Panic Attacks: A window of opportunity

“Oh great! Just when I got my panic attacks under control I get a demotion at work. Well, I guess I’d better get my Xanax refilled.”

Well, let’s not jump the gun here. That demotion-generated panic attack is likely a few months off. So that gives you plenty of time to do something constructive about it.

By the way, why not work on getting your panic attacks under management, not control?

With Viibryd hitting pharmacy shelves last week, most of the chat on chipur (chipur chat?) has been about depression.

So let’s play fair and take a look at some new research addressing the generation of panic attacks…

The Study

A Brown University (Providence, RI, US) research team, led by Dr. Martin Keller, suggests a traumatic or stressful event does not generate an immediate and earth-shaking panic attack.

Now, I believe most would have argued otherwise. But according to the study there’s a steady and gradual increase in panic/anxiety symptoms over a number of weeks following the event.

That’s important info, don’t you think?

According to team member Ethan Moitra, of the Dept. of Psychiatry and Human Behavior at Brown’s Warren Alpert Medical School…

“We thought the symptoms would get worse right away. We definitely expected the symptoms to get worse over time, but we also thought the symptoms would get worse right away.”

Study participants were 418 adults diagnosed with panic disorder or panic disorder with agoraphobia. All of them had been enrolled in the Harvard/Brown Anxiety Research Project (HARP) between 1998 and 2004.

The research team asked the participants standardized questions about important events in their lives and their levels of anxiety.

The Findings

For stressful life events in the categories work (e.g.: layoff, demotion) and friends/family/household (e.g.: family argument) – panic symptoms with a fluctuating severity before the event increased steadily, but gradually, for at least 12 weeks afterward.

And how ’bout this? Seven other categories didn’t influence panic at all. Two of them being crime/legal and deaths. I find that interesting – and encouraging.

The study also confirmed something I believe most enduring panic attacks already knew. In the vast majority of cases, stressful/traumatic events are associated with the onset of panic disorder.

Why? Well, who knows for sure – but according to the study team the answer may be biological in nature.

Stressful life events might exacerbate an underlying predisposition in people with panic disorder to anticipate the arrival of bouts of hyperventilation – which leads to panic responses.

One other finding of the study. Panic symptoms did not seem to increase in advance of stressful life events, even if they were predictable – say, a work layoff.

The Take-Away

According to Dr. Keller…

“If they have the event and they are not feeling much different then maybe the vigilance on the individual’s part decreases somewhat. With the knowledge we have, you may need to stay vigilant for three months or maybe longer. This is something you have to watch for.”

Bottom-line: As much as you may believe it will, that stressful or traumatic event isn’t going to generate a panic attack right away. Oh, without intervention it may happen eventually; but not tonight or tomorrow morning.

Just knowing that gives you the insight and time to continue working on your panic/anxiety prevention strategies and techniques. And to me, that’s the beauty of the study’s message.

So make panic/anxiety management (not control) an every day practice. It’ll pay huge dividends.

The research, funded by the National Institutes of Health, was published in advance in the June 11 issue of the Journal of Affective Disorders.

To review all of the chipur articles on the psychology of depression, anxiety, and bipolar disorder just click here.