The first feeling that I had was just an overwhelming wave that goes through my body.
I feel very hot, my heart will start to race and I feel like I'm going to pass out or
possibly sometimes you think I'm going to die.
It's just such an overwhelming feeling.
I then thought I want to sit down, I've got to sit down because I'm going to fall down
if I don't.
In trying to walk from where I was to the chair my legs just go like jelly and it's
very difficult even just to make a simple walk happen.
When I sat down basically it's like I'm in a daze.
I can see everything happening around me, I can see other people walking past me.
Often times noises are amplified, you hear things a lot louder.
I just felt why are these people in control and I'm not, what's wrong with me?
And basically I just sat for 5-10 minutes, it keeps coming back in little waves.
You seem to feel that you're getting a little bit more control and then it hits again.
Basically I just sat there until my husband was finished with the lady at the checkout.
Donna, you ok?
Do you think you need an ambulance?
Do you want me to get one?
What's happening in a situation like this where pure panic takes over?
We all panic sometimes but for some of us it's a frightening and confusing occurrence
which doesn't match what's going on in our lives.
Hello I'm Carina Kelly and in this video we're going to take a look at panic.
When panic gets out of control it's called panic disorder.
You might feel that it's all in your mind, that you're going crazy or you might feel
that it's purely physical and you're having a heart attack.
Neither is true but panic disorder is a genuine medical condition which in most cases can
be treated.
You may wish to watch this program more than once or show it to your partner, family members
or friends.
In fact, later on we'll have some tips for family members on how best to help the sufferer
of panic disorder.
The information in this video is intended to help you understand this problem, its symptoms
and the treatments available.
There are easily identified chapter headings on the screen designed to help you rewind
or fast forward to particular sections you may wish to watch again with your video remote.
It's a good idea to jot down any questions that occur to you which you might like to
ask your doctor during your next visit.
The information we will be covering includes what is panic disorder and what are the symptoms?
What are the causes of panic disorder?
What are the treatments available?
What can family members do to help?
And what happens when panic disorder goes untreated?
We'll meet Donna and Andrew later on.
We'll also talk to Dr Frank Barbagallo, a general practitioner with an interest in panic
disorder.
It affects around two in every hundred Australians, although some experts believe that many more
sufferers go undiagnosed.
Panic attacks are disturbing and threatening events that leave the sufferer exhausted and
anxious.
Panic disorder is a condition where a person suffers four or more panic attacks in one
month, but people with fewer attacks than this can also be seriously disabled.
The symptoms of panic attacks vary from patient to patient, but they include at least some
of the following.
Racing heartbeat and chest pains or pressure in the chest making the sufferer fear they
are having a heart attack, dizziness and lightheadedness, nausea or indigestion, flushes or chills,
shortness of breath or smothering sensations, tingling or numbness, trembling or shaking,
sweating, choking.
Apart from these physical manifestations, a panic attack can also bring on a series
of most unpleasant feelings, a sense of terror, a fear of dying, feeling as though you haven't
got a grip on reality, worries about losing control or doing something embarrassing.
A panic attack can make a person feel that they are dying or going mad.
The attacks are so unpleasant that the sufferer will often go to great lengths to avoid the
place or situation where the panic attack occurred.
That might mean refusing to drive or go to the supermarket.
This is how panic disorder can really interfere with a person's day to day life.
I didn't want to drive at all.
I basically avoided it.
My poor husband got to drive everywhere.
I had the kids in the car once and I just wanted out.
I wanted out of that car.
You can't do that.
So it's the fear that it could happen to you in the car.
Donna first started suffering from panic attacks about seven years ago.
As the mother of four boys, she has her hands full and the panic attacks were making her
life a misery.
How long does a panic attack last and how does it leave you feeling?
Depending on the intensity of it, it can last all of two seconds.
It can be lasting over a couple of hours, intensity increasing and decreasing over that
period of time.
The more anxious, the more your thoughts return to how you're going to feel, it can come on
again.
Afterwards, I just feel very drained and very exhausted really and I just want to be away
from everyone.
I want to be on my own.
Donna, how would you describe a panic attack, both physically and mentally?
What happens to you?
Definitely, it's a mental thing.
It's what your fear of the unknown, fear of what could be going to happen.
But then the physical symptoms are very real too.
You can't believe that your mind can control your body so much to make physical symptoms
happen.
Your heart races, you feel sick in the stomach, you get a headache, you basically get this
wave come through you, a hot wave.
So the physical side is there but it's the mental side that sets it off.
What did you think when this first happened to you?
That there was something desperately wrong with me.
I actually went to my doctor and said that I think I need to have a brain scan because
there must be something wrong with me.
So what causes panic disorder?
The short answer is that we don't know.
We know that it runs in families, that you have a higher chance of being a sufferer if
someone in your family is a sufferer.
We know that the average age when people start to suffer is from the mid-20s to the early
40s.
People with a history of depression or anxiety are also more likely to suffer panic attacks.
Andrew has been suffering from panic attacks for 15 years.
He believes his condition has cost him a marriage and a promising career.
I was a geology student at uni and I was also doing some computers and I had a panic attack
trying to go underground into the mining area and they needed to be fairly brave and fairly
courageous.
They needed to fly places and I couldn't do that anymore.
Was it difficult to get diagnosed?
Very, very.
