Talk:Panic disorder

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[edit] Do not Merge

Do not Merge. I don't think the article on Panic Attacks should be merged with the article on Panic Disorder. They are greatly different and in fact many people can have panic attacks without having panic disorder. It is sufficient that the articles are linked by internal links etc. however they should remain two distinct articles. Lastly, the Panic Attack article describes a symptom while the Panic Disorder article discusses a disease- they are not the same and thus should not be merged. Merging them would only lead to confusion.Paulee24 00:43, 20 July 2007 (UTC)

[edit] DSM criteria

Is this a quote? If so, it needs to be a blockquote. As it is, it would be a copyright violation. Aleta 07:29, 15 January 2007 (UTC)

[edit] Hypoglycemia

I cut this paragraph from the article. Even if hypoglycemia causes panic attacks, it's not panic disorder. Therefore, I don't think this belongs in this article.

Hypoglycemia may also cause panic attacks. In this condition the receptors for insulin do not respond properly to insulin, interfering with the transport of glucose across the membranes of cells. The brain depends on a steady supply of glucose — its only source of energy. When there is a sudden fall in blood sugar levels the brain sends a hormonal signal to the adrenal glands to produce adrenaline. This hormone functions to raise blood sugar levels by converting glycogen into glucose, thus preventing brain starvation, but it is also a panic hormone that is responsible for attacks of fear. The non-drug treatment for this is the adoption of the hypoglycemic diet.[1]

-- Aleta 09:02, 24 January 2007 (UTC)

Rather than hacking out this important paragraph, it would have been better to explain that there are possible organic causes of panic attacks, and differentiating that from panic disorder per se. However the experience may be the same, as this paragraph alludes to. Your editing is careless and uninformed. But then again, so are most third party observers to those who suffer from this.
Nodekeeper 12:28, 17 June 2007 (UTC)

Panic disorder is defined as recurrent unexpected panic attacks, amongst other DSM IV criteria. While a condition resulting in recurring hypoglycemia would seem to be able to trigger these attacks based on your description (and theories do exist that describe central norepinephrine as a player in panic attacks), the hypoglycemic condition alone would not seem like sufficient qualification for panic disorder in itself under the DSM IV criteria as it states that the panic attacks must not be due to the "direct physiological effects of a substance (eg., a drug of abuse, a medication) or a general medical condition (eg., hyperthyroidism)". I would imagine that the hypoglycemia would fall under the general medical condition.

However, according to Theory and Practice of Psychiatry (Cohen, 2003), patients with panic disorder might have an underlying etiology of a hypersensitive noradrenergic system. Hence someone with this condition who is predisposed to attacks hypoglycemia might therefore be prone to triggering his/her over-sensitive noradrenergic system and therefore his/her panic attacks.

Also, I took out "alcohol" from the section that listed possible "stimulants" that might exacerbate panic attacks soley due to the fact that it is a CNS "depressant".

Hope that helps. —The preceding unsigned comment was added by TomKuca (talk • contribs) 23:00, 17 April 2007 (UTC).

[edit] Panic Disorder vs. ???

It's clear to me that there is a difference between panic attacks and panic disorder and agorophobia and other related medically unclassifible conditions. I suspect my most recent edit crossed the line from the AMA standard panic disorder definition (which I did not look up, not being a psycologist anyway), but I see no other suitable page in wikipedia for what I consider important and relevant material. Looks like the hypoglycemia info is similarly orphaned for now - suggestions? Stevefranks 10:51, 5 March 2007 (UTC)

[edit] Recent Changes to the Introduction

Hi Everyone... I wanted to comment on the following addition: Like other psychiatric disorders, many of the symptoms of Panic Disorder mimic the symptoms of a hidden physical complications. In the case of hypoglycemia, the symptoms of sudden onset trembling, palpitation, mental confusion, increasing anxiety, sweating, dizziness and psychological distress so closely mimic Panic Disorder that physicians frequently prescribe anti-anxiety drugs. In the case of trauma, traumatized individuals are often subjected to stress which affects their access to ideal nutrition, and often attempt to self-medicate with substances known to affect their ability to metabolize glucose. Often a missing key in the treatment of Panic Disorder, physicians are looking more and more to a nutritionally supportive link in this illness.

