The coronavirus (COVID-19) has been recognised as an international public health emergency by the World Health Organization. Drastic changes in lifestyle and behaviour occurred as a result of the outbreak.
Research has documented that individuals who were quarantined displayed evidence of depression, fear, anger and guilt (Brooks et al., 2020). Being under quarantine can lead to an individual experiencing overwhelming stress related to the duration of quarantine, fears of infection, lack of information and inadequate supplies (Brooks et al., 2020).
Since the outbreak, there has been an increase in concern with regard to panic and an increase in anxiety among individuals. As such, it is imperative to understand the dynamics of panic and anxiety that many individuals may be experiencing during this time.
What is Panic Disorder?
Panic can be defined as “an acute, intense attack of anxiety associated with personality and disorganisation; the anxiety is overwhelming and accompanied by feelings of impending doom” (Austin et al., 2014). Separation anxiety disorder, selective mutism, social anxiety disorders and panic disorders make up the spectrum of anxiety-related disorders. Other anxiety-related disorders include specific phobias, agoraphobia and generalised anxiety disorder.
Frequently occurring panic attacks are recognised as a panic disorder. According to the DSM-5, a panic attack is an unexpected surge of fear or discomfort which peaks within a few minutes. Simultaneously, four or more of the following symptoms can occur – palpitations, sweating, trembling, shortness of breath, feeling of choking, chest pain, nausea, light-headedness, paresthesia, derealisation, fear of losing control and dying (American Psychiatric Association, 2013).
A panic disorder is considered to be a psychiatric disorder accompanied by social and occupational impairments (Schumacher et al., 2011). This disorder can be characterised by its resistance to impulsive remission, comorbidity with other disorders (e.g. generalised anxiety, depression and alcohol abuse), and decreased quality of life. (Austin et al, 2014; Sánchez-Meca et al., 2010).The diagnostic criteria for a panic disorder (as adapted from the DSM-5) include (APA, 2013):
a) Recurrent panic attacks as described above
b) At least one of the attacks is followed by a month (or more) of either a persistent worry of an additional panic attack or a significant change in behaviour related to the attack
c) The disturbance is not due to the physiological effect of a substance (e.g. drugs or alcohol) or another medical condition
d) The disturbance can’t be explained by another mental disorder. For example, a panic attack won’t occur in response to feared social situations.
Currently, there is no known cause for panic disorder. However, studies have shown that neurobiological factors are a key contributing factor, and panic disorder has a high co-morbidity with generalised anxiety, depression and alcohol abuse (Austin et al., 2014).
Treating Panic Disorders
The first step in treating a panic disorder involves visiting a doctor who can assist with diagnosis and treatment plans, such as referral to a mental health specialist (National Institute of Mental Health, 2016). Treatment of a panic disorder involves psychotherapy, medication or both. The most common psychotherapy used is cognitive-behavioural therapy (CBT). Cognitive-behavioural therapy is an effective psychotherapy which can aid in reducing panic frequency and severity as well as improving the functioning of the patient (Locke, Kirst & Shultz, 2015).
Medication prescribed for treatment include selective serotonin reuptake inhibitors (SSRIs), serotonin-norepinephrine reuptake inhibitors (SNRIs), beta-blockers and benzodiazepines. Additionally, listening as well as education can assist in reducing anxiety (Locke et al., 2015).
Should you require assistance for eating disorders, please contact the following organisations:
South African Depression and Anxiety Group - 011 234 4837
Adcock Depression and Anxiety Helpline - 0800 70 80 90
Dr Reddy's Mental Health Helpline - 0800 21 22 23
Cipla 24-hour Mental Health Helpline - 0800 456 789
Suicide Crisis Helpline - 0800 567 567
References
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders. (5th Ed.). Washington DC: APA.
Brooks, S. K., Webster, R. K., Smith, L. E., Woodland, L., Wessely, S., Greenberg, N., & Rubin, G. J. (2020). The psychological impact of quarantine and how to reduce it: rapid review of the evidence. The Lancet.
Austin, T., Bezuidenhout, C., Botha, K., Du Plessis, E., Du Plessis, L. Jordaan, E., Lake, M., Moletsane, M., Nel, J., Pillay, B., Ure, G., Visser, C., von Krosigk, B. and Vorster, A. (2014). 2nd Revised Ed. Abnormal psychology: a South African perspective. Cape Town: Oxford University Press Southern Africa.
Locke. A., Kirst. N., & Shultz. C. (2015). Diagnosis and Management of Generalized Anxiety Disorder and Panic Disorder in Adults. American Family Physician. 91(9). 617-624. National Institute of Mental Health. (2016). Panic Disorder: When Fear Overwhelms. Retrieved from - https://www.nimh.nih.gov/health/publications/panic-disorder-when-fear-overwhelms/index.shtml
Sánchez-Meca, J., Rosa-Alcázar, A. I., Marín-Martínez, F., & Gómez-Conesa, A. (2010).
Psychological treatment of panic disorder with or without agoraphobia: a meta-analysis.
Clinical psychology review, 30(1), 37-50.
Schumacher, J., Kristensen, A. S., Wendland, J. R., Nöthen, M. M., Mors, O., & McMahon, F. J. (2011). The genetics of panic disorder. Journal of medical genetics, 48(6), 361-368.