Characteristics of Panic Disorder in
Comparison with Generalized Anxiety Disorder
1. Clinical onset is later.
2. The role of heredity seems to be greater.
3. The ratio of women to men is greater.
4. Alcoholism is more common.
5. While depression is common in both, it is unusually more
so in panic disorder.
Panic and generalized anxiety disorders differ most early
in the diffuseness of the anxiety seen in the latter
and its focused intensity in the former . But research has
shown that they differ in a number of other ways as
well. In addition to investigating the characteristics of panic disorders,
researchers are also conducting experiments designed to better understand
how the attacks come about. It has been discovered that equildium
lactate when administered intravenously to patients with panic disorder
will often provoke a panic attack while this does not happen in normal situations.
There is an active effort in a number of laboratories at the present time to identity the mechanisms
by which sown lactate causes panic attacks.
Phobias
‘Phobos’ was the Greek god of fear. His likeness was
painted on masks and shields to frighten enemies in battle.
The word phobia) derived from his name, came to
mean fear, panic , dread, or fright. Like people who
have generalized anxiety disorders, people who have
phobias know exactly what they are afraid of except for
their fears of specific objects, people, and situations,
phobic individuals usually do not engage in gross distortions
of reality. Nothing physical seems to be wrong
with them. However, their fears are out of proportion
with reality, seem inexplicable, and are beyond their voluntary control.
One question that inevitably arises in discussions
of anxiety is why people spend so much time brooding
about vague menaces when there are so many real dangers
to worry about. Perhaps the degree of fear we feel
about a potentially harmful event is linked not primarily
to the degree of threat (in terms of the probability that
it will actually happen to us) or even to the amount of
injury that we imagine we might sustain if the worst did
happen, but to the disturbing quality of the event or
situation itself. For example, even though there are
three times as many traffic fatalities as there are murders,
our thoughts are rarely preoccupied by the danger of an
automobile accident . Fear of violent crime on the other
hand: touches many of us. Crucial to the 'experience of
fear is whether people feel that they will be able to respond
meaningfully to a situation-that is, whether they will be able to cope.
Phobias can cause people to lead restricted lives.
Some fears, while strong, do not reach phobic proportions.
For instance in photo, although this man is afraid of heights,
he endures the discomfort because he cannot afford to have
someone fix a clogged gutter, and to ask his wife to
climb the ladder would be humiliating. If he had a true
phobia of heights, he would not climb the
ladder no matter how costly or humiliating his refusal
to do so would be. An effective therapy for
conquering phobic fears is shown in photo b. The patient,
who has an intense fear of heights, is
helped to climb the stairs in the presence of her trusted therapist.
For many phobic individuals this type of exposure to a feared situation
eventually results in extinction of the irrational fears and the
ability to cope with formerly frightening situations.
Phobics and Fear
Phobics do not need the actual presence of the
feared object or situation to experience intense tension
and discomfort. The following account by a psychiatrist
with an airplane phobia shows that simply imagining a
phobia-related event can elicit strong psychological and
bodily reactions.
I was pampering my neurosis by taking the train to a
meeting in Philadelphia. I t was a nasty day out) the
fog so thick you could see only a few feet ahead of your
face) and the train) which had been late in leaping
N CHJ York) was making up time by hurtling at a
great rate across the flat land of Jersey . As I sat
there comfortably enjoying the ride) I happened to
glance at the headlines of a late edition) which one of
the passengers who had boarded in New York was
reading...“TRAINS CRASH IN FOG," ran the banner
headlines) …”10 DEAD, MANY INJURED ."
I reflected on our speed, the dense fog outside,
and had a mild transitory moment of concern that the fog might
claim us victim) too) and then relaxed as I picked up
the novel I had been reading . Some minutes later the
thought suddenly entered my mind that had I not
chickened out about flying, I might at that
moment be overhead in a plane . At the mere image
of sitting up there strapped in by a seat belt, my
hands beg an to sweat, my heart to beat perceptibly
faster, and I feel a kind of nervous uneasiness in my
gut. The sensation lasted until I forced myself back to
my book and forgot about the imagery.
