Panic disorder a
threat to health


By Jerry Guo

Victor Tang, 31, a sales manager, could sense that something was going wrong with his health. There was sudden dizziness, sweating, racing heartbeat and shortness of breath.
“Thinking it was a disease, I consulted general practitioners and underwent physical examinations such as an electrocardiogram. Though the results were normal, the situation was worsening,” said Mr. Tang.

Finally, the fourth general practitioner he saw diagnosed him with having panic disorder and referred him to a psychiatrist.

Panic disorder is a kind of mood disorder. It is defined as the presence of at least three physical or emotional symptoms of anxiety attacks in the previous month, associated with persistent fear of further attacks, phobic avoidance behaviors, and impairment of social function.

A telephone survey of 3,004 randomly selected respondents was conducted in 2002 by the Hong Kong Mood Disorders Center to assess the incidence of panic disorder in Hong Kong.

The result showed that 4.4 percent of respondents suffered from panic disorder. It is estimated that there are at least 120,000 sufferers aged from 15 to 60 in Hong Kong.

“Unexpected and recurrent panic attacks are the hallmark of panic disorder. They occur when the brain’s normal mechanism for reacting to a threat is inappropriately aroused,” said Twiggy Mak, clinical psychologist at the center.

Panic attacks are accompanied by physical and psychological symptoms.

Physical symptoms include racing heartbeat, shortness of breath, sweating, trembling, feeling of choking, chest pain, sudden chills, dizziness and tingling sensations.

Psychological symptoms include terror that is almost paralyzing, fear of losing control or going crazy, and fear of dying.

These attacks pass in a few minutes but can recur for hours.

The causes of panic disorder include hereditary, psychological, environmental and physiological factors.

Psychological causes comprise a rigid personality, over-anxiety, perfectionism and a tendency to overreact to normal bodily sensations.

Environmental causes include stress, unemployment, domestic discord and other unpleasant experiences.

“Another main cause is the abnormality of neurotransmitters in the brain, especially a hormone called serotonin,” said Miss Mak.

Regarding the findings of the Hong Kong Mood Disorders Center’s survey, Prof. Daniel Shek of the Department of Social Work at The Chinese University of Hong Kong related the high incidence of panic disorder in Hong Kong to the social environment.

“Great stress and a bad social atmosphere have made it easier for people to feel anxious.

“This, together with poor knowledge of mental health, makes them fail to handle stress when problems arise,” said Prof. Shek.

Though its causes are complex, panic disorder is treatable.

Substantial research, according to Miss Mak, has demonstrated that meditation and cognitive behavioral therapy are highly effective.

“Meditation works by regulating serotonin and other neurotransmitters,” Miss Mak said. “The new generation of drugs will not cause addiction.

“In cognitive behavioral therapy, therapists correct patients’ views on panic disorder, help them change avoidance behaviors, and demonstrate ways to reduce anxiety.

“Generally, meditation lasts for six months to a year. CBT requires 12 to 16 courses of 45 minutes each,” said Miss Mak.

The survey also showed that only 40 percent of sufferers had sought medical consultation. Among them 49.5 percent consulted general practitioners, 20 percent consulted non-psychiatric specialists, and 18 percent consulted psychiatrists or psychologists.

According to Miss Mak, poor knowledge of panic disorder has prevented most sufferers from timely and effective treatment.

Without appropriate treatment, panic disorder can have serious consequences.

“Sufferers will gradually have phobic avoidance behaviors, and ultimately develop agoraphobia — fear of going outdoors — because of intense fear and anxiety,” said Miss Mak.

According to Miss Mak, untreated panic disorder will lead to other mental diseases such as depression. It can also worsen physical diseases such as high blood pressure and heart disease.

When asked how to control and protect panic disorder, Miss Mak said, “First, health education is needed to improve people’s knowledge and raise their awareness of mental health.

“Second, people should hold right views on stress and learn how to adjust their mood.”

She advised sufferers to see doctors early.

After a year’s treatment, Mr. Tang has recovered and enjoys normal life again.

Said he: “Panic disorder is not fearful. It is as common as other diseases.”

Twiggy Mak.