Case Study

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Nisha Jasani

PSY-30300-0l02

Prof. Christopher Scribner

Date: February 20, 2022

Personal reaction

When reading through the case I was in shock and I learned so much about panic

disorder and panic attacks than I knew. One of the things that shocked me and surprised me is

the type of fears which Harrison has. The fears surprised me but reading through the

underlying cause of the fears I understood Harrison better. When Harrison says that he used

to swim and float in water and stopped after he got into a relationship, I felt that I cam relate

to the experience. When we find a person that gives us a sense of purpose sometimes one can

feel the fear of loosing their life and leaving their loved ones alone. Another interesting fear

which Harrison states is the fear of stairs, I have met people who fear heights because of the

fear of falling down and crushing. I have not met a person that fears stairs before and this was

new to me.

I have known about panic disorder and panic attacks for quite some time but from the

case I got a new insight of panic disorder. Harrison talks about how he spends part of his life

in bed and ends up breaking, telling lies and feting friendships. I have had similar experiences

where I get nervous for a friends’ hangout and end up giving some excuses just not to go. I

have always thought I was either introverted or had anxiety of being in social settings.

Reading the case has helped me have an understanding of the cause of palpitations and

elevated breathing in individuals during panic attacks. The case says that during the attacks

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there is a slight decrease in the level of carbon dioxide which results in a false suffocation

alarm and hence the body responds through the elevated levels of breathing.

I learned that phobias are linked to panic disorder and realized that one can have so

many phobias at one time. I was surprised that there is a phobia known as agoraphobia.

Learning about this made me feel sympathy for the people have panic attacks as I realized it

can control so much of someone’s life. Agoraphobia is a fear that one will have a panic attack

in public. The fear can take over someone’s life such that they end up locking themselves

inside their houses for the fear that they will have attacks when they go outside. Imagine

getting panic attacks because of underlying fears and then developing another fear in the

process. That must be quite a lot to handle and process if one does not have people that

understand them. My reaction to the entire case is that panic attacks are very serious, have

serious effects and should not be taken lightly.

Case analysis

A diagnosis of panic disorder requires Four or more of the following:

1. Palpitations or accelerated heart rate - when the patient describes his experience of

how his panic attacks are, he says that, “I cannot breathe……as the harbinger of a

heart attack.” This statement shows that the heart rate is accelerated at that point and

the patient experiences an episode similar to a heart attack.

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2. Chest pain or discomfort- Harrison says that, “the pain in my chest presents itself to

me as a harbinger of a heart attack” He describes this as a feeling that comes when he

has panic attacks and hence meets the criteria of having chest pains.

3. Fear of chocking- Harrison always feels like he is out of control. He explains that his

father tried to kill him through strangulation and that is a cause of the fear of chocking

(Perrotta, 2019).

4. Fear of dying – Harrison has so many fears and most of them are due to their fear of

loosing his life. He says that initially he used to swim but he got a fear of swimming

when he started dating. This shows that he feared losing his life and leaving his loved

one alone. Harrison has a very intense fear when he first started experiencing the

panic attacks (Perrotta, 2019). Harrison had only experienced anxiety and the first two

times he had to go to the hospital even when he is told not to worry about it.

5. Feeling of unreality or being detached from oneself - Harrison describes about an

incident where he is with friends in a retreat where he was having a dinner with

friends. During the dinner he suddenly had a panic attack, he says, “I feel detached

from them. And indeed, from an outward reality.” This shows that the patient during

the attacks would feel like he was not part of what was going on around him.

6. Numbness or tingling sensations (paresthesias) – the patient says, “my legs are not

servants of my will.” This shows that he feels numb and hence does not have the

control over his legs (Robinaugh et al., 2019).

7. Fear of loosing control or going crazy - this is very evident throughout the case.

Harrison after the panic attack says that, “something terrible will happen if I walk into

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my room. And something terrible will happen- is happening If I continue to stand

here” (pg. 4). At this point Harrison was standing up and he felt like he had lost

control over himself and his legs. He had a fear of losing control even more (Uhde et

al., 2019). He further says that he cannot escape the feeling which makes him feel

more out of control. Harrison says, “I am not safe. Even in the bedroom arranged

entirely panic may intrude.” (pg. 5)

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References

Perrotta, G. (2019). Panic disorder: definitions, contexts, neural correlates and clinical

strategies. Current Trends in Clinical & Medical Sciences, 1.

Robinaugh, D., Haslbeck, J., Waldorp, L., Kossakowski, J., Fried, E. I., Millner, A., ... &

Borsboom, D. (2019). Advancing the network theory of mental disorders: A

computational model of panic disorder.

Uhde, T. W., Roy-Byrne, P. P., Vittone, B. J., Boulenger, J. P., & Post, R. M. (2019).

Phenomenology and neurobiology of panic disorder. In Anxiety and the anxiety

disorders (pp. 557-576). Routledge.