I must say I found this experience a vivid lesson in
the nature of phobias. Here I had reacted with hardly
a flicker of concern to an admittedly small
but real danger of accident as evidenced by the fog caused
train crash an hour or two earlier; at the
same time I had responded to a purely imaginary
situation with an unpleasant state of nervousness
experienced both as somatic symptoms and as an
inner sense of indescribable dread so characteristic of
anxiety. The unreasonableness of the latter was
highlighted for me by its contrast with the absence of
concern about the speeding train, which if I had
worried about it, would have been an apprehension
founded on real, external circumstances. -(Nemiah).
The onset of many phobias is so gradual that it is.
difficult to tell whether there were any specific precipitating
factors. In other cases, the apparent time of onset,
although not necessarily the cause, can be pinpointed.
I was riding in my husband’s car and I suddenly
became terrified. I felt as if I would die. I made him
turn around and take me home. I ran into the house
and suddenly felt safe. I could not understand what
had happened. I had never been afraid of cars. The
next day it happened again and it kept getting
worse. Finally just being on the street and seeing a
car would bring on a terrible feeling. Now I just stay
at home. -(De Nike and Tiber, 1968, p. 346)
Phobias may begin with a generalized anxiety attack,
but the anxiety then becomes crystallized around a
particular object or situation (for example, elevators,
snakes, or darkness) . As long as the feared object or situation
can be avoided, the anxiety does not reach disturbing
proportions. Some objects of phobias-such as
cats, cars, and stairs-are considered aspects of everyday
life by most of us. Other objects and situations-snakes,
death, and heights are disliked to some extent by most
people. However, phobias involve levels of fear that, in
addition to being over intense, interfere with normal
living patterns.
One study of phobic patients showed that their fears into
five categories related to (1) separations, (2) animals,
(3) bodily mutilation, (4) social situations, and (5) nature.
Phobias tend to grow progressively broader.
For example, one woman had a subway phobia that began
with an inability to ride an express train between two
fairly distant locations . Gradually the phobia developed
until she would have to get off the train at each local
stop, wait until her anxiety diminished, get on the next
train , get off again at the next stop , and so on, until her
destination was reached.
Phobic individuals usually develop ways of reducing
their fears. The professor managed to live with his
phobia, and the subway rider mentioned earlier was able
to get from one place to another. However, the often
cumbersome procedures that phobic’s devise do not
eliminate their fear; indeed, the fear seems always to be
one step ahead of them. In one sense, phobic individuals
who cannot cross the thresholds of certain rooms or
cannot work may be as incapacitated as people with severe
psychotic symptoms. In another sense, they are
more fortunate than people who exhibit free-floating
anxiety, since at least their fears are directed toward a
specific object, and they can reduce their anxiety by simply
avoiding that object.
Phobias, like other forms of maladaptive behavior,
do not occur in isolation. They are usually intertwined
with a host of other problems. In consequence, it is difficult
to estimate their frequency accurately. While mild
phobias are common, phobias that are serious enough
to be clinically diagnosed occur relatively infrequently.
They are the main complaint in perhaps 2 to 3 percent
of all clinical cases (Kolb). Phobias do not require hospitalization.
Professional treatment, (see link below) when it is given,
is usually carried out on an outpatient basis.
One of the most interesting aspects of phobias is
that the stimuli that evoke them are not picked at random.
The most common fear-arousing stimuli tend to
be animals, objects, or events that presented real dangers
in earlier stages of human evolution (McNally).
Although extreme fear of dogs, snakes, and spiders
seems maladaptive today, such fear may have been
highly adaptive in earlier times "modern" phobias
are rare. For example, pajama and electric-outlet phobias
occur infrequently, even though these objects are
often associated with trauma.
