Panic disorder is a debilitating mental health issue characterized by recurrent and unexpected occurrence panic attacks. During a panic attack, an individual develops a feeling of dying, with the experience of the emotion being intense to the point of causing ample amounts of fear and anxiety. The attacks can last for about 10 minutes in its peak before the problem begins to settle and the symptoms subside. People suffering from panic disorders experience repeated and unexpected attacks that terrify them to the point of causing more attacks. The condition typically incites other severe and constant feelings of anxiety within a person that affects their mental health.
The condition is classified as an anxiety disorder in DSM-5 which describes the criteria of classifying the condition. A panic disorder occurs when a person experiences a frequent, recurring, unexpected and recent panic attacks followed by at least a month or more of related behavior change and a persistent concern of more attacks such as a heart attack, or a substantial difference in how the individual behaves and responds to the attacks such as trying to avoid unfamiliar situations ( American Psychiatric Association. 2000) . Additionally, a condition is diagnosed to be a panic disorder if it not attributed to the physiological effects of using drugs, and the state cannot be explained using another mental disorder such as a specific phobia or social upheaval.
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Historical context
Panic has not always been considered to be psychiatric conditions until in 1980 with the development of DSM-3 criteria to establish the overall concept of panic disorder. Before its recognition, the disease was characterized by other anxiety disorders that have been around in the entire human existence. While panic disorder has a long history due to how human beings understand anxiety and its symptoms, the classification of the disease happened in the last century through basic and clinical research, which made it possible to diagnose and treat the condition. Panic disorder gained recognition as a treatable condition after many years of figuring out how to manage anxiety. Like Schizophrenia, panic disorders were hardly known to be an illness before the 19t century ( Nolen-Hoeksema & Rector, 2015).
The first meeting to discuss the condition was held in 1978 at a time when the term anxiety disorder was yet to be coined. The conference sought to discuss the need for promoting awareness on treating phobias, which led to decide on contextual and exposure therapies. In 1980, a Phobia Society of America was founded to determine the diagnostic practice and future treatment options for the condition. With the development of communication technology that increased access to information across the world, researchers started linking panic attacks with the abnormal flow of blood in the brain. This discovery led to learning that panic disorders were associated with the pervasive social and health consequences, leading to an exploration of therapies and anxieties for treatment options ( Nolen-Hoeksema & Rector, 2015) . For example, they started incorporating patient education, advocacy, and Christian education as a way of dealing with the condition.
Cause of illness
Panic disorders can arise due to the genetics where an individual inherits the genes from their parents. Studies on the condition have revealed that more than half of individuals diagnosed with panic disorders also have siblings suffering from the same disease ( Rachman & De Silva, 2009). This means the disorder is hereditary with the risk higher among genetic-based individuals. This, however, does not mean genes cause the panic attacks. However, the studies show that genetic factors cause someone to be more prone to panic attacks and disorders among other related cases such as hypersensitivity.
Secondly, intelligence can play a role in a person developing a panic disorder. The condition is more common among individuals who experience intense thinking within their brains, with such individuals exacerbating symptoms as the mind appears to spin out of control. Reports have indicated that people with a higher IQ are more likely to experience the symptoms of panic disorder since they tend to focus more internally inside their head ( Rachman & De Silva, 2009) . This leads to an increased awareness of their emotional sensations that create a ground for a panic disorder to develop.
Additionally, hypersensitivity is another cause of panic disorders in individually defined as a more significant overall awareness of the body. Individuals diagnosed with a panic disorder are over-sensitive and experience an urge of adrenaline and anxiety that increases the risk of the disease to develop. Similarly, most of the fear relates to a response by the body to a fight or a flight that generates adrenaline and increases the risk of a panic attack. Most individuals with a panic disorder have too much or too little of a neurotransmitter in their bodies which makes it too easy to trigger adrenaline and create an environment prone to a panic disorder ( Rachman & De Silva, 2009) .
Stress can also contribute to the development of panic disorders in a person. The everyday stresses may trigger panic attacks, though it is not a must for everyone experiencing panic attacks to be going through signs of stress. However, individuals experiencing severe symptoms of anxiety are more prone to panic attacks arising from negative thinking and high tension. Increased pressure due to passing through difficult circumstances may increase the risk of a panic disorder . This is because weight also increases a likelihood of follow-up attacks after someone has experienced a panic attack, with these attacks also causing much of the pressure.
