Treatment of Panic

I am going to do some refresher work on controlling panic. My first assignment is to respond to some questions about my own experiences and then compare it to typical patterns often seen in people with panic disorder.

1. How old were you when you experienced your first panic attack?

• I would have to say I was in early grade school. I have recollections of panic on the first day of school and every year when we started swimming lessons. I remember my second grade teacher trying to prepare me for immunizations but it just made things worse for me and I ended up in the nurse's office afterward. I remember feelings of anxiety if children were being noisy because I was afraid they were going to get into trouble for behaving that way.
• This does not fit the normal pattern as panic disorder tends to begin in early adulthood (during a person's 20s) It is usually sudden and begins with a very bad attack. Also, the onset often follows a period of stress in a person's life, including events such as graduation, divorce, a new marriage, a new baby, a new job, unemployment, death of a loved one, or illness in the family (Antony and Swinson 2000)

2. Were you experiencing any life stress during the year before your panic attacks began? If so, what types of stresses?

• I imagine I was under stress at starting school. I was uncomfortable about leaving home, although I was jealous that my older sister got to go to school and I didn't. I recall being bullied in early gradeschool by an older male student who prevented me from leaving the playground so I could go home. This frightened me terribly and I was always nervous that he was going to be at the gate after school.
• In reflecting on the current increase in panic, I have experienced severe stress during the past year. I continue to commute from Provo to Salt Lake on public transportation (If I need to get off of the bus, it needs to be done by the time the bus reaches Utah Valley University . After the UVU stop, the bus travels nonstop to downtown Salt Lake. A bus back to Utah County is not scheduled until 3:00 PM). My father had congestive heart failure and was hospitalized. He was then placed in the Long Term Care Center. I have made arrangements and handle the financial aspects for him. I arranged to sell his mobile home by comunicating long distance with the management of the mobile home park and the medicaid office in Cheyenne WY. I assisted my father in getting a divorce. This was probably the most stressful portion for me. His wife is now saying she plans to sue me. There has been multiple trips to Cody (8 hours one way). The economy also dived and the State of Utah had to cut extensively. I was afraid I would lose my job for nearly four months before knowing. Now the question is whether there will be funding for next year. Our office is also moving into a new building, which means a new environment AND a new bus route.

3. What areas of your life are most affected by your panic attacks?

• social functioning-I experience anticipatory anxiety but it doesn't always mean I will have a panic attack. I have panicked while shopping, while out to dinner with my husband, at schooll performances of the children, church, during classes for my own education, various restaurants, various stores, even in my bedroom while relaxing and alone. There is no pattern. It could happen at any time or anywhere.
• Work-In the past year I have struggled a lot with being away from home. I have panicked frequently at the office and go to the Garden Room for down time. I have also found myself in the restroom. A few times I have had to leave work. I carry Xanax with me and when I have panic attacks on top of each other, I medicate myself and ride the Trax to the Southern part of Salt Lake County where I can catch a bus into Utah County.

4. In addition to your panic attacks, do you experience other problems with anxiety, depression, excessive alcolot or drug use, or other difficulties?

• I have anxiety about having panic attacks. It is constantly present and makes me hyper alert to my surroundings. I am hypervigilant regarding who is around me and what they are doing, noises I hear, safety and security measures, etc.
• I have been treated for post-partum depression but I feel my panic underlies the depression. I am depressed because I am withdrawn from life. I am withdrawn from life because I do not want to panic in a public domain. I do not want to panic in front of people and I especially do not want to embarrass my family.