Panic Disorder

WHAT WENT WRONG?
Patients experience intermittent episodes that have a sudden onset and no pre-
dictable pattern, causing intense anxiety associated with pronounced physical symp-
toms. These episodes are short in duration and recurrent in nature. The disorder
tends to present before the age of 25, is twice as common in women as it is in men,
and tends to be familial. Some patients will choose to self-medicate with alcohol
in an attempt to escape the disease, diminish symptoms, or decrease the occur-
rence of the episodes. Others become dependent on tranquilizing medications.
Panic attacks can impede a person’s life and restrict activity, especially in antici-
pation of a panic attack.

PROGNOSIS
With proper treatment, the frequency and intensity of the episodes will decrease.
Some patients may not experience complete resolution of symptoms, even with
appropriate medications.



SIGNS AND SYMPTOMS

• Depersonalization, as if the symptoms are happening to someone else
• Sense of doom, fear of dying due to the intensity of the physical symptoms
• Fear of losing control due to the unpredictable nature of the episodes
• Worry about future attacks due to the unpredictable nature of the episodes
• Change in behavior due to anxiety about being in a place where an attack
might occur

• Palpitations, tachycardia, and chest pain
• Dyspnea
• Choking sensation
• Nausea
• Dizziness
• Diaphoresis
• Numbness

TEST RESULTS

• EKG normal.
• Cardiac monitor normal.
• Lab results normal.
• Pulse oximetry normal.

TREATMENT

• Cognitive-behavioral therapy.
• Relaxation therapy.
• Administer antidepressants:
• selective serotonin reuptake inhibitors
• tricyclics
• monoamine oxidase inhibitors
• Administer benzodiazepines as adjunctive treatment:
• clonazepam, alprazolam, lorazepam
• Provide reassurance to patient.


NURSING DIAGNOSIS
• Powerlessness
• Fear
• Social isolation

NURSING INTERVENTION
• Provide reassurance to patient.
• Reduce anxiety.
• Monitor vital signs.