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Medical Edge Newspaper Column from Mayo Clinic

THERE’S HOPE FOR LONG-TIME SUFFERER OF PANIC DISORDER

DEAR MAYO CLINIC: My 24-year old son has suffered from anxiety and panic attacks for eight years. He is very intelligent but unable to attend college, work or social events. When he was 16, he began experiencing light-headedness, dizziness, sweating and tremors, and was diagnosed with depression and panic disorder. He has seen many psychologists and psychiatrists and has been on and off various medications, but he is still very ill. Some days he is withdrawn while other days he will go out with friends, but drinks a few beers first. He has lost hope. To make matters worse, he has no health insurance. — Pennsylvania

ANSWER: Your son’s situation is complicated because he has been ill for so long. His symptoms are consistent with panic disorder, but we advise a complete medical exam to rule out medical conditions such as a thyroid or heart problem. If all the medical tests are normal, then there are several steps your son should take.

Panic disorder can be debilitating and destructive, and is often accompanied by depression and alcohol or drug abuse. It develops when a person becomes afraid of internal body sensations such as a racing heart, difficulty catching one’s breath and light-headedness.

Psychological treatment and medical therapy are the treatments for panic disorder. Cognitive-behavioral therapy, or CBT, is a very effective psychological treatment. It involves techniques that help patients learn that the uncomfortable and scary body sensations they experience during panic attacks (e.g., racing heart, dizziness) are not actually dangerous. These sensations might even be carefully provoked during treatment sessions to help patients learn healthier ways of thinking and reacting to panic symptoms — thereby reducing their panic attacks.

Medication therapy for your son’s condition is also an important option. Selective serotonin reuptake inhibitors are the first-line choice and enhance the brain’s ability to use serotonin, a chemical believed to play a role in anxiety and mood states. We advocate including CBT as a long-term solution. In addition, using alcohol when suffering from panic disorder and depression can worsen symptoms over time, and can impair any psychological or medical treatment. It should be avoided.

While most treatment for his condition is outpatient, in severe and chronic cases such as your son’s, inpatient treatment can be the most effective course.

Finally, your son may be eligible for state- or county-sponsored health care, as well as support from organizations such as the Anxiety Disorders Association of America. Talk with his physician about these and other options for financial support.

— Katherine M. Moore, M.D., and Jonathan S. Abramowitz, Ph.D.,
Psychiatry and Psychology, Mayo Clinic, Rochester, Minn.

Additional Resources:
Panic Disorder
Appointment Information
More Information on Panic Disorder

READERS: Stressed out? Don’t be surprised if your doctor suggests meditation.

Several clinical trials in recent years have looked at meditation as a way to manage and reduce stress, both physical and mental. And the preliminary results of these studies have been encouraging.

Meditation takes many forms, but the goal of all of them is to focus your attention. Meditation is a mind-body process. When focused, the mind is calmed and the body can relax, creating a sense of well- being. The mind’s health influences the body’s health.
Mayo Clinic Health Letter says that meditation can reduce:

— High blood pressure
— Anxiety
— Substance abuse
— Post-traumatic stress syndrome
— Visits to health-care providers

You can take a class to learn meditation or learn it using books or tapes. Meditation doesn’t replace medical treatment, but it appears to reduce stress and may positively influence the effect of more standard therapies.

Additional Resources:
More Information on Meditation

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Medical Edge from Mayo Clinic is an educational resource and doesn’t replace regular medical care. To e-mail a question, go to www.mayoclinic.org, or write: Medical Edge from Mayo Clinic, c/o TMS, 2225 Kenmore Ave., Suite 114, Buffalo, N.Y., 14207. For health information, visit www.mayoclinic.com.