Is panic disorder a physical or mental problem… or both?
by William D. Kernodle, M.D
The following article is excerpted by permission from the book, Panic Disorder: The Medical Point of View, by William D. Kernodle, M.D. This section pertains to “Key Points About Panic Disorder.”
A panic attack is a normal physical reaction occurring at an inappropriate time. Panic disorder may affect 5% of the population. By diagnosing panic disorder early, effective treatment can begin which should control or eliminate panic disorder, as well as prevent any possible complications. Panic attacks are benign; the complications of panic disorder can be malignant. Possible complications are anticipatory anxiety, demoralization, depression, agoraphobia, alcoholism and even suicide.
The best way to prevent complications of panic disorder is to diagnose it early. Panic disorder should be a rule-in diagnosis, not a rule-out diagnosis.
There is strong evidence that panic disorder has a biological core. Its complications are primarily psychological. Panic disorder is believed to have a strong biological core because of its strong familial and genetic tendencies: because panic attacks can be reproduced by physical means in the majority of patients vulnerable to panic attacks; and because medication is highly effective in blocking panic attacks. This same medication can prevent panic attacks from being caused by physical agents such as sodium lactate. PET scan data have established brain abnormalities in panic disorder. More evidence for the biological core of panic disorder should be seen in the future.
Panic disorder fits well into the medical model, including diagnosis, treatment and prognosis. It is analogous to ulcer disease. There are different stages: mild, moderate and severe. It is often chronic. Stress is contributory but not a sufficient cause for panic disorder, just as in ulcer disease.
In motivated patients, treatment using medication, education and cognitive-behavioral techniques is 90% effective. While this treatment combination has been scientifically verified, it is not standard treatment in this area. Supportive psychotherapy may be helpful, but is not as specific in treating panic disorder. Long-term exploratory psychotherapy used to find the cause of panic disorder has been ineffective and cannot be verified scientifically. Psychological and social factors should certainly be addressed if other treatment methods have failed or are not bringing the desired results.
Multiple factors are involved in panic disorder. Even though we have not yet pinpointed the exact cause, or causes, of panic disorder, we now have extremely effective treatment to help patients live normal, productive lives.
Ed. note: We have had numerous inquiries as to the medical viewpoint versus a more psychologically-based causation stance. In an effort to share more of such information with our readers, we are pleased to provide this article. ENcourage Connection is committed to disseminating information supplying a broad spectrum of ideas, and we trust that our readers will benefit as a result of having a well-rounded “education” in furthering each person’s efforts toward wellness.
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(This posted article was originally published in our ENcourage Connection Newsletter, print version.)