On the 31st March 2005, at 8:00 p.m. the Than Hsiang Mitra Welfare Centre had a special public talk on panic attack or panic disorder at the Great Compassion Hall of Than Hsiang Temple. The speaker for the talk Dr. Teh Ewe Sow conducted the talk in Mandarin.

Panic disorder is a common anxiety disorder in which a person has episodes of intense fear or anxiety that occur suddenly, often without warning and without any obvious reason. These episodes, called panic attacks, can last from minutes to hours. They may occur only once in a while, or they may occur quite frequently. Such attacks causes much discomfort and may have one or several of the following symptoms.

•  a feeling of fear or danger;

•  a feeling of the need to escape;

•  palpitations, feeling that your heart is pounding or racing;

•  sweating;

•  trembling, shaking, clammy cold hands;

•  shortness of breath or a smothering feeling;

•  a feeling that you are choking, difficulty in swallowing;

•  chest pain or discomfort;

•  nausea or abdominal (gastrointestinal) discomfort or diarrhea;

•  dizziness or lightheadedness;

•  muscle tension, stiffness or cramps

•  a sense of things being unreal, depersonalization;

•  out-of-body feeling

•  a fear of losing control or "going crazy";

•  jumpiness or a fear of dying;

•  tingling sensations  or numb feeling;

•  chills or hot flushes, feeling of cold or hot

The sufferers of panic disorder or panic attack will probably feeling lost, desperate and scared. Sufferers also tend to be irritable and complain about feeling on edge, are easily tired and have trouble sleeping.

The frequency and severity of the attacks varies from person to person, an individual might suffer from repeated attacks for weeks, while another will have short bursts of very severe attacks. The sufferer often worries about the physical and emotional consequences of the Panic Attacks. Many become convinced that the attacks indicate an undiagnosed illness and will submit to frequent medical tests. Even after tests come back negative, a person with Panic Disorder will remain worried that they have a physical illness. Some individuals will change their behavioral patterns, avoiding the scene of a previous attack for example, in the hopes of preventing having another attack. Occurrence of attacks for panic disorder can also have three main situations that may trigger the attacks namely,

•  Unexpected - the attack "comes out of the blue" without warning and for no discernable reason.

•  Situational - situations in which an individual always has an attack, for example, upon entering a cave, a very small room.

•  Situationally Predisoposed - situations in which an individual is likely to have a Panic Attack, but does not always have one. An example of this would be an individual who sometimes has attacks while driving.

Sufferers of anxiety disorders and their families may spend months, even years, without knowing what is wrong. It can be frustrating and can put a strain on relationships; this strain is not necessarily alleviated once there is a diagnosis. Recovery can be a long process.

Family members often want to help the sufferer, but do not know how. An important fact to keep in mind is that anxiety disorders are real, serious, but treatable medical conditions. Having one is not a sign of weakness or lack of moral fiber. There is reliable evidence linking Panic Disorder and other anxiety disorders to brain chemistry, and even life events can trigger the onset of an anxiety disorder in a person who is genetically predisposed.

Like any other illness, anxiety disorders can take a toll on the family and friends of the sufferer. Household routines are disrupted, sometimes special plans or allowances need to be made, and the person with the disorder may be reluctant to participate in typical social activities. These factors can have a negative impact on family dynamics.

Family members should learn as much as they can about the disorder, which will help them know what to expect from the illness and from the recovery process. Family member should also learn also when to be patient with the sufferer and when to encourage the sufferer to face the anxiety situations.

Family support is important to the recovery process, but there is no magic cure. Getting better takes hard work, mostly on the part of the sufferer, and patience, mostly on the part of the family. Some things family members can do to help a loved one diagnosed with an anxiety disorder are:

It is also important for family members to keep in mind that the recovery process is stressful for them too. They should build a support network of relatives and friends for themselves. Remember that with proper treatment by a mental health professional anxiety disorders can be overcome.

Many people who have panic attacks don't seek medical care because of embarrassment or the fear of taking medicine. If you have panic attacks, it is very important to seek medical care and discuss your problem with your doctor. After you have been evaluated thoroughly, your doctor will be able to tell you if your panic attacks are related to panic disorder or are caused by another problem. Simple treatments are available to help control panic disorder. 

Several medicines can make panic attacks less severe or stop them altogether. Anxietytics, such as Benzodiozepines work fast but only temporally relief the anxiety, It is generally recommended for short term use and use when necessary to relieve acute anxiety.The long term use of Benzodiozepineshas the risk of drug dependence. On the other hand, antidepressant medications which would not cause drug dependance problems is usually recommended for regular long term use to eliminate the anxiety symptoms. Antidepressant would not manifest its therapeutic effect after the first few doses. Patience is required, as antidepressant needs to be taken regularly for a few weeks before it works. Side effects from medications are usually mild. Antidepressants will not make you lose control or change your personality.

Your doctor will design a treatment plan just for you. A treatment period lasting at least six to nine months is usually recommended. Some people taking medicine for panic disorder are able to stop after only a short time. Other people need to continue treatments over a long period of time, or even for their lifetime.

Psychotherapy, practically Cognitive Behavioral Therapy (CBT) is very effective for treating panic disorder. In cognitive theory, panic attacks occur as a result of catastrophic misinterpretation of normal bodily response to anxiety. Hyperventilation (over breathing) is o0ften the very mechanism that exacerbate the panic attacks. The practice of correct relaxing, breathing techniques, diaphragmatic breathing technique can also relieve the symptoms of panic disorder. The combination of both psychotherapy and medicine is usually superior to either one single method in treating panic disorder.