2. Triple Whammy—HIV, Mental Disorders, African Americans
Panic disorder is characterized by sudden attacks of terror, usually accompanied by a pounding heart, sweating, weakness, dizziness, or faintness. Panic attacks may also involve feeling flushed or chilled, tingling or numbness in the hands, nausea, chest pain, or smothering sensations. Panic attacks usually produce a sense of unreality, a fear of impending doom or of losing control.
Persons experiencing a panic attack, especially for the first time, may believe they are having a heart attack or are about to die. The timing of panic attacks is unpredictable, and the time between attacks may lead to intense worry and dread of the next attack. Attacks can occur at any time and typically peak within 10 minutes, but some symptoms may last much longer.
Panic disorder affects approximately 6 million American adults, [Kessler 2005] with twice as many women experiencing them as men. [Robins 1991] Panic attacks often begin in late adolescence or early adulthood, [Robins 1991] but not all persons who experience panic attacks will develop panic disorder. Many people experience a single attack and never have another. There appears to be genetic tendency to develop panic attacks. [Genetics Workgroup, 1998]
Intense or repeated panic attacks can become disabling and require treatment to minimize the risk that patients will begin to avoid places or situations where panic attacks have previously occurred. Such avoidance can affect an individual’s choice of employment or living situation.
Some people’s lives become so restricted that they avoid normal activities, such as grocery shopping or driving. Approximately one-third of panic disorder patients lead restricted lives and become housebound or able to approach a feared situation only when accompanied by a trusted person. [Robins 1991] When the condition progresses this far, it is called agoraphobia, or fear of open spaces.
Panic disorder is one of the most treatable anxiety disorders, with most patients responding to appropriate medication or some types of cognitive psychotherapy to reshape the thought patterns that lead to fear and anxiety.
Other serious problems—such as depression, drug abuse, or alcoholism—often accompany panic disorder, [Regier 1998, Kushner 1990] and these conditions should be treated separately.