"I don't know Doc, everything is fine at home but I think something is wrong with me. Out of the blue, I have palpitations, I feel scared, I get dizzy, I can't breathe and I think I am going to die! It happens several times a day and I am exhausted. My whole life has changed, I think I will have to quit my job. I have seen all kinds of doctors but they haven't found anything!"
Seema came to see me and appeared very anxious in the room. She said she was 32 years old married and worked in one of the Multi-National Companies. She said she was married and had a 6-year-old daughter who was doing well.
Anxiety disorders is a broad term for a set of conditions where a person's main complaint is anxiety or tension or worry. These are common disorders and a significant chunk of population suffers from it. Illnesses or disorders such as generalized anxiety disorder, panic disorder, social anxiety disorder are some of the examples.
Typically, a person rushes to an emergency room thinking they are a having a heart attack or a stroke and tests reveal no physical or blood abnormalities. A person might visit several different doctors, in different specialties, "looking for an answer". He or she might spend significant amount of money on various blood tests, procedures. When tests reveal that "nothing is wrong", it might be immensely frustrating. It can feel worse when a doctor suggests, "you need to see a psychiatrist". Yet, that might just be the solution.
Having Panic Disorder does not mean one is "crazy". It is a diagnosable condition with well documented treatment. In India, the life time prevalence of what are called common mental disorders(CMDs) is 20-25%. Anxiety Disorders, including Panic disorder is one of them. The specific prevalence of Panic Disorder is not known in India but it is high enough that a significant percentage of our population suffers from it and very few seek any help from a psychiatrist. Usually women suffer from it more than men do. The illness occurs usually in younger adults but it can occur at any age.
By definition, a person suffering from Panic Disorder experiences intense fear, palpitations, shortness of breath, tremors, giddiness and a variety of symptoms several times a day. These episodes last several minutes. Eventually these episodes can cripple one's life and create a fear of the next attack.
The good news is there is well documented and researched treatment for it. These treatments include medications and therapy. In counselling or therapy, some of the things an individual learns is to recognize a panic attack for what it is, and to use techniques to counter the panic attack. For example reminding oneself "I am not going to die, this is a panic attack" can work if one learns to use the technique and use it effectively. Medications are also a good option. Whether to go with therapy or medications or both can be discussed in a session. A psychiatrist advises treatment based on how debilitating the symptoms are, how long they have been present etc.
Dr. Naveen Jayaram
Attending Consultant - Psychiatry
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