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Panic Attacks and Their Relationship to Heart Difficulties

Posted Jan 14 2009 7:22pm

I came across this interesting article today, which discusses recent research finding with respect to Panic Disorder (a mental health diagnosis) and its relationship to heart attacks and other coronary difficulties. The research suggests that there is a small increase in the future likelihood of a heart attack in those individuals who have had a panic attack prior to the age of 50. Conversely, those same individuals are less likely to die as a result of heart problems than the population at large. From the article:

Dr Walters and her colleagues looked at primary care medical records for 57,615 adults diagnosed with panic attacks/disorder and 347,039 adults who did not have the condition. They found that those aged under 50 were more than a third (38%) as likely to have a heart attack and nearly half (44%) as likely to develop heart disease subsequently than people who had not been diagnosed with the condition. For people aged over 50 there was a slightly increased risk of heart disease (11%).

However, when the researchers looked at deaths amongst adults diagnosed with panic attacks/disorder, they found that for all ages the risk of death from heart disease was reduced by about a quarter (24%) compared with the normal population.

The article is fairly well detailed, and offers some speculation about the possible reasons for these associations. What I find interesting about this is the ongoing complexity of the relationship between panic and heart problems. Simplistically, they are separate issues, at least in terms of etiology. However, their symptoms often mirror each other: many individuals who are subsequently diagnosed with a panic disorder are first seen at an emergency room, simply because the symptoms often feel like a heart attack.

On the other hand, this research may suggest there is some sort of additional relationship between the two. Back in the day when I was doing much more treatment, I would discuss panic attacks as part of my stress management groups. I would note that on the one hand, if one is having a panic attack, they are not experience a severe, acute physical problem (though the symptoms are severe, acute, and extremely uncomfortable). On the other hand, I would also note that chronic stress, anxious responses to that stress, and in particular panic-like responses are also not very good for one’s long-term health. In addition, the lifestyles often adopted by those with significant cases of panic disorder are not conducive to a healthy, balanced lifestyle. People will often restrict their activities as a result of panic, to include things like exercise - restrictions that would then negatively impact one’s health.

I think a couple of things come out of this article that are important considerations for anyone dealing with panic, either as a clinician or a client (or the family member of a person with panic). First, get treatment for it. Regardless of what the actual link is, obviously getting panic under control is an all-around good thing. Secondly, don’t consider only one half of the dynamic. Doctors, consider the need to refer for therapy. Therapists, refer the client for a physical. While the gap between the medical and mental health fields is shrinking, it is still prevalent,and I have no trouble acknowledging that mental health professionals often forget to consider the medical aspects of certain issues during the course of their treatment of a client, particularly when the issue is not being addressed by medication. If you or a person you know suffers from panic - visit both! One’s condition may not be either/or - it may be a combination of both mental health and medical issues. And even if the etiology is medical, a mental health consultation may help point you in the right direction regarding future changes to your lifestyle, changes to address the condition.

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