Although panic disorder may occur without agoraphobia, the latter is generally linked to the former due to the extreme fear of the patients for embarrassment as he or she experiences panic attack in public places. In this case, panic disorder patients avoid populated social settings like grocery, church, and theaters. They prefer safe places like home and to be with safe people like parents in order to avoid embarrassment during a panic attack.
This avoidance is further aggravated by the anticipatory anxiety as the patient imagines what possibly might happen when he or she experiences panic attack in public places. The tendency for the disparity in the diagnosis of panic disorder is blamed with its comorbidity with other psychiatric disorders. This is highly observed among individuals with substance-abuse history, especially those who have taken benzodiapine in self-medication as well as those who consume alcoholic drinks heavily. As well, around 75% of patients had major depression while experiencing panic disorder (Hirschfeld, 1996).
On the other hand, the non-specificity of the patient’s conditions, laboratory tests and physical examination are employed to rule out the complication symptoms brought by other medical disorders like hypoglycemia, pheochromocytoma, and thyrotoxicosis. In connection to this, the echocardiogram and electrocardiogram, ECG, are used to detect cardiovascular disorders like mitral valve prolapse and paroxysmal atrial tachycardia which symptoms are similar to panic disorders. As revealed by medical studies, 43% of patients with reported chest pain but have normal coronary angiogram were typically associated with panic disorder.
This was also true for referred patients for cardiac examination. Nonetheless, panic disorder was the primary diagnosis among patients referred for medical tests specific for irritable bowel syndrome and pulmonary function. Panic Disorder Treatment Although a number of therapeutic interventions have been employed in the treatment of panic disorder, only the traditional cognitive-behavioral therapy was empirically proven to cause reduction in the frequency and intensity of panic attacks (Arntz, 2002).
Based on the cognitive-behavioral model, any psychiatric disorder is a product of behavioral, psychological, and biological factors (Sudak, Beck, and Wright, 2003). In addition, genetic predisposition and psycho-sociological factors trigger the development of mental health problem in an individual. The effect of such largely depends on the capacity of the individual to endure the changes brought by these factors and the availability of environmental scaffold. Specifically, in the cognitive-behavioral approach of treatment, patients are informed about and trained to control their thoughts that trigger anxiety.
These thoughts are misinterpretation of internal or external events which result to the perception of threat. In such manner, their thoughts generate tremulous bodily responses such as fast beating of the heart and shortness of breath. Cognitive-Behavioral Therapy The cognitive-behavioral therapy has five domains in the treatment of anxiety disorders among children and adolescents. Information about the disorder and its stressors are provided by means of psycho-education component while the correct autonomic arousal and other physiological responses are done through somatic management (Sudak, Beck, and Wright, 2003).
In addition, the development of cognitive restructuring are designed for the identification of the source of negative thoughts then substitution with positive thoughts to reinforce coping mechanisms (Sudak, Beck, and Wright, 2003). Moreover, the exposure domain, conditions the individual to appropriately face the cause of negative thoughts while the relapse prevention is designed to consolidate and generalize treatment gains (Sudak, Beck, and Wright, 2003).