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panic disorder have Trias that is Phobic Avoidance, Antisipatory Axiety, and Panic Attack.there is to kind of Panic disorder w/ or w/out Agoraphobia.treatment and intervention not only with medication but also Phsycotherapy such as CBThttp://www.teenmentalhealth.org/images/resources/Guide_to_Panic_Disorder_Final.pdf
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Albertus S.AWinda A.LDwi E.S
PANIC DISORDER
oPanic disorder happens when person experiences panic attack, complication in life because of them, when there is no danger
oSudden
oUnexpected
oUncontrollable panic attack for no reason
TRIAD OF PANIC DISORDERPanic Attack
Phobic Avoidanc
e
Anticipatory
Anxiety
+Functional impairment
SIGN & SYMPTOMS
PANIC DISORDER
NOTE: Some people with panic disorder find that caffeine (or other stimulants) makes things worse. They may even give up foods such as chocolate or drinks such as coffee, tea, cola or cocoa.
ADOLESCENCE HAVE PANIC DISORDERoPanic disorder common in Teenager
oUsually begins in late adolescence (between 18-25 yo)
oGirls > boy
NEUROBIOLOGY OF PANIC DISORDERParts of Brain (major role in panic disorder):Frontal lobesHypothalamusAnterior PituitaryLimbic System AmygdalaHippocampusBrain StemLocus Coeruleus
Threatening information(sigh=rober, sounds=loud bang,
etc.)Prefrontal Cortex
Amygdala Hippocampus
Hypothalamus
Anterior Pituitary
Blood Circulation
Adrenal Gland(Cortisol)
Physical responses to stress(e.g increased HR, Heavy breathing, etc.)
CRH
ACTH
NEUROTRANSMITTER
SEROTONIN
EPINEPHRINE
GABA
NOREPINEPRHINE
Regulatin mood & other brain function
Play role in physical responses
Stop the physical fear responses
Similar to epinephrine involved panic attack
1. Psycoeducation
2. Self-monitoring of symptoms
3. Breathing retraining/relaxation techniques
4. Cognitive restructuring to correct catastrophic misinterpretations of bodily sensation
5. Exposure therapy
A Type of CBT PCT (Panic Control Therapy)
1. Patient did :
•Run up stairs
•Spin around
2. Therapist asks :
•What specific fears?
•What was scary about?
•Why scare?
1.SSRi Sertraline Fluoxetine Citalopram
2. Benzodiazepine Clonazepam Diazepam
Treatment PROS CONS
CBT • Effective• Has longterm effects after initial
treatment phase (12 week complete)
• Can be given Individual/group
• Not easy available• Not
regulated/standardized• Duration treatment
attendant of session
Medication • Effective• Easy to use• Widely available• Inexpensive
• May take up to 6 weeks to work
• side effects• FDA has ‘black boxed’
SSRI medicines• evidence shows SSRI use
is related to• decreased suicide• Relapsed if stop