Nearly one-half of patients with panic attacks do not seek care for their problem. Patients may endure symptoms for years before they seek treatment. For others, it may take years for their symptoms and disorder to be correctly diagnosed and adequately treated. One study reported that it routinely takes more than 10 years for the correct diagnosis of an anxiety disorder to be made.Early studies found that 70% of patients may have to consult over 10 physicians for relief of symptoms.
Attitudes and behaviors on both the patients’ and practitioners’ behalf contribute to the patient’s reticence in seeking treatment. Patients may think, “Am I the only person who has this problem?” or, “I should be able to get over this on my own.” or, “What do I have to be anxious about?” Practitioners and their staff may trivialize the illness or concur with the patient’s doubts over, “What do you have to be anxious about?” Practitioners may offer ineffective recommendations, such as, “Just relax”, or, “There’s nothing to worry about.” or, “Go for a walk… take the day off.” These recommendations, coupled with past ineffective pharmacological treatments, may prevent many patients from seeking treatment for a condition in which both the patient and practitioner have concern that the condition actually exists. Patients who experience cardiovascular symptoms may seek treatment in the emergency department for a wide range of catastrophic fears, from that of having a “heart attack” to a “stroke,” only to be told, “There is nothing wrong with you. You are perfectly healthy!” The objective signs of anxiety are often transient, and there is a wide overlap with other possible disorders. Coupled with a lack of sophisticated technology to detect a panic attack, both patients and practitioners may have persistent doubt as to the validity of a panic attack.
Patients may feel embarrassed when describing symptoms or be at a loss to adequately describe them and feel inadequate for not having a better description. They may fear that others will judge them harshly. Alternatively, they may judge themselves harshly, with thoughts such as: “Nothing can be done,” “There’s nothing wrong,” “I think I’m going crazy,” “People will think I’m crazy,” or, “I will be committed to a mental institution.”
When anxiety disorders, especially panic disorder, remain untreated or are inadequately treated, one can expect patients to contribute to high medical utilization with subsequent increase in costs, time, and procedures, and a decrease in available services to others.