2. The role of heredity seems to be greater.
3. The ratio of women to men is greater.
4. Alcoholism is more common.
5. While depression is common in both, it is unusually more
so in panic disorder.
Panic and generalized anxiety disorders differ most early
in the diffuseness of the anxiety seen in the latter
and its focused intensity in the former . But research has
shown that they differ in a number of other ways as
well. In addition to investigating the characteristics of panic disorders,
researchers are also conducting experiments designed to better understand
how the attacks come about. It has been discovered that equildium
lactate when administered intravenously to patients with panic disorder
will often provoke a panic attack while this does not happen in normal situations.
There is an active effort in a number of laboratories at the present time to identity the mechanisms
by which sown lactate causes panic attacks.
Phobias
‘Phobos’ was the Greek god of fear. His likeness was
painted on masks and shields to frighten enemies in battle.
The word phobia) derived from his name, came to
mean fear, panic , dread, or fright. Like people who
have generalized anxiety disorders, people who have
phobias know exactly what they are afraid of except for
their fears of specific objects, people, and situations,
phobic individuals usually do not engage in gross distortions
of reality. Nothing physical seems to be wrong
with them. However, their fears are out of proportion
with reality, seem inexplicable, and are beyond their voluntary control.
One question that inevitably arises in discussions
of anxiety is why people spend so much time brooding
about vague menaces when there are so many real dangers
to worry about. Perhaps the degree of fear we feel
about a potentially harmful event is linked not primarily
to the degree of threat (in terms of the probability that
it will actually happen to us) or even to the amount of
injury that we imagine we might sustain if the worst did
happen, but to the disturbing quality of the event or
situation itself. For example, even though there are
three times as many traffic fatalities as there are murders,
our thoughts are rarely preoccupied by the danger of an
automobile accident . Fear of violent crime on the other
hand: touches many of us. Crucial to the 'experience of
fear is whether people feel that they will be able to respond
meaningfully to a situation-that is, whether they will be able to cope.
Phobias can cause people to lead restricted lives.
Some fears, while strong, do not reach phobic proportions.
For instance in photo, although this man is afraid of heights,
he endures the discomfort because he cannot afford to have
someone fix a clogged gutter, and to ask his wife to
climb the ladder would be humiliating. If he had a true
phobia of heights, he would not climb the
ladder no matter how costly or humiliating his refusal
to do so would be. An effective therapy for
conquering phobic fears is shown in photo b. The patient,
who has an intense fear of heights, is
helped to climb the stairs in the presence of her trusted therapist.
For many phobic individuals this type of exposure to a feared situation
eventually results in extinction of the irrational fears and the
ability to cope with formerly frightening situations.
Phobics and Fear
Phobics do not need the actual presence of the
feared object or situation to experience intense tension
and discomfort. The following account by a psychiatrist
with an airplane phobia shows that simply imagining a
phobia-related event can elicit strong psychological and
bodily reactions.
I was pampering my neurosis by taking the train to a
meeting in Philadelphia. I t was a nasty day out) the
fog so thick you could see only a few feet ahead of your
face) and the train) which had been late in leaping
N CHJ York) was making up time by hurtling at a
great rate across the flat land of Jersey . As I sat
there comfortably enjoying the ride) I happened to
glance at the headlines of a late edition) which one of
the passengers who had boarded in New York was
reading...“TRAINS CRASH IN FOG," ran the banner
headlines) …”10 DEAD, MANY INJURED ."
I reflected on our speed, the dense fog outside,
and had a mild transitory moment of concern that the fog might
claim us victim) too) and then relaxed as I picked up
the novel I had been reading . Some minutes later the
thought suddenly entered my mind that had I not
chickened out about flying, I might at that
moment be overhead in a plane . At the mere image
of sitting up there strapped in by a seat belt, my
hands beg an to sweat, my heart to beat perceptibly
faster, and I feel a kind of nervous uneasiness in my
gut. The sensation lasted until I forced myself back to
my book and forgot about the imagery.
