Panic Disorders: What do you know about them?

The stigma that surrounds mental health issues can be deleterious to those who actually suffer from mental health issues. The notion that mental health issues make one ‘weak’ or ‘overtly emotional’ can instill fear and embarrassment into people who suffer, further exacerbating their condition. However, these societal notions and stigma stem from a place of ignorance and misunderstanding, where a lack of comprehension will lead to such thoughts and false perception. Hence, we’re shedding light on an issue that affects 3-5% of the population – panic disorders. 

Panic disorder is a real illness, and it’s not a sign of weakness or episodes of ‘spiralling out of control’. If not treated, it can lead to depression and affect your life. How do you know if you have it, and what can you do about it? We’ve interviewed Dr Victor Kwok, Head and Consultant of the Department of Psychiatry from Sengkang Health to bring expert insight and advice to the table about panic disorders.

Marie France Asia: What makes a person more susceptible to panic attacks?

Dr Victor Kwok: There are multiple postulated causes for panic disorder. It could be due to genetic factors, and it is known that having first-degree relatives with this condition increases the risk. It has also been postulated to be due to an imbalance in neurotransmitters in the brain. It could also be a learned behaviour. For instance, the person has associated fear with a certain situation or object that will trigger the feeling of fear when exposed to the same scenario. In general, women are 2-3 times more likely to suffer from this condition. It can occur at any age.

In general, women are 2-3 times more likely to suffer from this condition. It can occur at any age but typically in early adulthood. The disorder could sometimes be precipitated by stressful events in life such as family problems or work problems.

MFA: Is panic disorder an illness perpetuated by nature or nurture?

VK: It is likely to be due to a combination of both factors, as with most mental disorders. That is why treatment of mental disorders usually involve medications to target the “nature” part and therapy to target the “nurture” part.

MFA: What are the most tell-tale signs of having a panic disorder?

VK: There are both physical and emotional components and each episode usually lasts for a few minutes. It involves physical sensations like a racing heart, sweating, giddiness, numbness of hands, chest pain and shortness of breath. Some people feel like they are having a heart attack or stroke. The exact symptoms may differ slightly from person to person. Emotionally, panic attacks can make people feel like they are dying, going “crazy” or “losing control”. Panic attacks become a panic disorder when they happen repeatedly for at least a month, and the person either worries when the next attack will strike or modifies their behaviour in maladaptive ways to avoid the attacks.

The person will often mistake symptoms of panic attack for other types of medical conditions like heart attacks or stroke, and will rush to the emergency department or their family doctor first. However, it is important to make sure that the doctor does examine the patient and run some tests to ensure that it is really not a heart attack or stroke.

MFA: Is there a cure? How can it be prevented?

VK: Medications are very effective and most patients will show marked improvement in a matter of weeks. These medications do not work within minutes; they need to be taken daily and patients can expect to see a decrease in the intensity and frequency of each episode.

Therapy is also effective and the best evidence is for CBT (Cognitive-Behavioural Therapy). These could involve challenging unhelpful thoughts that lead to an exaggerated emotional response. Others involve relaxation techniques like breathing exercises and repeated exposure to triggers (if present) which are helpful. There will also be no physical pain with treatment.

MFA: How can people around someone with this condition/illness give practical help?

VK: If a person who is known to have a panic disorder is having an episode of panic attack, it is helpful to remain calm around them and wait for the attacks to dissipate (as the attacks will usually disappear within minutes). They can also try to distract them with activities like taking sips of warm water or listening to music.

In between episodes of panic attacks, do remind them to take their medications and follow their therapists’ instructions. This could be a regular practice of relaxation techniques.

MFA: What can we do to diminish the stigma that surrounds mental illnesses in general?

VK: Readers can educate others about mental illness especially if they hear someone speak incorrectly about them. We should also be more mindful and avoid using words and phrases with negative connotations when relating to mental illness e.g. “crazy”, “psycho”, and “forgot to take medicine”. Others like reducing discrimination in insurance, education, and workplace are still work-in-progress.

Winnie Tan

Photo: SengKang Health

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