Panic attacks assessment

Looking back on it, I was a classic case. Chronic bladder infections, panic attacks, gastrointestinal problems, brain fog, weakness, skin rashes. I was a mass of panic and fatigue. I went to every olo-gist and specialist that there was. None of them was taking a holistic approach. I don t remember any of them ever doing any kind of occupational or environmental assessment, and it never occurred to me. I was just as puzzled as puzzled could be. I m embarrassed to say it took me fifteen years to find the cause. 

Complicating the proper assessment and, by implication, the most appropriate therapy for many patients, is the very real possibility of neuropsychiatric syndromes that may mimic classic psychiatric disorders, exacerbate them, or coexist with such disorders as major depression, panic attacks, and brief reactive psychosis. Thus, the CNS may be affected by various primary malignancies or secondary metastases cardiovascular disorders, leading to ischemic episodes or hemorrhagic events and several HIV-related complications. 

Ms. A, a 25-year-old Caucasian female, presents to her primary care physician. Dr. D, with myriad health concerns, including skin rashes, symptoms of panic attack (described by the patient as periods of dizziness, increased heart rate, tingling sensations and extremity numbness, shortness of breath, and feeling trapped), headache, hopelessness, and weight gain. Dr. D assesses Ms. A for depression and anxiety and refers her to an in-clinic therapist for regular individual therapy. She meets with the therapist once per week over the next 2 months and discusses her concerns about her drinking, as well as her concurrent symptoms of depression and anxiety. 

I Efficacy. The majority of studies assessing the efficacy of MAOIs in treating panic disorder were open-labeled. These trials lacked sufficient dosage and duration of treatment, adequate sample size, and valid ratings of panic attacks. No maintenance trials of MAOIs are published. The course of response mimics that of TCAs. MAOIs are reserved for the most refractory or difficult patients. ... 

Further reading Patient resources Chapter S7 Panic attacks Preparation Assessment... 

The effects on public order, as well as economic and social effects, should be considered in an assessment of weaponized antiirax risk. Decontamination of the Hart Senate Office Building in Washington, DC, required 7 months at a cost of 23 million. Decontamination of the postal facilities that processed the "anthrax letters" in Brentwood, DC, and Hamilton Township, NJ, required more than 1 year at a cost in excess of 100 million (Fernandez, 2002). The psychological effects of an anthrax attack could exceed the medical or economic effects, especially in the short term. Panic caused by seemingly random outbreaks of symptoms in apparently unrelated persons or events "could degenerate into panic, flight, communications breakdown, general societal dysfunction" (Wein et al., 2003). 

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