Panic Disorder

S. was a 28-year-old married woman with two children, aged 3 and 5 years. S had
experienced her first panic attack approximately 1 year prior to the time of the initial
assessment. Her father had died 3 months before her first panic attack; his death was
unexpected, the result of a stroke. In addition to grieving for her father, S became
extremely concerned about the possibility of herself having a stroke. S reported [that
before her father’s death, she’d never had a panic attack nor been concerned about her
health.] Apparently, the loss of her father produced an abrupt change in the focus of her
attention, and a cycle of anxiety began [which led to a heightened] awareness of the
imminence of her own death, given that “nothing in life was predictable.” . . . S became
increasingly aware of different bodily sensations. Following her first panic attack, S was
highly vigilant for tingling sensations in her scalp, pain around her eyes, and numbness in
her arms and legs. She interpreted all of these symptoms as indicative of impending stroke.
Moreover, because her concerns became more generalized, she began to fear any signs of
impending panic, such as shortness of breath and palpitations. Her concerns led to
significant changes in her lifestyle [and she avoided] unstructured time in the event she
might dwell on “how she felt” and, by so doing, panic. . . . S felt that her life revolved around
preventing the experience of panic and stroke”
(Adapted from Craske et al 2000; pp. 45-46.)

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