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“Panic Disorder: (n.) A disorder characterized by sudden attacks of fear and panic. The episodes may resemble a heart attack. They may strike at any time and occur without a known reason but more frequently are triggered by specific events or thoughts, such as taking an elevator or driving. The attacks may be so terrifying that some people associate their attacks with the place they occurred and will refuse to go there again. Allison Lenz // “Panic Disorder” // Information Design // Schule für Gestaltung // St.Gallen, Switzerland // René Keller // Fall 2010

A panic attack is a sudden, intense experience of fear coupled with an overwhelming feeling of danger, accompanied by physical symptoms of anxiety, such as a pounding heart, sweating, and rapid breathing. A person with panic disorder may have repeated panic attacks –at least several a month– and feel severe anxiety about having another panic attack.”

“Each year, panic disorder affects one out of 63 Americans. While many people experience moments of anxiety, panic attacks are sudden and unprovoked, having little to do with real danger. Panic disorder is a chronic, debilitating condition that can have a devastating impact on a person’s family, work, and social life. Typically, the first attack strikes without warning. A person might be walking down the street, driving a car, or riding an escalator when suddenly panic strikes. Pounding heart, sweating palms, and an overwhelming feeling of impending doom are common features. While the attack may last only seconds or minutes, the experience can be profoundly disturbing. A person who has had one panic attack typically worries that another one may occur at any time.�

Project Description and Goals The goal of this project was to represent a set of data in a visual way using digital media. My personal goal for this project was to bring the cold facts to life, to tell a story, and to awake emotions in the viewer by raising awareness of a current issue. I wanted my work to have meaning beyond just representing data.

“As the fear of future panic attacks deepens, the person begins to avoid situations in which panic occurred in the past. In severe cases of panic disorder, the victim refuses to leave the house for fear of having a panic attack. This fear of being in exposed places is often called agoraphobia. People with untreated panic disorder may have problems getting to work or staying on the job. As the person’s world narrows, untreated panic disorder can lead to depression, substance abuse, and in rare instances, suicide.�

Research // Infographics

Charts, Words, and Numbers

Only Words (and some arrows)

Graphic Forms and Words

Before brainstorming for the final concept, I wanted to look at other infographics that have been done to represent different kinds of information in different ways. All of these examples are for print media, however, which means I had to think about my information design piece differently. I had to account for the affordances of digital media, like movement and time.

“Scientists are not sure what causes panic disorder, but they suspect the tendency to develop the condition can be inherited. Some experts think that people with panic disorder may have a hypersensitive nervous system that unnecessarily responds to nonexistent threats. Research suggests that people with panic disorder may not be able to make proper use of their body’s normal stress-reducing chemicals. People with panic disorder usually have their first panic attack in their 20s. Four or more of the following symptoms during panic attacks would indicate panic disorder if no medical, drug-related, neurologic, or other psychiatric disorder is found: pounding, skipping or palpitating heartbeat, shortness of breath or the sensation of smothering, dizziness or lightheadedness, nausea or stomach problems, chest pains or pressure, choking sensation or a “lump in the throat,” chills or hot flashes,

Research // Theme After generally researching some initial topics ––from student debt in America to the medical benefits of laughter–– I decided to go with the topic of anxiety disorders, more specifically panic disorder. This topic not only had sufficient data to be represented in some form of digital information design, it also holds personal significance to me; college students are one of the most susceptible groups of people to anxiety disorders. Therefore, the final topic will also focus on college students. Also interesting to note is the lack of interactive or motion graphic designs in the promotional or help materials of mental health organizations. ADAA claims to have visited over 300 universities and all they passed out were brochures that I’m sure no college student will take the time to read. They need a more effective means of communication appropriate to a college aged audience.

sweating, fear of dying, feelings of unreality or being detached, tingling or numbness, shaking and trembling, fear of losing control or going crazy. A panic attack is often accompanied by the urge to escape, together with a feeling of certainty that death is imminent. Others are convinced they are about to have a heart attack, suffocate, lose control, or “go crazy.” Once people experience a panic attack, they tend to worry so much about having another attack that they avoid the place or situation associated with the original episode.”

Narrated Text Sixty Million Americans, 20 percent of the entire population, will have just one panic attack in their lives. If these attacks start to occur repeatedly, they are a symptom for what is called panic disorder, one of the many anxiety disorders that affects millions of Americans each year. Anxiety is the most common form of mental disorders, affecting 40 million American adults age 18 and older each year, a total equal to 18.1 percent of the population. ----------In the year 2000, 3 million adults were diagnosed with panic disorder, 1.7 percent of that age group. That’s equivalent to almost one third of the population of New York City. ----------In 2010, 6 million adults suffered from panic disorder, which is 2.7% of that age group and equal to one and a fourth times the population of New York City. Panic disorder is twice as common in women as in men. ----------The probable causes of panic disorder include - brain chemistry - personality - genetics - and life experiences or changes you are 8 times more likely to develop panic disorder if you have an immediate family member with the disorder you are 20 times more susceptible if that relative had their first episode before the age of 20. 75 percent of those with an anxiety disorder will have their first episode by age 21.5, college age. ----------7 percent of college students have a diagnosed anxiety disorder. Still, one in eight college students will experience unrelenting anxiety and recurring panic attacks, most likely triggered by major lifestyle changes.

