What is Panic Disorder?
Panic disorder – is a type of anxiety which is mainly experienced by sudden feeling of panic. The National Institute of Mental Health reports that more Americans are suffering from anxiety than from any other type of mental illness. More than 18% of adults in the US suffer from anxiety.
The fragile nature of the individuals involved makes it hard to treat Dual Diagnosis — the coexisting problems of addiction and mental illness. A patient with mental illness is at an increased risk for addiction, especially if they abuse medications or alcohol. The effects of panic disorder, a mental disorder that leads to periods of severe mental stress combined with physical symptoms of anxiety, are especially drastic for patients with Dual Diagnosis.
Clinical anxiety, unlike normal, healthy reactions in stressful or hazardous situations, is characterized by persistent and often unfounded fears that may interfere with work, close relationships and social activities. Symptoms of panic disorder can be both physical and psychological and a multidisciplinary approach to treatment is needed to address these symptoms.
In order to address their symptoms, alcohol or medicines are not unusual for individuals with panic disorders. Indeed, the NID estimates that people with anxiety are twice as likely as the general populace to experience substance abuse. Unfortunately, self-medication attempts often reverse fire, by intensifying its effects. The psychological and physical symptoms of anxiety may worsen alcohol and drug use, strengthening the need for more of these substances to operate normally. The result is a cycle of drug abuse, which can lead to chemical addiction.
How Does A Panic Attack Happen?
The “fight or flight” response is the body’s response to situations that threaten your safety. The body’s functions speed up in response to any potential immediate danger, when adrenalin is released to give you more energy and trigger a panic disorder. People tend to experience similar symptoms during panic attacks, even when no real threat is present.
A Panic Attack Can Be Caused by Situations in Which Most People Feel Totally at Ease, for Example:
- Speaker before a group
- Attending a party with other people
- Taking the escalator or elevator
- Driving a car
- Taking public transportation
Different causes can contribute to panic, but the result remains the same: a cascade of alarming symptoms that cause the person to fear her life.
The Following Symptoms May Be Present:
- Irregular heartbeat
- Difficulty breathing
- Chest pain
Many people think that panic disorder is very rare. According to Psychology Today, approximately 14 out of 75 people aged between 18 and 64 in the US will suffer from stress-related disorders at some point in their lives. For the average individual with the disorder, at least one attack is expected every week for the next four weeks or more, and most attacks last about 10 minutes. Although the attacks are rarely fatal, they can seem as if they are life-threatening to the individual who suffers them. An essential feature of panic disorder is the fear of further attacks and the fear of losing control in public.
Turning to Alcohol and Drugs
People with panic disorders often abuse drugs and alcohol to numb their fear or calm themselves down. Addicts can develop a dependence on substances due to frequent use, which becomes an escape. Attempts to self-medicate with alcohol or drugs worsen the disorder since these substances can trigger panic attacks.
A study published in Behaviour Research & Therapy showed that alcoholism occurs between 10 – 40% of all people who have panic disorder. Also, they found that between 10-20% of people who have panic disorder abuse substances. Substance abuse is frequently used as a self-medication for anxiety rather than alcoholism. In most cases, anxiety symptoms begin before alcoholism develops. Although substance abuse may have costly consequences, many people with Dual Diagnosis feel that consuming alcohol or taking drugs works wonders for managing their symptoms.
Recovery from alcohol addiction involves patients with Dual Diagnosis learning healthy, sober ways to cope with their panic symptoms to get onto the right track and break the cycle of hard drug use. The patient with panic disorder will maintain inner balance through the treatment process as he/she works on his/her drug or alcohol rehab.
Treatment and Diagnosis
Finding the right treatment for dual diagnosis can be challenging, just like any other diagnosis. It is sometimes hard to differentiate between a mental illness and or an addiction, even for the experts. It is a given that a lot is happening inside and outside these individuals, causing them to be in a vulnerable state. It is crucial for a client suffering from panic disorder and addiction to seek treatment for the root causes of their anxiety.
Rehab can be rendered impossible by the nature of a client’s panic disorder. Socially anxious patients may find it hard to open up when they’re in front of a group. People may fail to attend treatment due to the overwhelming fear of dying, illness, injury, and catastrophe.
