The sudden and repeated intrusion of fearful and in the most severe cases, terrorizing feelings experienced by a person when presented with known or unknown stressors is the basis of panic disorder. Panic disorder is one class of anxiety disorder recognized as a legitimate mental health condition that is diagnosable and treatable. Not only is the physical and emotional body affected by panic disorder but there are also significant brain areas targeted during onset of panic that can ultimately debilitate a person for periods of time.
Areas of the Brain Impacted During Panic
The basal ganglia, located under the cortex of the brain, is the initial area of impact for anxiety signals. Underneath the basal ganglia is the limbic system, which further comprises intricate processes also involved in the panic response. Each portion of the brain has a significant role in the panic response that ultimately leads to dysregulation of neurotransmitters when operating as an overloaded or impaired system versus a balanced system. The prefrontal cortex is the portion of the brain responsible for analyzing information and making decisions toward response. When faced with a trigger stressor, this area of the brain has a quick process to engage to prevent irrational response or prolonged fear, anxiety and panic attack. In a person with panic disorder, this area of the brain is impaired and unable to analyze the situation appropriately in order to respond in a logical manner.
Role of the Limbic System in Panic Disorder
The limbic system of the brain is considered the oldest part of the brain within its inner core and it is located at the top of the brainstem under the cortex. The limbic system splits into different functional areas such as the amygdala, hippocampus, hypothalamus, olfactory cortex and thalamus and is home to emotion regulation, memory, hormones, arousal and decision systems.
Within the limbic system of the brain is the amygdala, a set of organs involved in emotional reaction. It is within the amygdala that the commonly termed "fight or flight" response occurs after a stressor trigger is initiated. The panic response is conditioned through experiences and behavior but is preset at birth. When a dangerous encounter is perceived, the amygdala then keeps memory of the events involved that triggered the fear, and anything associated with that memory can then activate panic in the same way that occurred upon the first reaction of the stressor. Activation of the HPA (hypothalamic-pituitary-adrenal) axis occurs after the amygdala is generated, which then leads to cortisol and norepinephrine secretion. In a basic sense, the amygdala receives information and then reacts with no regulation of morality, reality or logic, thus the "fight or flight" response. The benefit of this type of impulsive response system is that the person can remove himself from danger immediately without prolonged thought; however, when the threat is not exactly reasonable or logical, this can lead to irrational response or ultimately a disorder.
Treatment and Support
Panic disorder can affect a person at any point in life; however, with proper diagnosis, treatment and support are readily available. There are several options for treatment that include medication therapy, cognitive behavioral therapy and support groups. According to the American Academy of Family Physicians' research study in 2005, each option for treatment is deemed effective independently, yet in conjunction, the level of therapeutic effectiveness increases significantly. In many cities, local support groups are set up, and referrals from a primary care physician can aid in beginning medication therapy as well as finding a local counselor to begin cognitive behavioral therapy.
