What is Panic Disorder?
Seafarers experience high levels of stress in their job. Seafaring entails dangers that are not present in many other occupations. Seafarers work under threat of injury from accidents and piracy and diseases. Stressors in seafarers can be personal or directly connected to work conditions. Personal stressors are referred to in terms of how satisfied the seafarer is with his or her work, and the self – perceptions associated with their work. Occupational stressors entail the specific adverse conditions and hazards associated with their work, such as the work being overly strenuous or repetitive, the physical risks associated with their post, their career prospects, employment and compensation and the separation from their loved ones. Accidents that result to injury and pirate attacks can also be traumatizing for the individual seafarer, intensifying the anxiety and fear.
High levels of exposure to stressors can lead to panic attacks. Therefore, seafarers, as people who are exposed to adverse working conditions with multiple stressors, are a population at risk for panic attacks. A panic attack is a sudden surge of intense fear and discomfort that peaks within minutes and involves combinations of the following symptoms.
1) Palpitations, pounding heart, or accelerated heart rate.
3) Trembling or shaking.
4) Shortness of breath or feeling smothered.
5) Feelings of choking.
6) Chest pain or discomfort.
7) Nausea or abdominal distress.
8) Feeling dizzy, light-headed, or like you are going to faint.
9) Having chills or feeling hot.
10) Numbness or tingling sensations.
11) Experiencing feelings of unreality or being detached from yourself (derealization and depersonalization).
12) Fear of losing control.
13) Fear of dying.
For an individual to be diagnosed with Panic Disorder, there has to be a recurrence of unexpected panic attacks, with at least one panic attack being accompanied by intense concern and worry about experiencing another panic attack, or perceived effects of a panic attack such as a heart attack or loss of control and drastic changes in behavior to avoid having any further panic attacks that may be negative, such as not going out or not exercising, within the time span of one month following the attack. The panic attacks need to not be explained by substance abuse, since certain substances are known to cause panic attacks or another disorder that causes panic attacks.
Panic Disorder is most commonly occurring between the ages 20 – 45, with occurrence earlier and later than that being rare. The disorder is chronic if left untreated and it waxes and wanes depending on the circumstances of the individual. Some people can go years without a panic attack while others can have a steady stream of panic attacks, which shows us that the severity varies. Full remission without treatment is possible but very rare. Women are more affected than men are but there are no additional sex differences when it comes to Panic Disorder. The main cause for fear in individuals suffering from the disorder is the physical symptoms associated with panic attack and fear of death resulting from one.
Panic Disorder is associated with disability and it has drastic effects on social and occupational functionality, particularly if the panic attacks are associated with social or work – related circumstances. This means that the individual may not show up for work on a regular basis, which may lead in unemployment. This is particularly bad in this instance because Panic Disorder has the biggest financial demands among anxiety disorders because of the frequent visits to doctors. Individuals suffering from Panic Disorder also have a poorer prognosis, considering the physical symptoms of the disorder and a poorer quality of life if left untreated.
Causes for Panic Disorder can be associated with temperament, particularly sensitivity to anxiety and neuroticism, as well as environmental causes, particularly specific stressors that are usually identified before the first panic attack occurs. Adverse childhood experiences and physical or sexual abuse in childhood are more commonly observed in Panic Disorder compared to other anxiety disorders and smoking can also be a risk factor. As in many psychological disorders, there is also a genetic factor. Seafarers are constantly exposed to stressors and many develop issues with anxiety, which means that Panic Disorder can occur, particularly in individuals with a genetic and temperamental predisposition for the condition.
Seafarers affected by Panic Disorder can have a high degree of job fatigue or quit their jobs to avoid the stressors that onset their panic attacks and their overall quality of life can be diminished if they do not seek treatment.
When looking at anxiety disorders, it is important to understand that not all the symptoms mentioned above need to be present to diagnose someone with an anxiety disorder. When examining the symptoms, the focus shouldn’t be one – sided but on deviations from the norm. So, if you suspect that you or someone close to you may suffer from an anxiety disorder, don’t look at the individual behaviors but, instead, look at what has changed.
Before assuming that an individual suffers from panic disorder, it has to be taken into account that panic attacks can occur naturally in life at times of high pressure or transition or be an isolated incident caused by a traumatic event or substance abuse, which is why there have to be multiple panic attacks and presenting worry regarding them before looking for a diagnosis. In cases of substance abuse it has to be examined if the individual is having the attacks as a response to a substance or due to withdrawal.
These distinctions are important so it is crucial to turn to a licensed mental health professional before assuming that you or someone close to you suffers from depression.
Panic Disorder is treated through therapy and medication. Pharmaceutical therapies for panic attacks focus on immediate relief and prevention. Anxiolytic medication is used for immediate relief from panic attacks, such as Xanax or Ativan, although they should not be used long – term. Certain antidepressant medications, such as Prozac, can be used to prevent panic attacks and are often prescribed as a first line of treatment. An issue with pharmaceutical therapies is that some of the medications can actually produce anxiety symptoms so their use should always be overlooked by a licensed physician.
The most effective treatment for anxiety disorders, including Panic Disorder is Cognitive – Behavioral Therapy (CBT). CBT involves identifying, challenging and replacing negative thoughts with realistic ones, recognizing symptoms, learning coping skills and confronting fears. CBT can teach individuals suffering from Panic Disorder to deal with their panic attacks by helping them recognize that what is happening to them and desensitizing them from anxiety.
The steps that can be taken to ensure the wellbeing of seafarers dealing with Panic Disorder are the same steps used to deal with anxiety. Better pay and job security, as well as less time away from their families can reduce anxiety and reduce stressors that may result in panic attacks. Reducing working hours and ensuring rest, improving the occupational conditions by doing whatever possible to minimize accidents and having more accessible first aid, and reducing the time spent at sea can help improve both the physical and psychological wellbeing of seafarers, including the prevention of panic attacks. Panic attacks can be prevented by the seafarer on board by using relaxation techniques, practicing mindfulness, meditation, exercising and sleeping and eating well and avoiding stimulants such as nicotine and caffeine.