Panic Disorder: The Great Pretender

by H. Michael Zal

Overview

Originally published: Cambridge, Massachusetts: Perseus Publishing, 1990."

Product Details

ISBN-13:	9780738205762
Publisher:	Hachette Books
Publication date:	08/02/2001
Pages:	234
Product dimensions:	5.50(w) x 8.25(h) x (d)
Lexile:	1370L (what's this?)

About the Author

H. Michael Zal, D.O., F.A.C.N., is a Board-Certified Psychiatrist who has maintained a private practice in Bala Cynwyd, Pennsylvania, for over twenty years. A graduate of the University of Pennysylvania and the Philadelphia College of Osteopathic Medicine, Dr. Zal completed a three-year National Institute of Mental Health Fellowship in Psychiatry through the Philadelphia Mental Health Clinic.

Table of Contents

	Introduction	19
1.	Anxiety: Past, Present, and Future--A Question of Definition	23
	Clinical Vignette: Mary Ann	25
	History	27
	Theories of Anxiety	28
	A Physiologic Viewpoint	30
	Normal Versus Abnormal Anxiety	32
	The Positive Aspects of Anxiety	34
	Pathological Anxiety	35
	The Signs and Symptoms of Anxiety	36
	A Modern View	38
2.	From Anxiety to Panic Disorder: An Historical Perspective	41
	The Classification of Mental Disorders	43
	1952--Diagnostic and Statistical Manual (DSM-1)	44
	1968--DSM-II	46
	1980--DSM-II	49
	Classification Controversies	51
	1987--DSM-III-R	54
	Limited Symptom Attacks	55
	Clinical Vignette: Wanda	56
	The Benefits of Awareness	57
3.	Panic Disorder: A Special Anxiety State	59
	Clinical Vignette: Ray	61
	What Is Panic Disorder?	61
	Definition: DSM-III-R Criteria	62
	Who Gets Panic Disorder?	64
	The Panic-Prone Person	65
	Typical Course or Presentation	66
	Other Clinical Presentations	68
	An Irritable Bowel Syndrome Presentation	70
	Clinical Vignette: Andrew	71
	Relationship to Substance Abuse	72
	Possible Resolutions of Panic Disorder	73
	Clinical Vignette: Rose	75
	Relationship to Pregnancy	75
	The Emotional Problem of the 1980s	76
4.	The Great Pretender: Differential Diagnosis of Panic Disorder	79
	Differentiation from Other Psychiatric Disorders	84
	Differentiation from Medical Conditions	89
	The Panic Disorder Medical Workup	93
5.	Panic Disorder: Is It Emotional or Physical?	97
	Biological (Physical) Theories	99
	Psychological (Emotional) Theories	110
	Hereditary Predisposition	113
	Etiologic Conclusions	114
6.	Panic Disorder through the Life Cycle: A Longitudinal--Life History Approach	115
	Early Development/Childhood	117
	Separation Anxiety	118
	Adolescence/Young Adulthood	120
	Clinical Vignette: Jody	121
	Middle Age	122
	Clinical Vignette: Marie	124
	Clinical Vignette: Russ	127
	The Geriatric Years	130
	Clinical Vignette: Mrs. Elliot	131
7.	Treatment: The Initial Phase--Reassurance and Education	133
	Clinical Vignette Continued	135
	The Therapeutic Aspects of Diagnosis	136
	Establishing Rapport	137
	Offering Reassurance	138
	Education	140
	Self-Help Techniques	142
	How Can Family Members and Friends Help?	143
	Clinical Vignette: Jim and Julie	145
	Making Human but Expert Contact	147
8.	Treatment: Individual Psychotherapy	149
	Clinical Vignette: Joyce	151
	The Psychiatric History: The Initial Phase of Psychotherapy	152
	The Mental Status Examination	153
	Areas to Explore and Understand in Therapy	155
	Recent Stress	155
	Dealing with Feelings	156
	Independence/Dependence	157
	Emotional Needs	158
	Dealing with Internal Conflict	159
	Toward a More Independent Life-Style	160
9.	Other Mental Health Treatments	163
	Stress Reduction	165
	Relaxation Training	167
	Group Psychotherapy	168
	Hypnosis	170
	Cognitive Therapy	172
	Exposure Therapy	175
10.	Treatment: Psychopharmacology	179
	Beta Blocking Agents	182
	Alpha-Adrenergic Agonists	183
	Antidepressants	184
	Tranquilizers	188
	Relapse after Withdrawal of Medication	191
	Clinical Choices and Guidelines	192
11.	Panic Disorder: The Future	195
	Classification	197
	Etiology	198
	Differential Diagnosis: Relationship to Other Disorders	201
	An Individualized Treatment Plan	204
	A Holistic Point of View: A Psychological, Behavioral, Biological Synthesis	206
	References	209
	Index	225

What People are Saying About This

Paul J. Fink

This book is a comprehensive document providing an overview of panic disorders from several dimensions...a significant contribution to the psychiatric literature. (Paul J. Fink, M.D., Past President American Psychiatric Association)

Howard P. Rome

...presents a synoptic view of the often tangled history of the many faces of anxiety...in a felicitous personal style. Dr. Zal is to be commended for this readable and informative personal perspective. (Howard P. Rome, M.D., Professor of Psychiatry Emeritus, Mayo Graduate School of Medicine)

Karl Rickels

Dr. Zal's holistic approach to the diagnosis and treatment of patients suffering from anxiety and/or panic disorder convincingly conveys to the reader that every suffering patient is a unique individual crying out for help; therefore, the best treatment...would most likely involve... psychodynamic understanding, cognitive restructuring, and psychopharmacology. (From the Forward by Karl Rickels, M.D., chief Investigator, University of Pennsylvania Private Practice Research Group; Stuart and Emily B. H. Mudd Professor of Human Behavior and Professor of Psychiatry, The University of Pennsylvania)

Editorial Reviews

A popular review of the causes, signs, and treatment of panic disorder. Written by a psychiatrist who has a medical and biological slant. Annotation c. Book News, Inc., Portland, OR (booknews.com)

Booknews