Back To CoursePsychology 106: Abnormal Psychology
26 chapters | 161 lessons | 13 flashcard sets
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Sarah has taught Psychology at the college level and has a master's degree in Counseling Psychology.
More than any other body part, our brains are what keep us safe. A reflex, such as pulling our hand back from a hot stovetop, is an instant reaction designed to protect us. These instincts kept prehistoric man alive. He instinctually knew to fear dangerous situations such as confrontation with large predators. Humans have maintained those automatic reactions to potentially dangerous situations.
In some instances, these reactions are still useful. When presented with a dangerous situation, our instincts still tell us we must either fight or flee. However, in our current society, this 'fight or flight' response is less relevant. We are not confronted daily with predators or falling boulders where we would need to react without conscious thought.
Regardless, this instinct still lives in our brains. In some people, this reaction can occur when confronted with a frightening or stressful situation that is not life threatening, such as public speaking or even driving. Sometimes, this same reaction can begin in the brain for no reason at all.
Intense, often debilitating fear from a normal situation can escalate into what is known as a panic attack. Panic attacks are sudden, unexpected periods of intense, debilitating fear where the affected person has a similar reaction as if confronted by a lion. These attacks usually peak within 10 minutes but can feel like a lot longer to those experiencing them.
During panic attacks, people experience extreme anxiety often accompanied by rapid pulse, heart palpitations, dizziness, hot or cold flashes, chest pain, weakness, nausea and a sense that they are having a heart attack or are going to die. Also common are symptoms of depersonalization and derealization.
These weird sounding names are actually rather simple symptoms to remember. Depersonalization is a feeling of being outside your own body while derealization is a feeling that the world is not real. These feelings, coupled with the many physical symptoms, frequently cause people to think that they are losing control of themselves and 'going crazy.' Unfortunately, this most often leads to further panic and an escalation of symptoms.
Although panic attacks are not dangerous, they are terrifying. Generally, panic attacks arise out of nowhere and are completely unexpected. People who experience a panic attack fear having another one. Panic disorder is an anxiety disorder characterized by frequent panic attacks and significant anxiety about having more attacks. For a diagnosis to be made, the fear of having more panic attacks needs to be present for at least one month, and usually corresponds with changes in behavior in order to avoid more attacks.
The anxiety and fear of having another panic attack can be just as difficult to deal with as the attacks themselves. Fear of having a panic attack in public, possibly while shopping or even driving, can cause sufferers to avoid certain activities or social situations. This situation is so common with panic disorder sufferers that psychologists have given it a name: agoraphobia. Unlike other phobias, agoraphobia is not a fear of a single situation or object.
Agoraphobia is a fear of any situation where escape may be difficult if symptoms of anxiety or panic were to occur. Symptoms of agoraphobia include anxiety about, and avoidance of, certain situations that make a person feel vulnerable. For some people, this may mean being in a crowd of people, standing in a line or being in a vehicle. Clinical agoraphobia is diagnosed in one out of every three panic disorder sufferers. This disorder so commonly occurs alongside panic disorder that, up until the recent DSM-5, it was not considered its own disorder.
Earlier, we learned that sometimes the 'fight or flight' response in the brain can misfire. Scientists have found that the misfiring of a specific part of the fear circuit of the brain called the locus coeruleus can trigger panic attacks. The locus coeruleus is a major source of the neurotransmitter norepinephrine, and norepinephrine is a trigger of the sympathetic nervous system. Whether or not danger is present, activation of the sympathetic nervous system prepares us for action. This creates bodily symptoms such as rapid pulse and breathing, sweating and flow of blood to the muscles in preparation to fight or flee.
Do these symptoms sound familiar? They should. These are essentially the same symptoms experienced during a panic attack. A person experiencing these symptoms could believe that they are beginning to have a panic attack. Unfortunately, this thought, and the fear that arises from it, could make this a self-fulfilling cycle.
Behavioral psychologists believe that panic attacks can also be a result of conditioning. The theory of interoceptive conditioning, which describes how physical stimuli can trigger reactions, is used to explain a cycle of bodily symptoms and resulting panic attacks that commonly occur in sufferers. This model theorizes that the physical symptoms of anxiety can become a trigger for panic attacks. Because panic attacks are accompanied by symptoms of arousal of the central nervous system, sufferers may mistake the occurrence of these common symptoms with another panic attack.
Psychologists have extensively studied both panic disorder and agoraphobia to better understand these cyclical patterns. A popular model that seems to span all fields of psychology is the fear-of-fear hypothesis. This hypothesis suggests a few things that you may have already guessed:
The fear-of-fear hypothesis can also be applied to agoraphobia. Cognitive psychologists have suggested that the fear of 'going crazy' or 'losing control' in a public place causes the avoidance symptoms of agoraphobia.
The most common treatments for panic disorder include psychotherapy and prescription medications. Often, benzodiazepines, a type of anti-anxiety drug, are used in the short-term to reduce symptoms of anxiety while the person undergoes treatment with a therapist. Relaxation techniques are also often taught and used as a supplement to other treatments.
PCT, or panic control therapy, is a technique used by cognitive behavioral therapists to treat panic disorder. PCT includes a number of strategies, including recreating and experiencing common physical symptoms in a safe environment. PCT therapists encourage clients to experience the physical sensations of panic while practicing positive thoughts and coping techniques. Psychodynamic therapy and cognitive therapy techniques have also been shown to have good results in treating panic disorder.
People who suffer from anxiety disorders have been found to have overactive fear circuits, which can trigger panic attacks in otherwise nonthreatening, everyday situations. A panic attack resembles a misfiring of the fight or flight response, preparing the body for action. This creates symptoms similar to being confronted with a deadly situation, but happens when in safety.
Along with physical symptoms, such as shortness of breath, chest pain, sweatiness and heart palpitations, panic attacks are often accompanied by feelings of depersonalization and derealization. This is when the person feels like they are outside of themselves watching or experiencing something that is not real. This combination of symptoms and feelings make panic attack sufferers feel like they are 'going crazy' or dying.
Some people can experience a panic attack and never have another. Others develop panic disorder. They suffer from frequent attacks and learn to fear the next panic attack. Often, they become fearful of physical symptoms of panic. The term interoceptive conditioning refers to this fear of physical symptoms and the tendency for these symptoms to trigger panic attacks. This is similar to the fear-of-fear hypothesis, which basically states that the fear of panic attacks can cause more panic attacks.
Many people who have panic disorder avoid situations in which they have previously had a panic attack. This can develop into agoraphobia, a fear of situations that may be difficult to escape or find help. Different types of psychotherapy are often combined with prescription drugs to treat panic disorder and agoraphobia. One type of cognitive behavioral psychotherapy that has been found to be effective is called panic control therapy, or PCT, and includes exposure to physical symptoms.
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Back To CoursePsychology 106: Abnormal Psychology
26 chapters | 161 lessons | 13 flashcard sets