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Panic Attack Isn't Cowardice.

Trauma, Stress, and Fear Trigger Hard-Wired Responses
By Daniel J. DeNoon
WebMD Health News

Editor's note: On Nov. 7, 2003, Army officials reduced the charges against Sgt. Georg-Andreas Pogany to dereliction of duty. The cowardice charges were dropped, The New York Times reports. His military trial has been rescheduled.

Nov. 6, 2003 -- A rare case of a U.S. soldier facing trial for being "cowardly," has experts scratching their heads.

Army Sgt. Georg-Andreas Pogany didn't know what was happening to him. His head throbbed, Pogany told The New York Times and The Gazette of Colorado Springs. His chest ached and his stomach rebelled. He shook for hours with an overwhelming sense that he could die at any moment.

Was it cowardice? That's what the U.S. Army charges in the first court-martial for "cowardly conduct as a result of fear" since the Vietnam War. Pogany's military trial is set for Nov. 7.

The Army has its own definition of cowardly conduct. But what Pogany experienced isn't the result of cowardice, experts tell WebMD. It's the result of being human.

Trauma, Stress, and Panic

About a month ago, on his second night in Iraq, Pogany saw an Iraqi cut in half by heavy machine-gun fire. It was his first exposure to this kind of situation, and he had what he describes as a panic attack. An interrogator assigned to a Green Beret team, Pogany told his superiors he was unfit for duty and needed help.

Instead, he was confined to his room and put on suicide watch, even though he says he wasn't suicidal. Eventually he was moved to a larger military base. A psychologist there diagnosed normal combat stress reaction and recommended he rejoin his unit after a few days' rest. Instead, he was called a coward and sent back to the U.S. for court martial.

Was it really a panic attack? That's what it sounds like to David H. Barlow, PhD, director of the Center for Anxiety and Related Disorders at Boston University.

"It certainly sounds like a panic attack," Barlow tells WebMD. "A panic attack is the fundamental emotion of fear. It's the flight/fight response that we all have in us. It involves massive changes in the brain. It is meant to prepare you to deal with this life-threatening event by running away or by fighting, attacking the source of danger."

Barlow says panic attacks occur in two different conditions. One is a "true reaction" to a traumatic event. The other is a "false reaction" where there is no obvious triggering event.

Barbara Rothbaum, PhD, director of the trauma and anxiety recovery program at Emory University in Atlanta, prefers a different term for what Pogany seems to have experienced.

"This soldier's case sounds more like a posttrauma reaction, which many people describe as a panic attack," Rothbaum tells WebMD. "Seeing something like that and having that kind of reaction is basically responding to a trauma."

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