Individuals addicted to nicotine can exhibit unique responses when they are deprived of a cigarette. Many people report being anxious, snappy, or moody when they try to quit smoking. All of these responses are common. But for people with panic disorder (PD), going without a cigarette may trigger a panic attack. According to a recent study conducted by Teresa M. Leyro of the Department of Psychiatry at the University of California in San Francisco, people with anxiety problems and a history of panic attacks in particular are more likely to smoke than people without a history of anxiety-related problems. However, few studies have looked at how nicotine cessation, an event that can cause tension and stress in individuals with no history of anxiety, affects those with a predisposition to panic.
Leyro enlisted 58 adult smokers and exposed them to bodily sensations designed to elicit fear or anxiety. The participants were comprised of individuals with and without a history of PD, and all reported smoking approximately 20 cigarettes a day. The experiment was conducted after they had gone without smoking for 12 hours to allow sufficient time for withdrawal symptoms to occur. Leyro discovered that the participants with severe PD and the most significant withdrawal had the highest rates of panic symptoms after the experiment.
These results suggest that individuals with PD may catastrophize their circumstances and be more sensitive to physical cues when in a heightened state of anxiety. Additionally, these same individuals took longer to recover from their panic than those with low withdrawal symptoms. However, Leyro also found that the participants without PD and with low levels of withdrawal had elevated panic symptoms, too. This could be due to the fact that in the absence of withdrawal symptoms, these individuals may have been overly stimulated by fearful or threatening emotions when they experienced the physical sensations. Leyro hopes that these findings open up avenues of further research. She added, “This line of inquiry can shed light on the etiology of panic psychopathology among smokers and ultimately inform the development of novel specialized interventions for this difficult-to-treat population.”
Leyro, T. M., Zvolensky, M. J. (2012). The interaction of nicotine withdrawal and panic disorder in the prediction of panic-relevant responding to a biological challenge. Psychology of Addictive Behaviors. Advance online publication. doi: 10.1037/a0029423
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