Associated Conditions of Panic disorder


About associated conditions: Associated conditions are those which appear statistically related, but do not have a clear cause or effect relationship. Whereas the complications are caused by Panic disorder, and underlying causes may be causes of Panic disorder, the following list shows associated conditions that simply appear with higher frequency in people who have Panic disorder. In some cases, there may be overlap between this list and risk factors for Panic disorder. People with Panic disorder may be more likely to get a condition on the list of associated conditions, or the reverse may be true, or both. Whether they are causes of, caused by, or simply coincidentally related to Panic disorder is not always clear. For general information, see Associated Condition Misdiagnosis.

Associated conditions list: The list of conditions mentioned by various sources as associated with Panic disorder includes:

Associated conditions: Panic disorder is often accompanied by other conditions such as depression or alcoholism, and may spawn phobias, which can develop in places or situations where panic attacks have occurred. For example, if a panic attack strikes while you’re riding in an elevator, you may develop a fear of elevators and perhaps start avoiding them. 1

Many people with panic disorder also suffer from depression—feelings of intense sadness, even hopelessness. Depression is accompanied by an impaired ability to think, concentrate, and enjoy the normal pleasures of life. Be sure to make your doctor aware of these symptoms as well. If you have been drinking or using drugs to try to control your symptoms, let your doctor know about that too. 2

Research shows that panic disorder can coexist with other disorders, most often depression and substance abuse. About 30% of people with panic disorder abuse alcohol and 17% abuse drugs, such as cocaine and marijuana, in unsuccessful attempts to alleviate the anguish and distress caused by their condition. Appropriate diagnosis and treatment of other disorders such as substance abuse or depression are important to successfully treat panic disorder. 3

The following are among the conditions frequently found to coexist with panic disorder:

Simple Phobias.   People with panic disorder often develop irrational fears of specific events or situations that they associate with the possibility of having a panic attack. Fear of heights and fear of crossing bridges are examples of simple phobias. Generally, these fears can be resolved through repeated exposure to the dreaded situations, while practicing specific cognitive-behavioral techniques to become less sensitive to them.

Social Phobia.   This is a persistent dread of situations in which the person is exposed to possible scrutiny by others and fears acting in a way that will be embarrassing or humiliating. Social phobia can be treated effectively with cognitive-behavioral therapy or medications, or both.

Depression.   About half of panic disorder patients will have an episode of clinical depression sometime during their lives. Major depression is marked by persistent sadness or feelings of emptiness, a sense of hopelessness, and other symptoms.

When major depression occurs, it can be treated effectively with one of several antidepressant drugs, or, depending on its severity, by cognitive-behavioral therapies.

Symptoms of Depression

  • Persistent sadness or feelings of emptiness
  • A sense of hopelessness
  • Feelings of guilt
  • Problems sleeping
  • Loss of interest or pleasure in ordinary activities
  • Fatigue or decreased energy
  • Difficulty concentrating, remembering, and making decisions

Obsessive-Compulsive Disorder (OCD).   In OCD, a person becomes trapped in a pattern of repetitive thoughts and behaviors that are senseless and distressing but extremely difficult to overcome. Such rituals as counting, prolonged handwashing, and repeatedly checking for danger may occupy much of the person's time and interfere with other activities. Today, OCD can be treated effectively with medications or cognitive-behavioral therapies.

Alcohol Abuse.   About 30 percent of people with panic disorder abuse alcohol. A person who has alcoholism in addition to panic disorder needs specialized care for the alcoholism along with treatment for the panic disorder. Often the alcoholism will be treated first.

Drug Abuse.   As in the case of alcoholism, drug abuse is more common in people with panic disorder than in the population at large. In fact, about 17 percent of people with panic disorder abuse drugs. The drug problems often need to be addressed prior to treatment for panic disorder.

Suicidal Tendencies.   Recent studies in the general population have suggested that suicide attempts are more common among people who have panic attacks than among those who do not have a mental disorder. Also, it appears that people who have both panic disorder and depression are at elevated risk for suicide. (However, anxiety disorder experts who have treated many patients emphasize that it is extremely unlikely that anyone would attempt to harm himself or herself during a panic attack.)

Anyone who is considering suicide needs immediate attention from a mental health professional or from a school counselor, physician, or member of the clergy. With appropriate help and treatment, it is possible to overcome suicidal tendencies.

There are also certain physical conditions that are often associated with panic disorder:

Irritable Bowel Syndrome.   The person with this syndrome experiences intermittent bouts of gastrointestinal cramps and diarrhea or constipation, often occurring during a period of stress. Because the symptoms are so pronounced, panic disorder is often not diagnosed when it occurs in a person with irritable bowel syndrome.

Mitral Valve Prolapse.   This condition involves a defect in the mitral valve, which separates the two chambers on the left side of the heart. Each time the heart muscle contracts in people with this condition, tissue in the mitral valve is pushed for an instant into the wrong chamber. The person with the disorder may experience chest pain, rapid heartbeat, breathing difficulties, and headache. People with mitral valve prolapse may be at higher than usual risk of having panic disorder, but many experts are not convinced this apparent association is real.4

1. excerpt from Panic Disorder: NWHIC
2. excerpt from Getting Treatment for Panic Disorder: NIMH
3. excerpt from Facts about Panic Disorder: NIMH
4. excerpt from Understanding Panic Disorder: NIMH

Last revision: July 1, 2003

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