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Panic Disorder: When Fear Overwhelms

(Source:  National Institute on Mental Health)

Introduction

Do you sometimes have sudden attacks of anxiety and overwhelming fear that last for several minutes? Maybe your heart pounds, you sweat, and you feel like you can’t breathe or think. Do these attacks occur at unpredictable times with no obvious trigger, causing you to worry about the possibility of having another one at any time?

If so, you may have a type of anxiety disorder called panic disorder. Left untreated, panic disorder can lower your quality of life because it may lead to other fears and mental health disorders, problems at work or school, and social isolation.

What is it like to have panic disorder?

“One day, without any warning or reason, a feeling of terrible anxiety came crashing down on me. I felt like I couldn’t get enough air, no matter how hard I breathed. My heart was pounding out of my chest, and I thought I might die. I was sweating and felt dizzy. I felt like I had no control over these feelings and like I was drowning and couldn’t think straight.

“After what seemed like an eternity, my breathing slowed and I eventually let go of the fear and my racing thoughts, but I was totally drained and exhausted. These attacks started to occur every couple of weeks, and I thought I was losing my mind. My friend saw how I was struggling and told me to call my doctor for help.”

What is panic disorder?

People with panic disorder have sudden and repeated attacks of fear that last for several minutes or longer. These are called panic attacks. Panic attacks are characterized by a fear of disaster or of losing control even when there is no real danger. A person may also have a strong physical reaction during a panic attack. It may feel like having a heart attack. Panic attacks can occur at any time, and many people with panic disorder worry about and dread the possibility of having another attack.

A person with panic disorder may become discouraged and feel ashamed because he or she cannot carry out normal routines like going to school or work, going to the grocery store, or driving.

Panic disorder often begins in the late teens or early adulthood. More women than men have panic disorder. But not everyone who experiences panic attacks will develop panic disorder.

What causes panic disorder?

Panic disorder sometimes runs in families, but no one knows for sure why some family members have it while others don’t. Researchers have found that several parts of the brain, as well as biological processes, play a key role in fear and anxiety. Some researchers think that people with panic disorder misinterpret harmless bodily sensations as threats. By learning more about how the brain and body functions in people with panic disorder, scientists may be able to create better treatments. Researchers are also looking for ways in which stress and environmental factors may play a role.

What are the signs and symptoms of panic disorder?

People with panic disorder may have:

  • Sudden and repeated panic attacks of overwhelming anxiety and fear
  • A feeling of being out of control, or a fear of death or impending doom during a panic attack
  • Physical symptoms during a panic attack, such as a pounding or racing heart, sweating, chills, trembling, breathing problems, weakness or dizziness, tingly or numb hands, chest pain, stomach pain, and nausea
  • An intense worry about when the next panic attack will happen
  • A fear or avoidance of places where panic attacks have occurred in the past

How is panic disorder treated?

First, talk to your doctor about your symptoms. Your doctor should do an exam and ask you about your health history to make sure that an unrelated physical problem is not causing your symptoms. Your doctor may refer to you a mental health specialist, such as a psychiatrist or psychologist.

Panic disorder is generally treated with psychotherapy, medication, or both. Talk with your doctor about the best treatment for you.

Psychotherapy. A type of psychotherapy called cognitive behavioral therapy (CBT) is especially useful as a first-line treatment for panic disorder. CBT teaches you different ways of thinking, behaving, and reacting to the feelings that come on with a panic attack. The attacks can begin to disappear once you learn to react differently to the physical sensations of anxiety and fear that occur during panic attacks.

For more information on psychotherapy, see http://www.nimh.nih.gov/health/topics/psychotherapies.

Substance Abuse Recovery and Recovery Support

Learn how recovery-oriented care and recovery support systems help people with mental and/or substance use disorders manage their conditions successfully.

Overview

The adoption of recovery by behavioral health systems in recent years has signaled a dramatic shift in the expectation for positive outcomes for individuals who experience mental and/or substance use conditions. Today, when individuals with mental and/or substance use disorders seek help, they are met with the knowledge and belief that anyone can recover and/or manage their conditions successfully. The value of recovery and recovery-oriented behavioral health systems is widely accepted by states, communities, health care providers, peers, families, researchers, and advocates including the U.S. Surgeon General, the Institute of Medicine (link is external), and others.

SAMHSA has established a working definition of recovery that defines recovery as a process of change through which individuals improve their health and wellness, live self-directed lives, and strive to reach their full potential. Recovery is built on access to evidence-based clinical treatment and recovery support services for all populations. Learn more about SAMHSA’s Working Definition of Recovery — 2012.

SAMHSA has delineated four major dimensions that support a life in recovery:

Health—overcoming or managing one’s disease(s) or symptoms—for example, abstaining from use of alcohol, illicit drugs, and non-prescribed medications if one has an addiction problem—and, for everyone in recovery, making informed, healthy choices that support physical and emotional well-being

Home—having a stable and safe place to live

Purpose—conducting meaningful daily activities, such as a job, school volunteerism, family caretaking, or creative endeavors, and the independence, income, and resources to participate in society

Community—having relationships and social networks that provide support, friendship, love, and hope

Hope, the belief that these challenges and conditions can be overcome, is the foundation of recovery. A person’s recovery is built on his or her strengths, talents, coping abilities, resources, and inherent values. It is holistic, addresses the whole person and their community, and is supported by peers, friends, and family members.

The process of recovery is highly personal and occurs via many pathways. It may include clinical treatment, medications, faith-based approaches, peer support, family support, self-care, and other approaches. Recovery is characterized by continual growth and improvement in one’s health and wellness that may involve setbacks. Because setbacks are a natural part of life, resilience becomes a key component of recovery.

Resilience refers to an individual’s ability to cope with adversity and adapt to challenges or change. Resilience develops over time and gives an individual the capacity not only to cope with life’s challenges but also to be better prepared for the next stressful situation. Optimism and the ability to remain hopeful are essential to resilience and the process of recovery. Visit SAMHSA’s Partners for Recovery Initiative’s Resilience Annotated Bibliography – 2013 (PDF | 531 KB).

Because recovery is a highly individualized process, recovery services and supports must be flexible to ensure cultural relevancy. What may work for adults in recovery may be very different for youth or older adults in recovery. For example, the promotion of resiliency in young people, and the nature of social supports, peer mentors, and recovery coaching for adolescents and transitional age youth are different than recovery support services for adults and older adults.

The process of recovery is supported through relationships and social networks. This often involves family members who become the champions of their loved one’s recovery. They provide essential support to their family member’s journey of recovery and similarly experience the moments of positive healing as well as the difficult challenges. Families of people in recovery may experience adversities in their social, occupational, and financial lives, as well as in their overall quality of family life. These experiences can lead to increased family stress, guilt, shame, anger, fear, anxiety, loss, grief, and isolation. The concept of resilience in recovery is also vital for family members who need access to intentional supports that promote their health and well-being. The support of peers and friends is also crucial in engaging and supporting individuals in recovery.

See http://www.samhsa.gov/recovery for more information.

 

 

 

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