A subset of panic disorder where symptoms/attacks occur without being triggered by fear/phobia.
Symptoms/attacks are described as intense discomfort, accompanied by at least four of the 12 symptoms listed under the DSM definition for panic disorder.
However, the symptoms of free-floating anxiety, fear of dying, fear of going crazy, or fear of losing control are noticeably absent.
Note: My initial panic attacks were triggered by emotional and somatic (physical) issues starting around 1975. After a year of therapy and 6 mo of meds during 1990-1991, my panic attacks slowly transitioned to those of the non-fearful variety. It is very rare for me to be triggered by emotional issues since 2000. 98% of my anxiety triggers are purely somatic now.
Selected references of interest:
Non-fearful vs. fearful panic attacks: A general population study from the National Comorbidity Survey
Chen J, Tsuchiya M, Kawakami N, Furukawa TA
J Affect Disord. 2009; 112(1-3):273-278
Non-Fearful Panic Disorder in Gastroenterology.
Porcelli P, De Carne, M
Psychosomatics 2008; 49:543-545
Nonfearful Panic Disorder in Chest Pain Patients.
Bringager CB, Dammen T, Friis S
Psychosomatics 2004; 45:69–79
Non-Fearful Panic Disorder: A Variant of Panic in Medical Patients?
Fleet RP, Martel JP, Lavoie KL, Dupuis G, Beitman BD
Psychosomatics 2000; 41:311–320
Non-fearful panic disorder: panic attacks without fear.
Beitman BD, Basha I, Flaker G, et al
Behav Res Ther 1987; 25:487–492
Panic disorder without fear in patients with angiographically normal coronary arteries.
Beitman BD, Kushner M, Lamberti JW, et al
J Nerv Ment Dis 1990; 178:307–312
Panic disorder and chest pain: a study of cardiac stress scintigraphy patients.
Carter C, Maddock R, Zoglio M, et al
Am J Cardiol 1994; 74:296–298
Panic disorder in the families of patients with normal coronary arteries and non-fear panic disorder.
Beitman BD, Thomas AM, Kushner MG
Behav Res Ther 1992; 30:403–406
Fearful and non-fearful panic attacks in a student population.
Wilson KG, Sandler LS, Asmundson GJ
Behav Res Ther 1993; 31:407–411
Non-fear panic disorder in neurological patients validated by lactate infusion.
Russell J, Kushner M, Beitman B, et al:
Am J Psychiatry 1991; 148:361–364
Hi
I am very interested in what your experiences have been. I hope you tell us more. Your story will help others who suffer from anxiety and especially panic attacks. I have had some panic attacks with relation to my MS and sensory triggers so I am intrigued by what you are writing.
Welcome to the site.
Thanks for the welcome.
There's a laundry list of factors, any of which could have contributed to increased susceptability to persistent anxiety.
Both my parents smoked unfiltered cigarettes all their lives. We now know exposure to substances released from tobacco before and after birth can have adverse long-term effects on children. Evidence: Frequent episodes of asthmatic bronchitis throughout my childhood. However, the long-term effects of passive/secondary smoke inhalation weren't in the literature of the time.
My mom was an alcoholic throughout my childhood. After re-examining her behavior over that timeframe, it's quite possible my mother was self-medicating for depression and/or anxiety. If true, there may be a genetic predisposition to mental health issues passed down from mom. Evidence besides my own issues: I learned a few years ago my estranged brother had been treated for bipolar disorder most of his adult life. Looking back, this diagnosis fits with his behavior, especially manic episodes.
Both parents had unrealistically high performance expectations for my brother and I, which were very difficult to meet. When we did do better, there was no praise or encouragement, only a demand for perfection. In addition, my father indoctrinated the family with the belief that people in authority -- parents, teachers, etc -- "... were always right even when they are wrong..."
Taken all together, it's not hard to imagine my brother and I experienced physical and emotional deficits. I also acknowledge correlation doesn't necessarily infer causation, so I tend to address the list as possible factors. Once I became aware of these factors however, I used them as anchoring points to determine how I might rethink and reframe emotional issues, and how to address physical symptoms.
Today, I tend to respond to emotional issues in a normal way. Instead, my anxiety triggers are primarily physical, all of which have been investigated:
[1] the inability to take in a satisfying breath
[2] premature ventricular contractions, sometimes two or three together
[3] epigastric pressure/pain caused by esophageal spasms