I didn't know what was going on and I was called sensitive, labelled just to get it
out of the way and a lot of people in society tend to say, push through it, don't be silly,
just go for it, just do it.
And one of the worst things that people with panic disorder can do is to do a task which
is very high in their fear level, too early, because all that does is send them into a
panic and then they believe they can't cope with it.
Dr Frank Barbagallo sees many patients with panic disorder.
His approach to combating the condition involves recognising that there is no simple quick
fix or magic remedy.
There's no quick fix or magic bullet as some patients are looking for.
It involves looking at the patient in their total environment, looking at the individual
factors and environmental factors that are contributing to their disorder and in a global
sense assessing what combination of various therapies will help them most.
What are the different methods you can use to treat panic disorder?
With panic disorder there's no one method that can be used on its own.
You really have to use a combination of treatments.
Initially I'd like to talk to patients about their own lifestyle management and looking
at aspects like cutting out caffeine, because caffeine can hype us up and it isn't really
in design, looking at things like having adequate rest and ensuring that you do some regular
exercise, they're really important for just general psychological wellbeing and relaxation.
Furthermore we really look at trying to train our patients specifically in the area of relaxation
management and that can involve just some simple techniques that can allow the patient
to just de-stress periodically during the day and also at the time of any symptom development.
Getting more specifically into treatments we'd like to talk about psychotherapy or
talking therapy as it's commonly known and there are a range of different types of therapy
that are really useful in helping patients combat this disorder.
On top of all that medication is now being shown to be increasingly important.
The reason is that new evidence is suggesting that panic disorder does have an underlying
biological basis which means that it is related to a chemical imbalance in as much as other
physical diseases like diabetes are for instance and the role of medication is becoming very
important as a result.
There are two types of medications that primarily would be useful.
Newer types of antidepressants such as the SSRIs or the selective serotonin reuptake
inhibitors are being shown to be the most favoured but there are also the older types
of benzodiazepine drugs which have been quite useful for symptom control.
Personally I've suffered probably seven years plus but increasingly got worse as time went
past and thank goodness I got help early stages so that I understood what was going on.
Did you know that treatment was available?
Not initially because I didn't understand what they were myself and it's the sort of
thing that you sort of think I'm not going to tell anybody that this is happening to
me because they're going to think I'm crazy but you're not and yeah I was just very lucky
that I did click on to a doctor that could help me up front.
What are you doing now to combat your panic attacks?
I am on medication at the moment.
I take a tablet each day and I also have learnt to when I do feel that this comes on how
to relax, how to combat it up front before it gets hold of me.
What do you do?
I just tense my whole body and then relax, just totally relax and I put pleasant thoughts
into my mind and whatever's worrying me personally I put it in a pink balloon and let it fly
away.
For me I've been catching the train down through tunnels and I have a lot of panic with that
and through this relaxation technique I can start to extend my relaxation, lower my stress
levels and hence not go into panic.
One of the greatest joys in having this panic attack was when I went and met a group of
people who had panic disorder, there were six of us and I actually felt understood for
the first time in 14 years.
If you're watching this video as a friend or family member of a sufferer you need to
remember that the patient is not putting it on and they can't just snap out of it because
you tell them to.
What they have is a genuine medical condition and there are positive things you can do to
help.
Let the sufferer set the pace for recovery.
Be predictable and encouraging but don't help the sufferer avoid things.
Don't panic when the person with the disorder panics.
Be patient but don't accept that your friend or family member will be permanently disabled.
For most people with panic disorder once they've been diagnosed the future looks good.
The most important thing is to find the right help.
Those who suffer in silence often become worse as time goes on.
Being undiagnosed is really a problem because it can cause a considerable amount of disability
in one's life.
The impact on the family and on other social structures can be profound.
A lot of patients with panic disorder actually end up developing other psychological problems
by the time they come to being diagnosed.
Up to 50 or 60 percent may have concomitant depression at the same time.
There's also a lot of overlap with disorders such as obsessive compulsive disorder and
even developing phobic disorders like agoraphobia is not uncommon.
These are the kind of complications that can really combine together and cause a lot of
disability in any one person's life.
How important is it to stick to the program?
It's exceedingly important.
The management plan that you've arrived at with your doctor is really going to dictate
how you get better and how you stay better.
If the temptation arises to cease medication or to cease using the therapies that you've
been taught what will happen is that the condition will recur, you'll suffer a relapse and then
you'll find it increasingly important to overcome that in the future.
Your doctor has a very important role as your guide so take their advice.
Remember even elite athletes listen to their coaches.
Winning the game is up to you.
As you follow the treatment program that both you and your doctor have chosen you'll find
yourself on the road to recovery and better health which is good news for you, your family
and friends.
If you take only one message away from this video it should be this, if you think that
you're suffering from panic disorder get help and get well.
The future is positive.
It's a very treatable condition Karina and with adequate treatment the person can really
get their life back.
They can really get their lifestyle back to where it was before and start to function
at their highest level.
They can really maximise and reach their potential as an individual.
I feel great about it.
I feel very positive about it.
I feel very up about it because I am starting to get control of the panic disorder and the
panic disorder controlling me and for the last 15 years I've been in the wilderness
not knowing what it's all about and now I can actually find out what it's about and
do something about it.
I'm not fearful of any situation now.
Instead of before thinking no I can't handle that, I can't do that I just think okay I'm
going to feel a little uneasy about that situation but I can do it.
It's absolutely fantastic.