15
tacks, and make significant behavioral changes as a result of the at-
tacks. If any one of these conditions is not met, the person probably
does not have panic disorder but another condition that features pan-
ic attacks as a symptom.
Anticipatory Anxiety and Avoidance
The memory of the fear and terror felt during a panic attack can nega-
tively affect a person’s emotional state and everyday life. Because hav-
ing an attack makes a person feel so out of control, they tend to be-
come extremely anxious about where and when the next panic attack
will strike. “When I wasn’t panicking, I panicked that I would start
panicking,” says McElroy. “I panicked that someone would find out
that I was panicking. I panicked that the rest of my life would be a
constant state of panic. I panicked that I would never have a career,
or a family, or a regular home outside of a hospital.”
11
Thinking about
Panic Disorder and Elderly Patients
Patients who are sixty- ve or older may experience panic disorder differently
than younger patients. Elderly patients with panic disorder are more likely to
report physical symptoms such as trembling and sweating than psychological
symptoms such as a fear of imminent death. Many elderly patients may hide
their symptoms because they fear it will appear as if their mental abilities are in
decline. Panic attacks can be brought on by underlying depression and anxiety
over the loss of a partner, feelings of isolation, and failing health.
Because elderly patients are more likely to have other health problems for
which they may be taking medication, the sudden appearance of panic attacks
in a person who has not had them in the past can signal there is an underly-
ing medical or medication problem. For example, changing medication doses
or switching medications can sometimes trigger panic attack symptoms. In ad-
dition, as people age, common health problems such as heart disease or lung
function can lead to anxiety, which may result in panic attacks. For these rea-
sons, an elderly patient who complains of panic attacks should receive a full
medical evaluation to rule out any other physical explanations.