Treatment
Despite being a serious health problem, there is an effective treatment for panic disorders mainly comprising of therapies, though some medication can be applied to lessen the symptoms. The first treatment option is a cognitive behavioral therapy that focuses on determining patterns of behavior and thought in an individual that causes the panic attacks. The therapy looks to help a person reorganize their thinking patterns and thoughts by considering their fears in a more realistic manner and develop the appropriate treatment ways ( Sánchez-Meca et al., 2010). For example, an individual may find out that the prevalence of panic attacks is most faced when they are driving. Studies have shown that about 90 percent of patients treated with cognitive behavioral therapy register complete recovery within three months of the treatment.
The second treatment method involves the use of exposure therapy that entails exposing a person to the physical sensations that are associated with the panic attacks in a safe environment than giving them an opportunity to learn better techniques of coping with the problem. This method is best applied to individuals whose panic disorder involves agoraphobia. Here, the affected individual accompanies a therapist who exposes him to the actual situation that provokes panic ( Sánchez-Meca et al., 2010) . Additionally, panic-focused psychodynamic therapy is another treatment method that determines how dependence and anger causes the panic attack. The treatment involves exploring some of the factors that cause stress leading to manic episodes, the developing strategies to separate the stressors from the mind.
Another treatment option is using medication which can control or lessen the symptoms related to the panic disorder, though on a temporal basis. The remedy is most effective when it is administered with other treatments and therapies. Some of the procedures include using antidepressants and anti-anxiety drugs to lessen the symptoms for a few weeks. Clinically, combining psychotherapy treatments with medication can produce excellent results in treating panic disorders ( Sánchez-Meca et al., 2010).
Prevention
Scientists are yet to discover a sure way of preventing panic disorders from developing. However, medical physicians recommend a variety of strategies that can reduce the risk of a panic disorder to develop. The first strategy is for individuals who experience a panic attack to get treatment as soon as possible and help stop the condition from getting worse or becoming frequent. Early medication can stabilize the body and bring a person back to normal. For example, using cognitive behavioral therapy can give an individual recognize their thought pattern and prevent the attack from occurring. This measure also involves preventing the relapse of worsening of a panic attack through sticking to the treatment plan even when the symptoms appear to subside.
Additionally, the regular physical activity can be a preventive measure for the panic disorders due to its ability to relieve stress and other hormones building in the body. Physical activities help in preventing anxiety in an individual and reduce the risk. A healthy combination of regular physical exercises and a balanced diet can lessen the likelihood of a panic attack and reduce the risk of a panic disorder to develop ( Livermore, Sharpe & McKenzie, 2010) . Additionally, other activities to reduce stress such as yoga can be a preventive measure to prevent the risk of the disease.
Another preventive measure involves eliminating the use of caffeinated beverages, alcohol, and smoking and taking more herbal remedies when treating stress among other symptoms. Caffeine is known to contribute to panic disorders by provoking panic attacks especially among those who are susceptible. Herbal remedies are significant in the body due to their ability to reduce hypersensitivity and stress receptors in the body ( Livermore, Sharpe & McKenzie, 2010) . Getting enough sleep can also prevent the risk of developing panic disorders as well as learning about panic and anxiety as a way of avoiding the condition from happening. Being aware of the causes can help a person to relieve the distress and understand that the feelings are normal.
Cross-cultural issues
While panic, like many other conditions, is known to be universal the manner in which it reveals itself differs between different cultures. Several studies have shown that anxiety disorders vary across cultures because of culturally specific ways of interpreting the symptoms of panic disorder, with the interpretation determining the physiological processes and traits attributed to the condition ( Hinton & Good, 2009). Therefore, an individual will look for any signs that their culture indicates to be dangerous and this makes the person have a great fear that may worsen the signs of the condition.
The cultural background of a person influences the experience and how they express their emotions. A cultural conceptualization of the functioning of the body and the mind plays a role in the development of panic disorders. Members of a particular culture will catastrophically recognize the symptoms of a disease based on the cultural attachments of the issue, for example, the race thoughts and a sense of imminent loss of control. Catastrophic conditions that give rise to panic among individuals vary depending on local ideas about the psychological and physiological significance of arousal symptoms ( Hinton & Good, 2009) .