To overcome the challenges of recovery, doctors who treat these complicated patients with Dual Diagnosis would need to be well-trained in treatments for Dual Diagnosis.
Medication as Treatment
To treat panic disorder and substance abuse, the American Academy of Family Physicians recommends integrating medication and psychosocial therapies. Dual Diagnosis patients who take antidepressants are often successful in stabilizing their brain chemistry while also controlling their anxiety responses. Specific antidepressants, including selective serotonin reuptake inhibitors (SSRIs) and tricyclic antidepressants (TCAs), have proved effective in improving social functioning and leading fulfilling, productive lives in panic disorder patients.
Types of Anxiety Disorders
Listed Below Are Some of The Most Frequently Diagnosed Anxiety Disorders:
- Generalized Anxiety Disorder (GAD): In this kind of panic disorder, the individual has an almost uninterrupted, unspecific sense of fear. With GAD, concern moves without any apparent connection from one subject to the other.
- Panic Disorder Caused by Social Interactions. Anxiety disorders, also called social phobias, can cause individual sufferers to be afraid of social interaction with others. Most commonly, this tends to happen with people who fear being in social situations, in crowds, in speaking in front of others, or in situations where everyone can see them.
- Post-Traumatic Stress Disorder (PTSD): This panic disorder can develop after an individual experiences a traumatic event, such as military combat, a natural disaster, a violent crime, or a sexual assault.
- Panic Disorder: It is characterized by episodes of uncontrollable or overwhelming terror. Although panic disorder attacks are rarely fatal, a person experiencing one may experience an overwhelming sense of doom and impending death. Hyperventilation, a rapid heartbeat, sweating, dizziness, nausea and vomiting, chest pain, a feeling of choking, and other unsettling side effects are possible. These panic attacks, like other anxiety-related responses, are usually unfounded in any real source of danger.
- Specific Phobias: A specific phobia is defined as an irrational, incapacitating fear of a specific object, situation, or animal. People suffering from this type of panic disorder will go out of their way to avoid the object of their fear, even if it means interfering with their daily lives. Fear of enclosed spaces (claustrophobia), fear of flying (aviophobia), and fear of heights are some of the most common specific phobias (acrophobia).
Underlying Causes of Anxiety Disorders
In Many Cases, an Anxiety Disorder May Develop as A Result of Multiple Factors, Such As:
- Family History: Having a parent or other close relative with an panic disorder can make a person more susceptible to these conditions, says Mayo Clinic.
- History of Trauma: A traumatic situation, such as child abuse or exposure to violence, increases the likelihood of developing an panic disorder-related condition, such as PTSD.
- Substance Abuse: Abuse of alcohol or drugs can result in neurological changes that can trigger or exacerbate anxiety. At the same time, anxiety can serve as a motivator for substance abuse.
- Overexposure to Stress: Individuals who are constantly subjected to high levels of stress — whether emotional, psychological, or physical — are more likely to exhibit symptoms of an panic disorder.
- Other Mental Illnesses: Anxiety is frequently associated with psychiatric disorders. Someone suffering from depression, for example, is more likely to develop an panic disorder than someone who has no other mental health issues.
Panic Disorder and Substance Abuse
It is known as a dual diagnosis or a co-occurring disorder when a substance abuse disorder occurs in addition to a panic disorder or other mental illnesses.
The Abuse of Substances can be a Consequence of Various Reasons, Typically Anxiety or Dependence on the Substance.
- Self-Managing Symptoms: Many people believe that individuals who suffer from panic disorders use alcohol or illegal drugs to alleviate physical or psychological symptoms.
- Biochemical Factors: Chemical imbalances in the brain are believed to cause panic disorders and substance abuse disorders. The involvement of alcoholism and mental illnesses, such as psychiatric disorders, have been linked to low serotonin levels. Among other functions, serotonin controls mood, energy, sleep, metabolism, and other functions. It is believed that there are more than 800 neurotransmitters within the human nervous system alone.
- Genetics: There is some evidence that both addiction and panic disorders have a genetic component. Anxiety disorders run in the family, making substance abuse and addiction a greater risk for those predisposed.
