Panic Disorder (Nursing)

00:01 Another disorder is panic disorder.

00:05 Persons who have panic disorder have a sudden, overwhelming sense of terror.

00:12 They may have panic attacks where they have chest pain, difficulty breathing, they have an overwhelming sense of doom, then intense apprehension.

00:23 I have had patients who have complained of their throat closing up.

00:28 It occurs very suddenly out of the blue.

00:32 And it is debilitated.

00:35 And they can't tell you that a specific experience has activated it.

00:41 One of the interesting pieces to panic disorder, I had a client, and she had fears of bridges.

00:51 But she didn't even have to be at a bridge.

00:54 She would be driving and suddenly, she'd have to pull over to the side.

00:58 She couldn't breathe.

01:00 She would be calling me, telling me that she couldn't lift her arms up.

01:05 It was totally debilitating.

01:08 But the problem was when she told me her symptoms, it sounded like a heart attack.

01:16 I have chest pain, I can't breathe.

01:20 I feel like the whole world is just going to end.

01:23 My chest is killing me.

01:26 We cannot diagnose that it is not a heart attack.

01:33 You want to always say to the person if they tell you they have these feelings you want to say, "Is this familiar?" "Is this feeling familiar?" A person who has a panic disorder will say to you, "Yes, yes, I have a panic disorder. This is panic, I'm in panic." And at that point, we can say to them, "Can you tell me something that has worked for you?" "I'm not going to leave you. I'm going to stand here, you are not alone." "Can we maybe breathe together?" The symptoms of the panic disorder, these palpitations, you'll see them trembling, they might start sweating.

02:17 They can't breathe, they have shortness of breath, they may complain of nausea and dizziness.

02:23 Usually you hear them complaining of chest pain.

02:27 And that throat occlusion that I was mentioning, they may say that they have numbness and tingling in their fingers and legs, and a terrible fear of dying.

02:41 And nothing seems real anymore.

02:44 It's almost as though they're outside of themselves looking in.

02:50 When this occurs, once again, as a nurse, you have to look at this.

02:56 You can't make a differential diagnosis that is not what we as nurses do.

03:01 But you can say, "Has this happened before?" "Do you have any cardiac problems?" And listen to the person.

03:12 Use your voice.

03:14 If you say, "Oh my god, oh my god, look at, Oh I, what can I do? Is there something I can do? Maybe I can bring you some water, do you need water?" It's only going to increase that sense of panic.

03:25 So we have to calm ourselves and bring our voices down and be there for the person.