This needs to be fixed... Firstly, the second sentence is not complete, illustrative nor accurate. I think it implies that doctors misdiagnose PD when it is actually hypoclycemia. Any one will tell you that tests for heart function (EKG), blood sugar (hypoglycemia) etc. are always performed to rule out before a diagnosis of PD is made. I have no doubt nutrition is important in treating PD, as is nutrition with any illness. However, it is completely out of place at the start of an article on PD to begin to critisize treatments, diagnosis and bring up alternative theories. This does not belong in the introduction. Before I change it I wanted to make sure everyone agreed.Unkle25 10:30, 19 August 2007 (UTC)

[edit] Tone of article

I have made several edits to this page today. While the origonal author's intentions were obviously noble, as a sufferer, I found the tone of several paragraphs to be patronizing, and frankly, somewhat insulting. I am hoping to make the material more attractive and likely to make a postive diference to those most likely to read the article, namely those with the condition. Appologies if I fail to make an improvement, and it is my intent not to make the article less encyclipedic, simply more sensitive. Stevefranks 09:05, 5 March 2007 (UTC)

As a person with PD, I feel, as was mentioned, that the article is very patronizing many places. To the uninitiated, it would seem that panic disorder is just a set of upsetting symptoms that occur from time to time and that can reasonably easily be controlled. No, PD can be a 24-hour a day nightmare that can last for years unabated. It's not surprising that the Wikipedia article has this tone-90% of the internet references are similarly misinformed. I think we need to make this article a bit more real-world in content and less second-hand, often well-intended misinformation.

Dehughes 01:01, 25 September 2007 (UTC)Dehughes

Hi Dehughes. I agree with what you are saying... Please take a look at the article on panic attack I think it has a better tone and is less patronizing. Should we all colloborate and start re-writing the PD article? Take CareUnkle25 07:06, 5 October 2007 (UTC)
Not only do I vehemently agree with Stevefranks and Dehughes, but I find that reading the wikipedia entry on panic attack to be an extremely therapeutic exercise when actually having a panic attack. Not so much with the panic disorder page, since a key element to the entire episode is that your body is errantly telling you that something is very physiologically wrong, and this page can re-enforce that thought by discussing hypoglycemia and other "real" conditions that might lead to what's happening. Me and everyone I know who have suffered from this have probably been tested out the wazoo for that stuff before finally coming to an anxiety disorder diagnosis. While hypoglycemia could certainly be a trigger for a specific attack (anything that makes you feel "weird" from a cold to a little indigestion can be, too), I don't really thing it's part of the overall disease. --Sam (talk) 15:15, 30 January 2008 (UTC)


[edit] Orphan sentence (?)

This sentence: "Multi vitamins and other medications can wear away anti-psychotics careful discretion on the part of the patient should disclose all information to Physician and staff so further intoxication does not occur."

doesn't seem to make sense any way I read it. Can we delete/fix? —Preceding unsigned comment added by 216.231.49.161 (talk) 03:18, 3 November 2007 (UTC)

[edit] Poor wording in "substance abuse"

In the section regarding substance abuse, the following text:

A study conducted by Dannon, Lowengrub, Amiaz, Grunhaus, & Kotler (2004)[8] on 66 adults examined the rates of comorbid cannabis use and Panic Disorder. Of the 24 participants who suffered from Panic Disorder and had comorbid chronic cannabis use, all reported that their first panic attack occurred within 48 hours of smoking marijuana.

strikes me as particularly poorly worded. If you replace "chronic cannabis use" with "bathing daily", you'll see what I mean.

A study conducted by Dannon, Lowengrub, Amiaz, Grunhaus, & Kotler (2004)[8] on 66 adults examined the rates of comorbid bathing and Panic Disorder. Of the 24 participants who suffered from Panic Disorder and took a daily bath, all reported that their first panic attack occurred within 48 hours of bathing.

Point: If you're a chronic cannabis user you may not ever go more than 48 hours between smoking marijuana, and if you take a daily bath you may not ever go more than 48 hours between bathing. —Preceding unsigned comment added by 80.213.156.201 (talk) 06:43, 22 January 2008 (UTC)

[edit] Capitalization

Call me ignorant, but why exactly is the disorder name given normal sentence casing ("panic disorder" or "Panic disorder") in the page title and is capitalized ("Panic Disorder") throughout the rest of the article? Tony Myers (talk) 02:35, 29 February 2008 (UTC)