A few weeks ago, I posted the first in a series of articles describing particular psychiatric disorders that are common to Defense Base Act claims. This series of posts provides the diagnostic criteria and features for each disorder. Today, I discuss “Panic Disorder.”
The American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (also called the DSM-5) assigns the following diagnostic criteria to Panic Disorder:
A. Recurrent unexpected panic attacks. A panic attack is an abrupt surge of intense fear or intense discomfort that reaches a peak within minutes, and during which time four (or more) of the following symptoms occur:
1. Palpitations, pounding heart, or accelerated heart rate.
3. Trembling or shaking.
4. Sensations of shortness of breath or smothering.
5. Feelings of choking.
6. Chest pain or discomfort.
7. Nausea or abdominal distress.
8. Feeling dizzy, unsteady, light-headed, or faint.
9. Chills or heat sensations.
10. Paresthesias (numbness or tingling sensations).
11. Derealization (feelings of unreality) or depersonalization (being detached from oneself).
12. Fear of losing control or “going crazy.”
13. Fear of dying.
B. At least one of the attacks has been followed by 1 month (or more) of one or both of the following:
1. Persistent concern or worry about additional panic attacks or their consequences (e.g., losing control, having a heart attacks, “going crazy”).
2. A significant maladaptive change in behavior related to the attacks (e.g., behaviors designed to avoid having panic attacks, such as avoidance of exercise or unfamiliar situations).
C. The disturbance is not attributable to the physiological effects of a substance (e.g., a drug of abuse, a medication) or another medical condition (e.g., hyperthyroidism, cardiopulmonary disorders).
D. The disturbance is not better explained by another mental disorder (e.g., the panic attacks do not occur only in response to feared social situations, as in social anxiety disorder; in response to circumscribed phobic objects or situations, as in specific phobia; in response to obsessions, as in obsessive-compulsive disorder; in response to reminders of traumatic events, as in posttraumatic stress disorder; or in response to separation from attachment figures, as in separation anxiety disorder).
Panic disorder is different than other disorders, but no less serious from a Defense Base Act disability standpoint. Sufferers of panic disorder have recurrent and unexpected panic attacks. These attacks occur out of the blue, and they cause significant physical and cognitive difficulties. By “unexpected” and “out of the blue,” the American Psychiatric Association means that there isn’t an obvious cue or trigger for the panic attack.
Further, panic disorder can result in extreme changes to a person’s behavior. The DSM-5 provides some illustrative examples: “avoiding physical exertion, reorganizing daily life to ensure that help is available in the event of a panic attack, restricting usual daily activities, and avoiding agoraphobia-type situations, such as leaving home, using public transportation, or shopping.” All of the DSM-5’s examples would make it difficult to work–and impossible to return to work overseas.
If you feel that you may be suffering from a psychiatric injury like panic disorder, seek mental health treatment immediately. Finally, if you were injured while working overseas for a military contractor, then contact Strongpoint Law Firm for help with your Defense Base Act claim. You may be entitled to significant indemnity and medical benefits.
Photo courtesy of Flickr user Digitalbob8.