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Healthy Outlook

No need to panic about anxiety

By Dr. Charles Saldanha

Friday, October 19, 2012

According to media accounts, during a road trip early in the season, San Francisco Giants first baseman Aubrey Huff woke in the middle of the night in his hotel room filled with anxiety. He felt like he couldn't breathe and feared he was having a heart attack. Huff fled the hotel and booked a flight to his home in Florida where he hoped to find relief. Instead, he reportedly endured a similar episode a day later.

The 35-year-old Huff later learned that he had experienced some classic symptoms of a panic attack: feeling trapped, feeling unable to breathe, fearing he was dying, having a desire to flee.

"I almost wish I had broken my leg than had [a panic attack]," he told the San Francisco Chronicle. "I can control that. I know what's happening. This, I didn't know what was happening. You can't control it. It's scary."

Panic attacks are indeed scary. Though some people experience only isolated panic attacks, others develop panic disorder, a condition in which a person has recurrent unexpected panic attacks and consistently worries about suffering another attack. The good news is that panic attacks are not medically dangerous and panic disorder is treatable. But untreated, the psychological impact of panic disorder can be crippling. In some cases, fear of triggering an attack can keep people from leaving their homes or going places, a condition called agoraphobia.

It's estimated that 6 million American adults suffer from panic disorder. It's unclear what causes panic disorder. Individual attacks may be triggered by situational stress, but research suggests there's a biological component to the underlying condition. For instance, panic disorder runs in families, which suggests a genetic link.

Whatever the cause, people with panic disorder have an abnormal stress response. A seemingly normal situation - driving across a bridge, for instance - can trigger their biological "fight or flight" response, an evolutionary adaptation designed to increase our chances of surviving a threat to our lives. This reaction is obviously useful when being attacked by a saber-toothed tiger, but it's problematic for someone who is in no immediate danger.

Fortunately, there are many types of help available to people with panic disorder. Psychotherapy, particularly cognitive behavioral therapy, can help persons with panic disorder manage their thoughts, feelings and behaviors to decrease panic attacks. Medications have also been shown to be effective in treating panic disorder and can provide relief during a panic attack. Studies suggest that a combination of psychotherapy and medication may be most effective.

After suffering his attacks, Huff told the Chronicle he started seeing a mental health professional and taking medication, which allowed him to return to the team after a stint on the disabled list. Huff deserves credit for being so open about his panic attacks. Sadly, some people with panic disorder feel ashamed that they can't always control their feelings and thoughts, and sometimes don't seek help for this treatable condition as a result.

But there's no shame in having a medical condition. We would never say to someone with high blood pressure, "What do you mean you can't control your blood pressure?" Like hypertension, panic disorder is a medical condition that can be managed and treated.

Healthy Outlook is written by the professional staff of Contra Costa Health Services, the county health department. Send questions to series coordinator Dr. David Pepper at For more health information, go to
About the Author
Dr. Charles Saldanha is the Chief Psychiatrist at Contra Costa Regional Medical Center.