11 May IS THERE A GENDER DIFFERENCE IN THE PREVALENCE OF PANIC ATTACKS AND PANIC DISORDER?
She was afraid she was going to die. Her heart was going very fast; she became dizzy and was feeling numbness and
tingling in her hands and arms. She felt a sense of impending danger and wanting to escape. She was so panicked that she had to pull over into a convenience store
parking lot and wait until she felt better to call her boyfriend and ask him to come and take her home.
Caroline rode the bus to campus to classes for a while after this panic attack. She parked her car and refused to drive anywhere. She began fearing another panic
attack and started skipping classes. A big school football game and party is coming and her boyfriend is threatening to break up with her unless she “gets a grip.”
Caroline’s mother receives a call from Caroline’s roommate telling her of the situation. Her mother takes Caroline to see a psychiatrist who prescribes paroxetine
(Paxil) 10 mg / day and suggest an outpatient evening treatment program. Treatment in the evening allows Caroline to go to classes in the daytime. Caroline reveals a
fear that she has some life threatening illness that the doctor has not found on a recent annual physical exam. Later in a group session, she states “she thinks
someone had put a voodoo spell on her.”
On the third night, Caroline is to take a cap or bus to the evening session because her mother has gone back home. It is two hours before the evening program is to
begin. Caroline calls the nurse in the outpatient evening treatment program saying: “I am too afraid to the leave the house, I’m sorry, I just can’t come tonight.
Perhaps I will be able to come tomorrow.” The nurse responds, “I want you to take several deep breaths and think about relaxing. Now that you feel very relaxed, I
want you to Visualize in mind walking to the door and opening it.”
Questions
1. What is the difference between a panic attack and Panic Disorder? What symptoms does Caroline have and do the match the criteria for a diagnosis of Panic
Disorder?
2. What is the usual onset of panic attacks and Panic Disorder? Is there a gender difference in the prevalence of panic attacks and Panic Disorder?
3. Caroline has Agoraphobia. What is Agoraphobia and what symptoms of this problem does Caroline exhibit?
4. How can Caroline’s significant others best support her in dealing with panic attacks and Agoraphobia?
5. One of Caroline’s group peers shares with nurse that he thinks Caroline is psychotic and paranoid and delusional about somebody putting a spell on her. If you
were the nurse, how would you respond?
6. How would you respond as the nurse if Caroline shares with you that she believes she has a fatal disease that no one has found and that someone is putting a
spell on her or choking and putting pins in a voodoo doll that represents her?
7. Why did the nurse respond by encouraging relaxation and visualization when Caroline called to say she would not make it to the evening therapy program?
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