It is the lack of diagnosis and the lack of adequate treatment services which is the driving force behind the development of the secondary conditions of these disorders. Although the symptoms of panic disorder were first noted in the 1800s (Boyd et al. 1991), panic disorder was only classified as a separate anxiety disorder by the American Psychiatric Association in February 1980 (APA 1980). As a consequence there was little understanding of it, not only by the people who suffer from it, but by the health professions generally. Many people have developed secondary conditions such as agoraphobia, major reactive depression, and drug and/or alcohol abuse.

The development of major depression can lead to suicide. According to one American study, 26.5 per cent of people who experience panic disorder will attempt suicide. People who have not been diagnosed as suffering from panic disorder, but who nevertheless experience panic attacks, are seven times more likely than the general population to attempt suicide (Malison et al. 1990). Other studies confirm that 10-40 per cent of people with an alcohol dependence had an anxiety-related disorder before their dependence developed (Cox et al. 1990).

The recognition of the sometimes severe disabilities associated with anxiety disorders has seen the inclusion of the more severe forms of panic disorder, obsessive compulsive disorder and social phobia into the category of serious mental disorder

(Andrews 1994). This is not to say people with severe disorders have a serious mental illness. Rather it is the recognition of the extreme disablement caused through the disorders.


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