or cocoa.

ADOLESCENCE HAVE PANIC DISORDERoPanic disorder common in Teenager

oUsually begins in late adolescence (between 18-25 yo)

oGirls > boy

NEUROBIOLOGY OF PANIC DISORDERParts of Brain (major role in panic disorder):Frontal lobesHypothalamusAnterior PituitaryLimbic System AmygdalaHippocampusBrain StemLocus Coeruleus

Threatening information(sigh=rober, sounds=loud bang,

etc.)Prefrontal Cortex

Amygdala Hippocampus

Hypothalamus

Anterior Pituitary

Blood Circulation

Adrenal Gland(Cortisol)

Physical responses to stress(e.g increased HR, Heavy breathing, etc.)

CRH

ACTH

NEUROTRANSMITTER

SEROTONIN

EPINEPHRINE

GABA

NOREPINEPRHINE

Regulatin mood & other brain function

Play role in physical responses

Stop the physical fear responses

Similar to epinephrine involved panic attack

1. Psycoeducation

2. Self-monitoring of symptoms

3. Breathing retraining/relaxation techniques

4. Cognitive restructuring to correct catastrophic misinterpretations of bodily sensation

5. Exposure therapy

A Type of CBT PCT (Panic Control Therapy)

1. Patient did :

•Run up stairs

•Spin around

2. Therapist asks :

•What specific fears?

•What was scary about?

•Why scare?

1.SSRi Sertraline Fluoxetine Citalopram

2. Benzodiazepine Clonazepam Diazepam

Treatment PROS CONS

CBT • Effective• Has longterm effects after initial

treatment phase (12 week complete)

• Can be given Individual/group

• Not easy available• Not

regulated/standardized• Duration treatment

attendant of session

Medication • Effective• Easy to use• Widely available• Inexpensive

• May take up to 6 weeks to work

• side effects• FDA has ‘black boxed’

SSRI medicines• evidence shows SSRI use

is related to• decreased suicide• Relapsed if stop