----------PANIC DISORDER IS SERIOUS. Its unique symptoms are very sudden and often unexpected. They appear unprovoked or are often mistaken for another condition, such as asthma. They are often disabling. One in three people with panic disorder develop agoraphobia, a fear of social situations, which severely limits a person’s lifestyle. Note that drugs, alcohol, and caffeine can make panic attacks worse. Process // Storyline

----------PANIC DISORDER IS SERIOUSLY TREATABLE. If caught early, panic disorder is one of the most treatable anxiety disorders. Through a combination of medication to stabilize chemical imbalances and/ or psychotherapy to talk through stress, treatment brings relief to 90 percent of cases in as early as 2 to 3 months! ----------However, a recent study by the University of Michigan showed that up to 84 percent of college students do not seek out treatment for their anxiety or depressive disorders, even if they exhibit significant symptoms. ----------The main reasons most college students do not seek out treatment for their symptoms amount to affordability ----------lack of awareness regarding services ----------skepticism about effectiveness of treatment ----------and lack of a perceived need for treatment. ----------------------------------

Typeface Choice

After gathering both scientific data and personal experience stories, I decided that this combination of both subjective and objective information would be best represented in the form of an After Effects movie. It made most sense to focus mainly on the hard facts, but also insert relevant emotional experiences. The final concept is a narrated movie expressing data using vector forms with continual and ever-increasing interruption scenes that tell the personal story alongside the factual narrative. The movie is meant to be both informative and to give a sense of what it might be like to experience a panic attack.

I selected sans serif typeface for easy legibilty and for the sense of modernity that the issue of anxiety disorders poses. A face like Helvetica or Univers would have been too neutral for such a highly sensitive topic, so I chose to use Gill Sans for its sharp terminals and more traditional, tighter letter spacing. Anything too widely spaced would not have communicated a sense of tension.

Gill Sans Regular 44 pt. – small text

Gill Sans Regular 70 pt. – medium text

Note: Total length approx. 3 min Interruptions marked as ----------Written text to be set in Gill Sans Regular

Gill Sans Reg 99 pt. – large text

“Because its physical symptoms are easily confused with other conditions, panic disorder often goes undiagnosed. A thorough physical examination is needed to rule out a medical condition. Because the physical symptoms are so pronounced and frightening, panic attacks can be mistaken for a heart problem. Some people experiencing a panic attack go to an emergency room and endure batteries of tests until a diagnosis is made. Once a medical condition is ruled out, a mental health professional is the best person to diagnose panic attack and panic disorder, taking into account not just the actual episodes, but how the patient feels about the attacks, and how they affect everyday life. Most health insurance policies include some limited amount of mental health coverage, although few completely cover outpatient mental health care.�

Process // Visualizations Once I had selected the core pieces of data, I worked to visualize the content during the process of finalizing the storyline. I often had the problem of being too literal or relying too much on the text. Since there would be a narrated text in the background, it was important for the visualizations to contain as little words as possible and rely on placement, size, movement, shapes, colors, etc.

I experimented with different sizes and amounts of people on the page. The impact is far greater with more people and no page borders.

The use of maps to represent the percentage of the population was, in a way, very literal. I wanted to see if I could achieve the same feeling of “the masses,� i.e. millions of people, only using vector figures.

“Most patients with panic disorder respond best to a combination of cognitive-behavioral therapy and medication. Cognitive-behavioral therapy usually runs from 12-15 sessions. It teaches patients: how to identify and alter thought patterns so as not to misconstrue bodily sensations, events, or situations as catastrophic; how to prepare for the situations and physical symptoms that trigger a panic attack; how to identify and change unrealistic self-talk (such as “I’m going to die!”) that can worsen a panic attack; how to calm down and learn breathing exercises to counteract the physical symptoms of panic; how to gradually confront the frightening situation step by step until it becomes less terrifying; how to “desensitize” themselves to their own physical sensations, such as rapid heart rate.”

Process // Concept The key part of the concept is the interruption scenes. They serve to describe the symptoms of panic disorder not only with words but also through timing, behavior, duration, and frequency. After careful consideration, I decided to make these scenes in black and white only so that they contrast strongly with the colors used in the normal narrative. They will be placed so as to interrupt the speaker as well as to mark the transitions in content. These interrupting scenes are not meant to be always legible; instead, their primary function is to give an impression, using type as image.

