Panic disorder and control of breathing
Respiratory Physiology & Neurobiology
|August 19, 2008
Summary
Panic disorder (PD) involves panic attacks (PA) with respiratory symptoms. While some studies suggest breathing abnormalities in PD, current evidence indicates a hypersensitive fear network, not fundamental respiratory dysfunction, triggers panic responses.
Area of Science:
- Psychiatry and Neuroscience
- Respiratory Physiology
- Autonomic Nervous System Function
Background:
- Panic disorder (PD) is characterized by unexpected panic attacks (PA) featuring anxiety, fear, and autonomic/respiratory symptoms.
- Stimulation of respiration and abnormalities like enhanced carbon dioxide (CO2) sensitivity are frequently observed in PD patients during PAs.
- Some research suggests PD patients with prominent respiratory symptoms may represent a distinct subtype, showing heightened sensitivity to respiratory tests.
Discussion:
- Accumulating evidence suggests that respiratory physiology in PD patients is generally normal.
- The tendency to hyperventilate and react to respiratory stimulants like CO2 is hypothesized to trigger a hypersensitive fear network in PD.
- Recent findings indicate potential subclinical abnormalities in respiration and other homeostatic functions in PD.
Key Insights:
- The fear network, involving key brain regions like the hippocampus, amygdala, and medial prefrontal cortex, may be abnormally sensitive in PD.
- This hypersensitive fear network theory may explain the efficacy of both pharmacological and psychosocial therapies for PD.
- Observed neurochemical abnormalities could reflect complex interactions within these brain circuits.
Outlook:
- Further research into the interplay between respiratory function and fear circuitry in PD is warranted.
- Investigating the respiratory subtype of PD may reveal specific therapeutic targets.
- Understanding these mechanisms could refine diagnostic approaches and treatment strategies for panic disorder.
Related Concept Videos
01:27Panic Disorder
Panic disorder is an anxiety disorder characterized by recurrent and sudden minutes-long episodes of intense fear, known as panic attacks. These attacks may feel like heart attacks and often happen without warning or a specific cause. They can include symptoms such as rapid heart rate, shortness of breath, chest pain, trembling, sweating, dizziness, and a sense of helplessness. During a panic attack, individuals may feel as though they are experiencing a heart attack or are in a...
01:25Hyperpnea and Hyperventilation
Hyperventilation refers to a higher-than-normal rate and depth of breathing, often associated with anxiety attacks. This excessive breathing surpasses the body's need to expel CO2, leading to a condition known as hypocapnia - an unusually low level of carbon dioxide in the blood. Hypocapnia can constrict cerebral blood vessels, reducing blood flow to the brain, which may result in dizziness or fainting. Early signs include tingling and muscle spasms in the hands and face, caused by falling...
01:18Anxiety: Overview
Anxiety is a common mental disorder featuring excessive worry, fear, and apprehension, significantly affecting daily life. People with anxiety disorders experience persistent and intense anxiety, interrupting their everyday functioning.
Individuals with anxiety often experience a range of physical and emotional symptoms, including sweating, trembling, tachycardia, and disturbances in sleep patterns. These symptoms vary in intensity and frequency but are generally disruptive and distressing.
Individuals with anxiety often experience a range of physical and emotional symptoms, including sweating, trembling, tachycardia, and disturbances in sleep patterns. These symptoms vary in intensity and frequency but are generally disruptive and distressing.
01:22Physiology of Respiration II: Neurogenic Control of Respiration
The neurogenic control of respiration coordinates various neural networks and pathways to regulate breathing rate and depth, meeting the body's oxygen and carbon dioxide exchange requirements. This system adapts to physiological and environmental conditions, ensuring optimal breathing patterns.
Central Control
The brainstem is the primary site of central control, hosting respiratory centers:
Central Control
The brainstem is the primary site of central control, hosting respiratory centers:
01:17Other Factors Affecting Respiration Centers
Breathing is primarily an involuntary activity regulated by the brainstem respiratory centers. However, it can also be consciously controlled, allowing us to hold our breath or take deeper breaths when needed. This voluntary control is facilitated by the cerebral motor cortex, which bypasses the medullary centers to stimulate the respiratory muscles directly.
However, the ability to hold one's breath voluntarily is not limitless. When the CO2 concentration in the blood reaches a critical level,...
However, the ability to hold one's breath voluntarily is not limitless. When the CO2 concentration in the blood reaches a critical level,...
01:23Physiological Control of Respiration
Introduction
Breathing, a seemingly passive process, is regulated by the respiratory center in the brainstem. This center coordinates the involuntary control of respirations, which means it occurs without conscious effort, ensuring a smooth and uninterrupted pattern.
Regulation of Ventilation
The body maintains ventilation by monitoring levels of carbon dioxide (CO2), oxygen (O2), and hydrogen ion concentration (pH) in the arterial blood. Among these factors, the level of CO2 plays a crucial...
Breathing, a seemingly passive process, is regulated by the respiratory center in the brainstem. This center coordinates the involuntary control of respirations, which means it occurs without conscious effort, ensuring a smooth and uninterrupted pattern.
Regulation of Ventilation
The body maintains ventilation by monitoring levels of carbon dioxide (CO2), oxygen (O2), and hydrogen ion concentration (pH) in the arterial blood. Among these factors, the level of CO2 plays a crucial...