a true story=p

A 26-year-old technician was a healthy and happy go lucky young man. He never had any problems with his friends or his health in his entire life. In fact he was an active sportsman during his college days.

One day, on the way to work while riding his motorbike, he suddenly experienced an intolerable rush of anxiety. This was accompanied by a pounding heart, heaviness of the chest, chest pain, numbness in the fingers and shaking. He was gasping for air, and feared that he was having a heart attack. He stopped his motorbike by the highway and lay down by the side of the road and called his wife to come and take him to the hospital.

At the hospital, he was immediately given oxygen and blood was taken for investigations. His ECG and even a scan was done to find out the cause of the sudden attack. Although the attack lasted only a few minutes, the fear of what was wrong, and what if it reoccurred, permeated his mind and he became anxious and fearful all the time. Since all the investigations, including his ECG, were normal, he became more perplexed and fearful that the doctors could not treat him because they did not know what was wrong with him. He requested further tests and was hospitalised for a week. Although the severe attack did not come back while he was in hospital, he was always anxious and apprehensive of getting another attack.

After one week, he was discharged, but he was unsure what was wrong with him. He became apprehensive about going to work alone on his motorbike and his wife had to drive him to the office daily. In the office, he was not as cheerful as before and refused to go out on assignments. He was afraid of having an attack while repairing machinery. His work performance suffered. His relationship with his wife also suffered because he was afraid to be intimate with her as he believed if he exerted himself he might get another attack. He dreaded going to work and his friends started to shun him, saying that he was lazy.

He subsequently had another attack in the office and was again admitted to the hospital, and once again, he recovered quickly after basic treatment at the emergency room. He was this time referred to a psychiatrist who diagnosed him as having a panic disorder.

He was treated with medications and a course of cognitive behaviour therapy. Currently, he is back to work, riding his motorbike and is able to control his illness. He still has the disorder but is no longer imprisoned by it.

http://psychiatry-malaysia.org/article.php?aid=21

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panic disorder

1. recurrent spontaneous attack;with no obvious precipitant
2. percictent concern about having additional attacks
3. worry about the implication
4. change in behaviour-->agoraphobia

imbalance of neurotransmitter

[NE increase;GABA/serotonin decrease]