After much experimentation, I decided that the use of grey translucent layes gave the best effect of a buildup of something not quite tangible, something more emotional. This idea of layering, of a buildup, was key to achieving the climactic moment at the end of the animation as well as to make each interruption scene seem more chaotic without adding unnecessary animation movements. I had to be very careful not to make the interruptions look too fake or “cheesy.�

“At the same time, many people find that medications can help reduce or prevent panic attacks by changing the way certain chemicals interact in the brain. People with panic disorder usually notice whether or not the drug is effective within two months, but most people take medication for at least six months to a year. Several kinds of drugs can reduce or prevent panic attacks, including: selective serotonin reuptake inhibitor (SSRI) antidepressants like paroxetine (Paxil) or fluoxetine (Prozac), are approved specifically for the treatment of panic; tricyclic antidepressants such as clomipramine (Anafranil); benzodiazepines such as alprazolam (Xanax) and clonazepam (Klonopin). Finally, patients can make certain lifestyle changes to help keep panic at bay, such as eliminating caffeine and alcohol, cocaine, amphetamines, and marijuana.�

Development // Screen Shots This stage marked that transition from visualizations in Illustrator to working with the content in AfterEffects. With the added consideration of time, the visual language changed. These screen shots show part of the first draft. Note the changes and the consistencies with the final draft. All the information in the main storyline appears on a white surface, while all the interruption scenes take place on black surfaces.

Having completed the first draft, the next step in the process would be to eliminate unnecessary numbers and make the animation more dynamic and more visual. Much of the fine tuning involved tweaking the timing and the movement.

“One approach used in several medical centers focuses on teaching patients how to accept their fear instead of dreading it. In this method, the therapist repeatedly stimulates a person’s body sensations (such as a pounding heartbeat) that can trigger fear. Eventually, the patient gets used to these sensations and learns not to be afraid of them. Patients who respond report almost complete absence of panic attacks. A variety of other atlernative therapies may be helpful in treating panic attacks. Neurolinguistic programming and hypnotherapy can be beneificial, since these techniques can help bring an awareness of the root cause of the attacks to the conscious mind. Herbal remedies, including lemon balm (Melissa officinalis), oat straw (Avena sativa), passionflower (Passiflora incarnata), and skullcap (Scutellaria lateriflora), may help significantly by strengthening the nervous system. Homeopathic

Final // Screen Shots These screen shots represent the key moments of the final animation. Note that throughout the sequence, a voice narrates the content in the background while the type and images move on screen. I wanted to make the interruptions increasingly frequent towards the end in order to achieve a buildup of panic attack symptoms, culminating in a final stage of panic. Because these scenes are very disruptive, I wanted to maintain the unity of the piece through a consistent use of color, type sizes, and vector people for the visualizations.

medicine, nutritional supplementation (especially with B vitamins, magnesium, and antioxidant vitamins), creative visualization, guided imagery, and relaxation techniques may help some people experiencing panic attacks. Hydrotherapies, especially hot epsom salt baths or baths with essential oil of lavender (Lavandula officinalis), can help patients relax. While there may be occasional periods of improvement, the episodes of panic rarely disappear on their own. Fortunately, panic disorder responds very well to treatment; panic attacks decrease in up to 90% of people after 6-8 weeks of a combination of cognitive-behavioral therapy and medication. Unfortunately, many people with panic disorder never get the help they need. If untreated, panic disorder can last for years and may become so severe that a normal life is impossible. Many people who struggle with untreated

panic disorder and try to hide their symptoms end up losing their friends, family, and jobs. There is no way to prevent the initial onset of panic attacks. Antidepressant drugs or benzodiazepines can prevent future panic attacks, especially when combined with cognitive-behavioral therapy. There is some suggestion that avoiding stimulants (including caffeine, alcohol, or over-the-counter cold medicines) may help prevent attacks as well.â&#x20AC;? Source: The Free Dictionary <http://medical-dictionary.>.

Professional Sources: Anxiety Disorders Association of America <>.

Rickey, Joe. “Anxiety affects 7 percent of college students.” Royal Purple: UWWhitewater Student Newspaper. Published Sept 18, 2007. Updated Jan 31, 2010.

National Institute of Mental Health <>. University of Maryland Medical Center < htm>. American Psychiatric Association. Diagnostics and Statistical Manual of Mental Disorders. 4th ed, text revision. Washington, D.C.: 2000. University of Michigan News Service. “Students with symptoms of mental illness often don’t seek help.” June 25, 2007 < php?id=5913>.


Other Sources:

Bolden, C. “Anxiety Disorders Among College Students.” My Anxiety. Oct 29, 2008 <>. Hathaway, April. “Anxiety Disorders: A Growing Concern for Students.” U-Albany E-Zine. May 5, 2007 <>. Ross, Jerilyn. “Help for College Students With Anxiety Disorders.” Sept 29, 2008 <>.

The list includes all the resources I used to gather data for the topic of panic disorder. Special thanks to two individuals, who wish to remain nameless, for generously sharing their personal experiences dealing with anxiety and panic attacks with me. All sources accessed on 22 Sept., 2010.

Panic Disorder Process Book  

A compilation of my inspiration, research, visualizations, and thought process that went into creating the motion graphic piece on panic dis...