Panic Disorder
When working with a patient who experiences panic attacks, part of the cognitive-behavioral treatment involves helping them identify what triggers their panic. Triggers can be specific places, settings or situations or may be specific sensations or thoughts. Panic disorder often involves the worry of having another panic attack and not being able to get to safety. Many individuals with Panic Disorder are anxious about driving situations, such as being trapped in traffic and unable to escape or of having a panic attack and losing control of the car. I often explore with them the details of various driving scenarios in order to identify the relationship between their irrational thoughts and feelings of anxiety.
Recently a patient shared his awareness that driving in bright sun could trigger his panic. We explored whether this variable was at all dependent upon whether he was in a familiar or unknown location, whether it mattered if he was driving for business or pleasure, if he somehow associated bright sun with past panic attacks, and if it was something about the warmth of the sun or the squinting that created a sensation at all like a sensation he might have during a panic attack. I asked him to clarify why bright sun would be worse than night or dusk given that one’s visual acuity is better when it is lighter.
Despite our best efforts to make sense of his observation, we were unable to identify any anxiety provoking thoughts about the sun. We briefly discussed the possibility of desensitization to the bright light as one way to decrease his anxiety, still not sure that I had ever heard anything like this before and feeling that I was missing something. I made a note to continue the exploration because the fact that the connection between bright light and panic seemed so clear for him made me think that there had to be something more to it.
Then last week I read this headline, “Photophobia Linked to Panic Disorder” about a study at the University of Siena (Italy). The article explains why they even looked for the connection; more panic attacks occur in spring and summer, and more panic attacks occur between the hours of six in the morning and six at night. Comparing the groups in the study has led researchers to the conclusion that photophobia may increase the risk of having a panic disorder, not that photophobia develops from having a panic disorder.
Recently a patient shared his awareness that driving in bright sun could trigger his panic. We explored whether this variable was at all dependent upon whether he was in a familiar or unknown location, whether it mattered if he was driving for business or pleasure, if he somehow associated bright sun with past panic attacks, and if it was something about the warmth of the sun or the squinting that created a sensation at all like a sensation he might have during a panic attack. I asked him to clarify why bright sun would be worse than night or dusk given that one’s visual acuity is better when it is lighter.
Despite our best efforts to make sense of his observation, we were unable to identify any anxiety provoking thoughts about the sun. We briefly discussed the possibility of desensitization to the bright light as one way to decrease his anxiety, still not sure that I had ever heard anything like this before and feeling that I was missing something. I made a note to continue the exploration because the fact that the connection between bright light and panic seemed so clear for him made me think that there had to be something more to it.
Then last week I read this headline, “Photophobia Linked to Panic Disorder” about a study at the University of Siena (Italy). The article explains why they even looked for the connection; more panic attacks occur in spring and summer, and more panic attacks occur between the hours of six in the morning and six at night. Comparing the groups in the study has led researchers to the conclusion that photophobia may increase the risk of having a panic disorder, not that photophobia develops from having a panic disorder.