Anxiety and Panic Disorder
Everybody has experienced feelings of anxiety from time to time; and sometimes people get so overwhelmed, they go into a state panic. Anxiety is actually a normal human reaction to stress. However, in severe cases, anxiety and panic can become disabling and interfere with everyday living. For an adolescent, life is already stressful enough. How does an adolescent, then, live day to day with one or both of these conditions?
This paper will take an in depth look at what anxiety, specifically generalized anxiety disorder (GAD), and panic disorder are, signs and symptoms that how severe anxiety and/or panic disorder is present in an adolescent, treatment methods for both GAD and panic disorder, and two websites offering advice and treatment for families with a diagnosed adolescent. While there are several types of anxiety disorders including GAD, Obsessive Compulsive Disorder (OCD), Post-Traumatic Stress Disorder (PTSD), phobias, and panic disorder, this paper will focus on generalized anxiety disorder (GAD) and panic disorder in the adolescent population.
Before we can discuss any aspects of GAD or panic disorder, we have to understand exactly what these two metal disorders are. Anxiety is the less severe disorder of the two. In general, anxiety is present in every human being. Feeling anxious is a normal circumstance in everyone’s life and, at times, can be beneficial in certain situations. Anxiety refers to the brain’s natural response to danger (Anxiety and Anxiety Disorders). To most people, this is referred to as our “fght or flight” response.
When an adolescent is diagnosed with generalized anxiety disorder, or GAD, the anxiety has been occurring at abnormal levels for at least six months. The anxiety has no apparent trigger, is difficult to control, and inders normal everyday living (Generalized Anxiety in Referred). Panic disorder is a similar, yet, more severe disorder than GAD. Panic disorder is diagnosed when the adolescent experiences multiple, unexpected “panic attacks” continuously over time. A panic attack is a completely disabling situation.
During an episode an individual experiences intense fear, apprehension, or terror, and is often accompanied by an impending sense of death or insanity (Panic Disorder. NCIB). Panic attacks are actually considered common to a degree, affecting roughly five percent of people at some point in their lives (Panic Disorder. ProQuest). It is when multiple panic attacks occur throughout time when a panic disorder diagnosis is made. Panic disorder is often present with other mental health problems and/or poor life style choices. These include GAD, depression, tobacco use, alcohol use, drug use, and even genetics.
These all can contribute to and exacerbate symptoms of panic disorder. Generalized anxiety disorder and panic disorder have similar symptoms, which we will look at Generalized anxiety disorder and panic disorder have similar signs and symptoms. GAD is diagnosed when excessive anxiety is constantly present for at least 6 months. Along with the excessive anxiety and worry, these physical and cognitive symptoms can be present: restlessness, fatigue, concentration deficits, irritability, muscle tension, and sleeping disorders to name a few. GAD is harder to detect in children and normally isn’t detected until the adolescent years.
Anxiety in a GAD diagnosed adolescent is likely to emerge in the presence of normal social, academic, or sporting events. Fear of Judgment from family and peers hangs heavy on the adolescent’s mind (Connolly, Simpson, and Petty 2006). The causes of the anxiety can arise from more ludicrous worries as well. This can include worries of a plague, nuclear war, or natural disasters occurring. With the mind being boggled from all the unnecessary worries by GAD, the adolescent’s academic, social, and athletic performance is now at risk of deteriorating. Any negative impacts on the adolescent will only escalate the anxiety.
Bad decision making can now occur. Three common bad decisions are drug, tobacco, and alcohol use. To add insult to injury, if any of these decisions are made, they too will only intensify the anxiety from addiction. GAD’s symptoms, however, have less severity on performance than panic disorder. Panic disorder’s symptoms are more severe and easier to notice. Common symptoms of panic attacks include: heart palpitations, sweating, trembling, shortness of breath, hyperventilation, choking sensations, chest pain, nausea, dizziness, depersonalization, or feeling a loss of identity, numbness, chills, hot flashes, fear of insanity, and fear of dying.
It is not necessary for the victim to experience all of the stated symptoms in a panic attack. However, the Diagnostic and Statistical Manual of Mental Disorders states that a true panic attack is accompanied by at least four of he previously stated symptoms. Additionally, the symptoms during a panic attack intensify within the first ten minutes (Matt’s and Ollendick 2002). The symptoms from a panic attack are no laughing matter. They can render the adolescent helpless. The panic attacks can happen at any moment and make even simple tasks, such as driving or eating, nearly impossible.
As discussed with GAD, social, academic, and athletic performance is at risk; even more so than with GAD alone. Panic attacks have such severity that they can force the adolescent to miss social activities, school, and or sporting events. Drug, tobacco, and alcohol use are also at risk with panic disorder as the adolescent is trying to alleviate symptoms on their own. Unfortunately, these will only increase the frequency of panic attacks. So how does an adolescent manage a disorder of this severity? There are healthier and more effective ways to deal with GAD and panic disorder.
While there is no known cure for GAD and panic disorder, they can be managed with psychotherapy, medications, or a combination of the two. One of the more popular psychotherapies is Cognitive-Behavioral Therapy (CBT) in which the individual works ith a trained mental health professional such as a psychiatrist, psychologists, or counselor. CBT has two components. The cognitive component helps the adolescent change the way they perceive their fears while the behavioral component helps the adolescent change the way they react to situations that trigger anxiety symptoms.
The adolescent learns coping methods that reduce anxiety levels, replace negative or non-realistic. However, sometimes CBT methods alone are not enough to control the symptoms of GAD and panic disorder. Sometimes medications are incorporated into the treatment plan. The most commonly prescribed medications used to treat GAD and panic disorder are antidepressants. There are several classes of antidepressants used to treat these disorders including Selective Serotonin Reuptake Inhibitors (SSRls), Tricyclics, and Monoamine Oxidase Inhibitors (MAO’s).
SSRls are the newest class of medications and tend to have fewer side effects than the other classes of antidepressants. They work by altering the levels of a neurotransmitter in the brain called serotonin. Some examples of SSRls are Prozac, Zolaft, Paxil, Celexa, and Lexapro. A popular Tricyclic ntidepressant medication prescribed to treat panic disorder is imipramine, or Tofranil. Adolescents taking MAOIS must be careful to avoid certain foods and avoid drinking red wine. They also cannot take many common medications because they can cause life-threatening drug interactions.
Besides antidepressants, anti-anxiety drugs are another class of medications that are helpful in controlling symptoms of severe anxiety or panic. Most are Benzodiazepines, which are usually prescribed for short term use due to the risk of dependence in prolonged use. Some examples are Xanax, Ativan, and Klonopin (Generalized Anxiety Disorder in Children). Today, there are thousands of websites offering support and resources for adolescents diagnosed with GAD and/or panic disorder. However, we must be careful in knowing the credibility of these websites.