"Recently, I often suffer from dizziness, numbness feeling over fingers, and having generalized weakness. Although I have undergone many investigations, the results are all normal. However, whenever the symptoms appear, I can't stop myself from worrying about having an incurable illness..."

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What is panic disorder?

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Panic disorder is a kind of anxiety disorder. Patients will experience panic attack repeatedly without any warning signs. During a panic attack, patient will be feeling extremely anxious, at times even without any reason. At the same time, they may experience different somatic symptoms, such as palpitation, sweating, hand tremor, dizziness or breathing difficulty. The vicious cycle continues as they interpreted the somatic symptoms in a disastrous way, e.g. thinking that they are having a heart attack or having a stroke and might lost consciousness at anytime. This further escalated their anxiety level. The panic feelings usually lasted for around 10 to 20 minutes and gradually subsided by themselves. Nonetheless, having a panic attack can be the worst experiences that one has in life. After each attack, patients tend to anticipate the next attack, which caused even heightened anxiety level. Some patients may developed maladaptive behavior, such as staying at home to avoid further attacks. This significantly impairs the patient's daily activity. During the panic attack, patient will be feeling extremely anxious.

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What is the cause of panic disorder?

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Whenever we encounter a dangerous or life-threatening situation, our body will initiates a series of physiological response called "fight or flight" response. Under this reaction, the sympathetic nervous system will become hyperactive, and the body will secrete a lot of hormone, called adrenaline. The hormonal change will cause an increase in heart beat and blood pressure, contraction of smooth muscles and dilatation of our pupil. The body will be in such a state to take immediate response to any external threat, either to run away from the threat or to prepare for a fight. This response is a natural reaction of the body that is not under our active control. Unlike others, people with panic disorder will initiate a "fight or flight" response in non-emergency situations, triggering the bodiliy response even when they are not necessary.

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What is the treatment for panic disorder?

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Since repeated panic attacks tends to have a negative impact on the disease progression, it is thus recommended for patient who suffers from panic disorder to receive treatment early. The treatment mainly includes medication and psychotherapy.

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• Medications
  The major medications used are antidepressants and tranquilizers. Antidepressant helps to regulate serotonin level inside the brain, thus improving the symptoms and decrease the chance of having panic attack. Side effects are usually mild and can include abdominal pain, nauseating discomfort, dizziness or headache. These sides effect, if seen, will gradually improves with treatment. Antidepressants might take two to four weeks to have full effect. Tranquilizers, on the other hand, can relieve symptoms in a short period of time. The advantage is the fast action, yet patients might get dependent on the medication. Therefore, long-term use is not recommended.

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• Cognitive behavior therapy
  Cognitive behavioral therapy has been shown to be effective treatment for panic disorder. Psychologists help patients identify negative thoughts and behavior patterns and subsequently developing more adaptive approach to their problem.