Causes

A panic disorder often appears in early adulthood. The first attack may occur after a period of high tension, for example, the loss of a loved one from death or separation, an illness, an accident, or giving birth. The panic attacks persist even after the stressful situation has passed.

It seems that women are twice to three times more susceptible to panic disorder than men. Recent calculations show that more than a million Canadians could be suffering from panic disorder, with or without agoraphobia. It is difficult to establish precise figures since victims often hide their condition and a good number of health professionals do not diagnose it.

In fact, panic disorder has been described as one of the great impostors in medicine since it can easily be confused with many other medical or psychiatric problems. Victims sometimes consult several doctors with no result. Feeling ill at ease and misunderstood and questioning themselves about their mental health, some abandon all hope of improving their condition.
 
Agoraphobia is the fear of finding oneself in a place where, if a panic attack did occur, escaping or getting help would be difficult. Some agoraphobics stay within a limited perimeter or need to be accompanied by a person they trust, which means that the disorder also affects family and friends. Others do put themselves at risk, but pay the price in high anxiety.

Normally, panic disorder victims can recall quite well their first panic attack because the physical and psychological terror was overwhelming. Some people believe they are suffering a massive heart attack or that they are losing their mind. The impulse to escape immediately or to ask for help propels some victims toward hospital emergency rooms, where they insist, for example, that they are afraid of having a heart attack, but tests usually reveal nothing abnormal.

The suddenness and violence of panic attacks lead some victims to avoid situations where they had an attack. They believe that the highway or the grocery store are frightening places in and of themselves. They tell themselves that in the event of another attack, at least they will not be at the wheel, or in a crowd, or confined in a train or plane where escape or appropriate help would be near impossible. Victims avoid certain activities and places from fear of having an attack and losing control of themselves. This is called avoidance agoraphobia. For example, such people could end up avoiding staying home alone, walking in their neighbourhood, going to the grocery store, the bank or shopping centre, going to the cinema or to a show using public transit, travelling by car, crossing over bridges or going through tunnels, or taking a plane and travelling. The interference in the person’s personal and professional life can become considerable.


The consequences can be serious

Panic attacks, anticipation anxiety and agoraphobia avoidance may have serious consequences if not treated. Victims of this disorder are more susceptible to depression than the population in general, with all the complications that implies. Some abuse alcohol, drugs or certain medications in a desperate effort to suppress the attacks, and under the effect of anticipation anxiety.

Others acquire a pathological dependency. They are incapable of envisaging situations they fear without someone else being constantly there. It is estimated that, with all its complications, panic disorder costs Canada hundreds of millions of dollars a year in medical expenses, disability claims and lost wages.