http://edition.cnn.com/2010/HEALTH/expert.q.a/08/17/panic.disorder/index.html

Why is panic disorder a psychiatric condition?

Asked by Chad, Richmond, Virginia

 *Why is panic disorder classified as just a psychiatric condition when
there are so many physical symptoms (some painful) that arise during the
attack? They would occur whether in good/bad mood, or even asleep.*

 Mental Health Expert Dr. Charles
Raison<http://www.tidyread.com/td/index.php?r=site/read&xml=eNo9i80KwjAQhN-lUC-FLbaeXCJFSlV68CTeZUkWEkiTuF2Lvr3JRZjDfPOzqv2hV5UVSaptxZkvExrQcfnDc-sg2XR6sx_Kru7HurtmkXHiYlwwHUI55GS-jLfHXFyqT1wiFngBZlgoCHpL6MVmRNbWbZTdTpx4Gs4MzWSRPa3NHd0aQ3X8AWS3M5c~>
 Psychiatrist,

Emory University Medical School
Expert Answer

This is a great question that cuts right to the heart of mind-body medicine.
Panic attacks are a great example of how our false dichotomies between
emotional and physical issues really don't stand up to the way the world
really is. Panic attacks are so physical, in fact, that they are often first
diagnosed when a person goes to the emergency room absolutely convinced that
he or she is having a heart attack.

Let me ask you some questions in return. Why do people with major depression
tend to have increased heart rate and blood pressure, and why do they have
increased inflammation, just like people who are sick? Why does stress early
in life greatly increase a person's risk for developing heart disease,
diabetes and dementia later in life? Why do the bodies of people with
schizophrenia seem to have a metabolism that puts them at risk for diabetes?
Why -- back in the old days before modern medications -- did nearly 5
percent of all people admitted to psychiatric hospitals drop dead from their
psychiatric diseases, usually after developing fevers as high as 110° F and
becoming stiff as boards?

You get my point. Because the mind and body cannot be separated (except
perhaps by the guillotine!), mental processes affect the functioning of the
body. And bodily processes affect the functioning of the brain. These days,
this is one of the hottest areas of scientific research in medicine.

So that is one answer to your question. The other answer is that
historically, illnesses are psychiatric until a clear cause for them is
found, and then they tend to migrate over to other medical disciplines. The
classic example of this is the insanity that often accompanies syphilis in
its advanced stages. A century ago, syphilitic patients filled psychiatric
wards. Then, antibiotics were discovered and the responsibility for
preventing syphilis-related insanity became the province of infectious
disease doctors.

As a psychiatrist, it is kind of discouraging that if we researchers do our
job right, there may be no "psychiatric" illnesses left in 100 years. They
may all be understood, and as a result will have been farmed out to every
other medical discipline, as appropriate.


-- 
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