Recognizing Panic Disorder
Everyone sometimes feels anxious for no identifiable reason. At these times we think, “Something is happening—I must stay alert.” Panic victims share these feelings, but for them the stakes are higher. Their distress is so overwhelming that the fearful possibilities take on mammoth proportions. “I’m having a heart attack,” they think, or “I’m losing my mind.” We all experience periods of vague anxiety, which often pass without our ever discovering or having to acknowledge the causes. Panic anxiety, however, is the cue for a determined (and often desperate) search for a source.

Panic attacks are characterized by rapidly escalating and overwhelming anxiety. In the beginning, panickers are rarely able to identify what has made them anxious, describing the episodes as occurring “out of the blue.” The attacks are triggered by frightening physical sensations that occur suddenly, much like an unconscious reflex. Among the most common are shortness of breath, a rapid heart rate, heart palpitations, sweating, trembling, a feeling of choking, chest pain, nausea, and dizziness. Frightened sufferers develop painfully sharp sensitivity to these sensations, often making several trips to the emergency room before they finally realize that their symptoms are panic-related.

Physical sensations alone are not the core of the illness. Fearful thoughts, unpleasant emotions, avoidant behaviors, disturbing sensations, and deteriorating relationships all collude with one another to maintain panic. Thoughts such as the fear of dying or of having a mental breakdown are common. Even mild anxiety can trigger an attack, and any disturbing emotion can be interpreted as a precursor to full-fledged panic.

Gradually, the fear of having an attack in public leads the panicker to avoid those places—a disorder known as agoraphobia. Problems in relationships, which may have been the original source of anxiety, become worse as panic episodes develop. Difficulty with self-assertiveness and with the resolution of conflicts increases. Friends and partners are often frustrated because they cannot understand what is happening.


The Road to Recovery
Fortunately, panic disorder can be treated successfully, frequently with a combination of psychotherapy and medication. Panic sufferers are now turning to yoga for help as well, for yoga offers a wide range of stress-reducing tools. An ancient model of recovery can be found in the Yoga Sutra of Patanjali, one which is also embodied in the Four Noble Truths of the Buddha. In its briefest form, this model is an outline of the stages in the healing process, presented here as four questions:

1. What is the nature of the pain that all humans experience?
2. What is the cause of that pain?
3. What will be experienced when the pain is removed?
4. How can the pain be removed?

Yoga tells us that before searching for a cure it is important to look deeply into the nature and causes of illness. It is also important to get an idea of how things will be when symptoms have been removed, because otherwise we may have illusions about what recovery will be like. For example, eliminating anxiety is not the outcome of treatment for panic—the outcome is the ability to manage anxious feelings.
If we rewrite the four questions of the ancient model, focusing on panic attacks, they might read:

1. What is panic disorder?
2. What causes it?
3. What will life be like for the person who has overcome panic attacks?
4. How is recovery accomplished?