definition of panic attacks. “A discrete period of intense fear or discomfort, starting
abruptly and reaching a peak within 10 minutes. May experience symptoms of palpitations, sweating, shaking or trembling, chest pain/discomfort, nausea, abdominal distress, dizziness, faintness, feeling unreal or detached from oneself,
fear or “going crazy” or losing control, fear of dyin
g, parethesias, chills or hot flashes, and sensation of shortn
ess of breathing or smothering”
(Varcarolis, 2011 p. 110). The admitting doctor ruled out everything physical which lead him to believe that there was something psychologically wrong. According to the DSM IV a patient needs four or more symptoms from the above list to receive this diagnosis (Mathyssek, 2012, p.1). G.G. had seven of the symptoms necessary to diagnose a person with panic attacks. One symptom G.G. is particularly concerned with is his difficultly remembering information. When a person is under severe stress it causes an increased production of glucocorticoids. If a person remains under stress for a period of time the glucocorticoids can cause structural damage to the hippocampus, which is responsible for memory (Peavy, 2009). G.G. had admitted to being under stress for a while now, which could have lead to some hippocampus damage and ultimately to why he is having trouble with his memory. G.G. is curious as to what caused him to have these panic attacks. As a nurse it is important to explain the different risk factors and triggers that made him more susceptible to panic attacks. It may also be pertinent to explain the different neurotransmitters and hormones that could be off balance because it could help him understand why he will take certain medications.
Case Study of Panic Disorder: Jane (Weinstock & Gilman, 1998)
This case study gives an insight into how panic disorder was dealt with before it was well known among practitioners.
Jane was the youngest of seven children and was always shy and nervous. She was also particularly attached to her mother. Her father drank heavily which caused arguments between him and her mother, which led to her feeling very anxious. At age 17, Jane's father was murdered. Jane married at 21 and had three children between the ages of 23 and 30. Her panic attacks began at age 26, and she was particularly concerned about the physical symptoms such as a pounding heart and feelings of breathlessness. Her panic attacks occurred mostly at night and increased in frequency over a ten year period. She began to fear panic attacks each night and so did not sleep much. She was light headed most of the time and lost her appetite, causing her to become significantly underweight.
Over this ten year period Jane saw over 200 different doctors. She was misdiagnosed with a variety of ailments, which resulted in unnecessary and brutal 'treatments'. These 'treatments' included electro-convulsive therapy, the removal of her tonsils, the pulling of all her teeth, and a series of ineffective medications. Jane believed she had cancer and that she was dying, despite being told she was in good health by many of the doctors.
When Jane was 37 her husband died of a heart attack. Surprisingly, her panic attacks subsided as she was busy raising her children and working. She remarried at age 42 and continued to feel well until her new husband began drinking; causing the anxiety that had been present in her childhood to return.