The patients with panic disorders vary in the degree of concern of symptoms such as dizziness, shortness of breath and palpitations due to the differences in how they conceptualize the cause of the condition and its danger ( Hinton & Good, 2009) . Some cultures have more fear of anxiety symptoms and thus higher rate of panic disorder. For example, a vast number of African Americans report higher levels of physical sensations when experiencing a panic attack when compared to other cultures. They are also known to have more intense fear of going crazy or dying when facing a panic attack because of fear of stroke. For example, sleep paralysis may make an African America develop an increased fear of the condition.
In some cultures, the panic attack may present with somatic symptoms and the person will focus on the physical sensation rather than the psychological symptoms. Hypertension is often present among the African Americans facing panic disorders because of the high rate of the condition in the culture. The symptoms of panic disorders also vary among different cultures. For example, the Hispanics experience frequent dizziness as a symptom of panic disorders.
Biblical worldview
Christians approach panic attacks in a biblical perspective by advising towards staying calm and recognizing that the condition is not life-threatening. The bible often advices Christians to allow God handle their daily fears by casting all their worries upon the Lord (1st Peter 5:7). Therefore, according to many Christian beliefs, they should expect confidence that the Bible will provide insight into solving the problem. Several scriptures are quoted to remind Christians that there is no panic before the throne in heaven because with God everything is under control. The bible says God is fully aware of everything that happens and the purpose of the happening, and therefore Christians should not live in fear but keep God as a fortress.
Additionally, Christians believe they are not immune to panic disorders as the problem is spiritual. However, they think a person who puts their faith in God will not experience panic disorders. There are a variety of scriptures that Christians quote from the bible to disassociate themselves with fear. For example, “There is no fear in love” (1st John 4:18), is used to remind people that God is more significant than every worry that people face in the world and this they should have confidence and trust in Him.
In this case, the bible does not mention any treatment of panic disorders, and therefore Christians do not need advice against seeking any therapies or medication for the panic disorders, instead, advising their followers to put their trust in God and avoid fear ( Authelet, Koenig & Langford, 2014). These beliefs also lead to downplaying some of the symptoms to be associated with panic attacks. For example, a person whose heart is racing may not necessarily be suffering from panic disorders according to some Christian beliefs. This helps in enlightening Christians to live a panic free life and not letting their daily worries to create panic disorders.
Conclusion
In conclusion, panic disorder is a form of anxiety disorder that involves unexpected and reoccurrence of panic attacks. The concept was officially recognized to be a mental disorder and appropriate treatment methods devised starting in the 20th century, even though it has been in existence for many years. Some of the causes of panic disorders include genetics, stress, and the intelligence of a person. However, the condition is treatable with the application of appropriate therapies and medical interventions. Some of the treatments such as cognitive therapy have been shown to be 90 percent effective in treating the condition among patients. Individuals can also implement several preventive measures such as regular exercises and yoga that can relieve the stress and prevent the disease from developing. However, the biblical worldview of panic disorder is different from the medical perception as it does not recommend seeking therapies but rather having faith in God. In future, more research should be done on bridging the gap between research and clinical practices to help individuals with panic disorders, especially with the inclusion of a cultural aspect related to the condition.
References
American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorder, text revision (DSM-IV-TR). Washington, DC: American Psychiatric Association , 739-741.
Authelet, E. J., Koenig, H. G., & Langford, D. L. (2014). Clinical and Spiritual Perspectives on Anxiety, Panic Attacks, and the Malfunctioning of Our Brains: An Interview with Dr. David Betat. In When the Caregiver Becomes the Patient (pp. 54-71). Routledge.
Hinton, D. E., & Good, B. J. (Eds.). (2009). Culture and panic disorder . Stanford University Press.
Livermore, N., Sharpe, L., & McKenzie, D. (2010). Prevention of panic attacks and panic disorder in COPD. European Respiratory Journal , 35 (3), 557-563.
Nolen-Hoeksema, S., & Rector, N. A. (2015). Abnormal psychology . Boston: McGraw-Hill.
Rachman, S., & De Silva, P. (2009). Panic disorder: The facts . OUP Oxford.
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.