- Addictions and Their Effects on The Body: Drug and alcohol abuse can lead to so-called antipsychotics such as Haldol, leaving a person feeling nervous, agitated, irritable, and obsessive. The brain attempts to regain balance as a person withdraws from the effects of substances.
Helping a Loved One Get Through Panic Disorder
Here Are a Few Tips to Keep in Mind when Talking to Someone About Drug or Alcohol Abuse and Panic Disorders:
- Be Compassionate and Nonjudgmental: Rather than focusing on the negative consequences of the individual’s substance abuse, emphasize the benefits of recovery and the positive outcomes of healing.
- Be Prepared for Denial or Defensive Behavior: Denial is a common symptom of addiction, and many people who are addicted will become defensive or hostile when confronted with their problem. Furthermore, panic disorders such as PTSD can lead to paranoid thinking or delusional beliefs, making communication more difficult.
- Remember that Substance Abuse and Panic Disorders Are Both Disease Processes: Drug and alcohol addiction were once thought to be signs of moral weakness, but addiction is now recognized as a chronic brain disease. Anxiety and addiction can both be treated with therapeutic interventions and the assistance of trained professionals.
- Offer Specific Solutions: When discussing addiction with someone, it’s helpful to be able to recommend specific recovery resources, such as the name of a therapist, physician, 12-Step group, or rehab facility that specializes in treating clients with dual diagnoses of anxiety and substance abuse.
Addiction is a progressive disease that will worsen if not treated, eventually worsening health complications, disability, injury, or death. Individuals who wish to assist friends or family members in dealing with a loved one’s panic disorder should consult professional crisis intervention services.
Cognitive Behavioral Therapy is one of the most effective treatment modalities for both anxiety and chemical dependency. Clients in Cognitive Behavioral Therapy, or CBT, learn how to identify and change self-defeating thought patterns that cause them anxiety and fear. Clients with a dual diagnosis of panic disorder and substance abuse can benefit from CBT to learn new coping strategies that will help them stay on track with their recovery goals even in high-stress situations. CBT can be used in both individual and group therapy settings.
Medication, when combined with psychological and psychosocial therapies, can be an effective tool in the prescription of panic disorder. SSRI (selective serotonin reuptake inhibitors) medications are frequently prescribed to treat anxiety symptoms and help people live more fulfilling lives. Drugs in this category are generally regarded as safe and effective, with a low risk of abuse or addiction. SSRIs, which include citalopram (Celexa), paroxetine (Paxil), and sertraline (Zoloft), work by increasing the amount of serotonin available to the brain, thereby reducing the negative thoughts and persistent worries associated with anxiety.
Eye Movement Desensitization and Reprocessing, or EMDR, has been shown to be effective in the treatment of panic disorder and substance use disorder. A study published in the Journal of Psychoactive Drugs found that eight sessions of EMDR combined with traditional treatment improved PTSD and depressive symptoms in patients with dual diagnoses.
Therapists use EMDR to help clients resolve past traumas by guiding them through a series of rapid eye movements that create new informational connections that aid in resolving unprocessed memories of panic disorder. This therapy effectively treats PTSD as well as several other psychological disorders. It aims to restore patients’ hope for the future by providing them with positive ideas in treating panic disorder.
Individuals with a dual diagnosis necessitate specialized care that addresses both issues. A comprehensive recovery program for co-occurring substance abuse and panic disorder includes multiple levels of care, beginning with detox and progressing through residential or inpatient rehab, outpatient treatment, and aftercare. Family therapy, 12-Step participation, and modalities such as equine-assisted therapy all help with recovery by strengthening the individual’s support system and reinforcing a sense of self-worth.
Research suggests that integrating therapeutic interventions that address anxiety and substance abuse is best for clients who have dual diagnoses. Contact us today 615-490-9376 for more guidance about panic disorder and help thereafter.
Ben Lesser is one of the most sought-after experts in health, fitness and medicine. His articles impress with unique research work as well as field-tested skills. He is a freelance medical writer specializing in creating content to improve public awareness of health topics. We are honored to have Ben writing exclusively for Dualdiagnosis.org.