Earlier this week it was revealed professional basketball star and former Minnesota Timberwolves player Kevin Love recently experienced panic attacks and may be suffering from panic disorder.
Often many athletes are reluctant to disclose their mental health difficulties due to stigma and concerns it will not be accepted among the athletic community. Love courageously discussed his recent situation, and such disclosure does a great service toward reducing the shame associated with experiencing a mental health condition.
While at least 20 percent of Americans may experience a panic attack in their lifetime, about 3 percent of the population experiences panic disorder, which is characterized by recurrent panic attacks and a fear of having additional attacks. Many individuals come to associate their panic attacks with the contexts in which they occur (e.g. locations, performance situations, activities such as driving) and come to avoid these situations for fear of experiencing another panic attack. Panic attacks are particularly distressing and most often are characterized by a sudden rush of fear, accompanied by a variety of physiological “symptoms” such as a racing heart, shortness of breath, sweating and tingling sensations in the extremities, among many others.
In Love’s case, he was taken to a hospital for evaluation after a panic attack, a common occurrence given the physical nature of the experience. When the initial panic attack typically occurs “out of the blue," individuals are often bewildered as to what is happening and quickly conclude they may be facing a medical catastrophe or, in many cases, that they are losing control of themselves. Receiving emergency medical services is often of limited benefit; patients are provided a battery of medical tests that confirm nothing is amiss, leave with some degree of reassurance, only to find the symptoms occur again. If the initial panic attack involves a more cognitive symptom pattern, such as experiencing de-realization - an unusual experience where individuals feel as if they are in a dreamlike state or perceptions appear slightly altered - they may tend to develop fears they are losing their mind and/or will lose control of their behavior. The net result of these fears is often dread about attacks occurring again, coupled with avoidance of activities, which can significantly limit an individual’s ability to function in their daily roles.
A research interest of mine is to retrospectively study the initial experiences of early emergency medical intervention for individuals with panic disorder to ascertain ways in which emergency medical personnel might better respond. A 1992 study by R.P. Swinson, B.J. Cox and K. Kuch published in the American Journal of Psychiatry found an accurate diagnosis of panic disorder diagnosis, and simple and brief instructions not to avoid activities associated with attacks, significantly affected the course of the disorder, reducing both panic frequency and avoidance. Since that study was published, little has been done to educate emergency medical service providers about panic attacks and panic disorder.
Often when celebrities (especially those in fields like athletics that are associated with a degree or normative anxiety about performance) are vocal regarding their experience, the perception may be that panic disorder is an exacerbation of normal performance anxiety. While performance anxiety can also be associated with panic, general life stressors might precede a panic attack. Under life stress some individuals experience a pattern of stress-related symptoms that are initially perceived as threatening, and the fear and mis-attribution of them quickly escalates into a panic attack. Individuals are not aware of this stress-fear-of-feelings cycle, and the experience becomes disconnected from the life stressors that preceded the initial attack. Panic disorder occurs in virtually all cultural groups in the U.S.; only recently has there been more attention to possible cultural differences and nuances in the experience of panic attacks and panic disorder.
Fortunately, this is a problem that can be treated successfully. Therapies that educate individuals about the panic process and help them understand how fearful thoughts exacerbate the cycle of panic - along with gradual exposure to feared situations and feared bodily and cognitive experiences - are very successful. Individuals who have been “beaten back” by their anxiety become empowered to overcome the problem, and the process often has additional benefits on one’s life, such as an increased sense of confidence and resilience to life stress.
It is important for anyone suffering with panic-related symptoms or panic disorder to find a therapist that has experience treating the problem and using exposure-based cognitive-behavioral therapy, which is strongly supported by research evidence, not only in randomized clinical trials but in naturalistic settings. Medication can also have a place in treating the condition and it is often prudent to see a psychiatrist or a primary care MD with knowledge of the panic disorder. Excellent sources of information about panic disorder and well-qualified therapists are available at the Anxiety and Depression Association of America and the Association of Behavioral and Cognitive Therapies.
Christopher Vye, Ph.D., L.P. is the Chair of the Graduate School of Professional Psychology at St. Thomas. His research and clinical interests are in the assessment and treatment of anxiety disorders. His research is aimed at learning more about the experiences of individuals who sought treatment in emergency medical services for their initial panic attack, to inform the design of a training program for emergency medical personnel to better assist individuals with panic. He has provided clinical services (currently on a limited basis) to individuals with panic disorder for more than 25 years. He provides frequent training and consultation regarding the treatment of anxiety for the professional community.