Panic Disorder: Pathogenesis and clinical findings Social Factors • Parenting and infant attachment • Childhood illness/abuse • Prolonged stress or trauma • Substance abuse Biological Factors • Dysregulation of autononomic nervous system and hypothalamic-pituitary-adrenal (HPA) axis • GABA abnormalities Psychological Factors • Strong belief/fear of physical or mental harm from bodily sensations • Neurotic personality Genetics ~30-40% heritability >> Panic Disorder - Panic Attack most often in absence of external cue/trigger Physical Symptoms • Incr Heart rate, hyperventilation, sweating, trembling, nausea, dyspnea, chest pain, heart palpitations, diaphoresis • Hyperventilation -> respiratory alkalosis • Dizziness, lightheadedness, numbness, shortness of breath Psychological Symptoms • Uncontrollable fear about symptoms/losing control/dying • Sense of altered reality Experiential Avoidance • Avoidance of situations that reproduce bodily sensations similar to panic attacks (exercise, caffeine, alcohol, saunas) Safety Behaviours • I.e. carrying anti-anxiety medication, locating the nearest hospital (to sense of security in the event of a panic attack) Anticipatory Anxiety • Intrusive thoughts and worries about where/when a panic attack will occur and the consequences (embarrassment, discomfort) #PanicDisorder #Anxiety #BehavioralDisorder #Pathophysiology #diagnosis #symptoms #signs #psychiatry
