Back with another week of the “Medical Spotlight” segment. We will continue from our previous story of Sam the teen who was headed to school and gets pulled over. 

 
Fortunately Sam leaves the encounter with nothing but a speeding ticket but it is definitely an experience that forever changes him. He continues on his way to school but he can't help to constantly look over his shoulder or in his rear view mirrors. It has gotten to the point that he can't even ride in the passenger seat without getting deathly afraid. Sam thinks he constantly hearing police sirens or seeing cop cars pull up behind him. It has been months since he was first pulled over but the fear still grips him. Since that time he has had to watched ten more people get killed during police stops and the fear that he is next has almost become paralyzing.  He becomes so fearful in leaving the house that he spends most of his free time home. Family & Friends have become concerned but really aren't sure what to do. 
 
Topic of day is Panic Disorder
 
Here we have Sam who has left what should have been a routine traffic stop but he came away with a problem that is much more severe. He has been struck with immense fear which that he may one day end up at the wrong end of a police stop. We can see that his normal activities of daily living are starting to become affected as well. 
 
To be continued next week. Lets talk about Panic Disorder
 
Panic Disorder
 
Unfortunately Panic Disorders are another common disorder I run into in my practice. Of course with our fictional character above the event that started it off was his run in with the police officer but I have had patients whose initial events ranged from : 
  • Being bit as a child by a pet
  • Abuse
  • Car accidents
  • Death in the family
  • Clowns

Clinical symptoms associated with Panic Disorder includes

  • spontaneous, discrete episodes of intense fear
  • significant changes in behavior associated with the attacks 
  • Many of these patients develop somatic dysfunctions (cardiorespiratory, neurological, gastrointestinal) which resulted in negative medical workups and repeatedly following up with medical care

Course

  • recurrent or chronic disease
  • few experience complete resolution
  • reduces the quality of life in affected patients and their families

DSM5 Criteria – Panic Disorder

  1. Recurrent unexpected panic attacks
  2. At least one of the attacks has been followed by a month or more of one or both of the following:
    1. Persistent concern or worry about additional panic attacks or their consequences (eg, losing control, having a heart attack, “going crazy”).
    2. A significant maladaptive change in behavior related to the attacks (eg, behaviors designed to avoid having panic attacks, such as avoidance of exercise or unfamiliar situations).
  3. The disturbance is not attributable to the physiological effects of a substance (eg, medication or illicit drug) or another medical condition (eg, hyperthyroidism, cardiopulmonary disorders).
  4. The disturbance is not better explained by another mental disorder. As examples, the panic attacks do not occur only in response to:
    1. Feared social situations, as in social anxiety disorder
    2. Circumscribed phobic objects or situations, as in specific phobia
    3. Obsessions, as in obsessive-compulsive disorder
    4. Reminders of traumatic events, as in posttraumatic stress disorder
    5. Separation from attachment figures, as in separation anxiety disorder
Again as a clinician it is important to recognize these early symptoms in your patients and point them in the right direction for help there are lots of different ways to go about doing so.  You don't have to be a health professional to see how damaging this disorder can have on a loved one, encourage them that what they are feeling isn't “crazy” and get them the help that they need. 
If you're in the south florida area you can see my wife who is licensed mental health counselor.  Day by Day Therapy