I must say I found this experience a vivid lesson in
the nature of phobias. Here I had reacted with hardly
a flicker of concern to an admittedly small
but real danger of accident as evidenced by the fog caused
train crash an hour or two earlier; at the
same time I had responded to a purely imaginary
situation with an unpleasant state of nervousness
experienced both as somatic symptoms and as an
inner sense of indescribable dread so characteristic of
anxiety. The unreasonableness of the latter was
highlighted for me by its contrast with the absence of
concern about the speeding train, which if I had
worried about it, would have been an apprehension
founded on real, external circumstances. -(Nemiah).
The onset of many phobias is so gradual that it is.
difficult to tell whether there were any specific precipitating
factors. In other cases, the apparent time of onset,
although not necessarily the cause, can be pinpointed.
I was riding in my husband’s car and I suddenly
became terrified. I felt as if I would die. I made him
turn around and take me home. I ran into the house
and suddenly felt safe. I could not understand what
had happened. I had never been afraid of cars. The
next day it happened again and it kept getting
worse. Finally just being on the street and seeing a
car would bring on a terrible feeling. Now I just stay
at home. -(De Nike and Tiber, 1968, p. 346)
Phobias may begin with a generalized anxiety attack,
but the anxiety then becomes crystallized around a
particular object or situation (for example, elevators,
snakes, or darkness) . As long as the feared object or situation
can be avoided, the anxiety does not reach disturbing
proportions. Some objects of phobias-such as
cats, cars, and stairs-are considered aspects of everyday
life by most of us. Other objects and situations-snakes,
death, and heights are disliked to some extent by most
people. However, phobias involve levels of fear that, in
addition to being over intense, interfere with normal
living patterns.
One study of phobic patients showed that their fears into
five categories related to (1) separations, (2) animals,
(3) bodily mutilation, (4) social situations, and (5) nature.
Phobias tend to grow progressively broader.
For example, one woman had a subway phobia that began
with an inability to ride an express train between two
fairly distant locations . Gradually the phobia developed
until she would have to get off the train at each local
stop, wait until her anxiety diminished, get on the next
train , get off again at the next stop , and so on, until her
destination was reached.
Phobic individuals usually develop ways of reducing
their fears. The professor managed to live with his
phobia, and the subway rider mentioned earlier was able
to get from one place to another. However, the often
cumbersome procedures that phobic’s devise do not
eliminate their fear; indeed, the fear seems always to be
one step ahead of them. In one sense, phobic individuals
who cannot cross the thresholds of certain rooms or
cannot work may be as incapacitated as people with severe
psychotic symptoms. In another sense, they are
more fortunate than people who exhibit free-floating
anxiety, since at least their fears are directed toward a
specific object, and they can reduce their anxiety by simply
avoiding that object.
Phobias, like other forms of maladaptive behavior,
do not occur in isolation. They are usually intertwined
with a host of other problems. In consequence, it is difficult
to estimate their frequency accurately. While mild
phobias are common, phobias that are serious enough
to be clinically diagnosed occur relatively infrequently.
They are the main complaint in perhaps 2 to 3 percent
of all clinical cases (Kolb). Phobias do not require hospitalization.
Professional treatment, (see link below) when it is given,
is usually carried out on an outpatient basis.
One of the most interesting aspects of phobias is
that the stimuli that evoke them are not picked at random.
The most common fear-arousing stimuli tend to
be animals, objects, or events that presented real dangers
in earlier stages of human evolution (McNally).
Although extreme fear of dogs, snakes, and spiders
seems maladaptive today, such fear may have been
highly adaptive in earlier times "modern" phobias
are rare. For example, pajama and electric-outlet phobias
occur infrequently, even though these objects are
often associated with trauma.
For the treatment method I recommend click here:
Anxiety, Panic Disorder & Generalized Anxiety Disorder
Anxiety, Panic Disorder & Generalized Anxiety Disorder