Mindfulness-Based Cognitive Behavior Therapy in Patients with Anxiety Disorders: A Case Series
Ms. B, a 37-year-old married woman, a computer engineer, but currently a homemaker, presented with complaints of intermittent tachycardia, breathlessness, choking sensation, palpitations, and thoughts that she would have a heart attack and collapse, with symptoms lasting for approximately ten to fifteen minutes. She had been experiencing these symptoms since the age of ten. She was apparently doing well till the age of ten, at which point she had an accident involving a truck when riding back home on her bicycle. Following this there was an incident of losing her grandmother due to cancer. Ten days following her grandmother's death she experienced a sudden onset of palpitations with breathlessness, accompanied by thoughts that she would die. The symptoms lasted for approximately 20 minutes, after which she felt better. These episodes continued for six months thereafter and in between the attacks she would anticipate the occurrence of another attack with dread. She became preoccupied with her health. Again at the age of 23, she experienced the same symptoms, which continued till the age of 27. During this time, she was also found to have developed sinus tachycardia. Her heart beat increased during her first pregnancy. It normalized after she delivered her child. During her second pregnancy, she once again had high blood pressure and had to be started on medication. In February 2003, she had one episode of sudden onset of palpitations and breathlessness, accompanied by tremors, an upset stomach, and fear that she was having a heart attack. An electrocardiogram revealed a normal report. Her palpitations subsided and the choking sensation, which she felt in her throat, resolved. A diagnosis of panic disorder was made. Since then, she has been constantly having tachycardia, and she is preoccupied with this.\nThe patient is the older of two siblings, born of a non-consanguineous union. There is a history of cardiac arrest in her paternal uncles. The patient's father has a cardiac problem. The client has been preoccupied with her health and illness since childhood. Her husband is concerned about her health, because of the episodes of panic. Premorbidly, she was well adjusted and sociable. A diagnosis of panic disorder was made and the patient was taken up for the study after consent was obtained.