In detail

Panic attacks

Panic attacks


The panic attack is an abrupt access of intense fear or anxiety (affective state characterized by psychomotor restlessness, indiscriminate fear, without object) that cause worrying symptoms, but which do not threaten life: accentuated heartbeat, difficulty breathing, feelings of loss of control or imminent death. Usually, it lasts from 5 to 20 minutes and can be caused by stressful circumstances or may occur unexpectedly.
The body has a system of response to fear, which prepares the individual to cope with a situation or to avoid danger. The panic attack occurs when this system overreacts or when it is not needed. During the panic attack, the nervous system reacts as when dealing with a life-threatening situation. This response causes physical symptoms and worrying feelings.
Panic disorder is diagnosed when a person has repeated panic attacks, is worried about the possibility of a new one and avoids places that can cause an attack. It is possible for a man to have panic attacks without developing a panic disorder, these attacks appear with anxiety disorders.
causes
The exact cause of panic disorder is not known. It is believed to be the result of an imbalance between brain chemicals (neurotransmitters).
It can also be transmitted from one generation to another (genetically). Children with parents with such disorders are 8 times more likely than others to develop the disease. Those with parents with depression or bipolar disorder are at increased risk. Nervous tension (for example, losing a relationship) can trigger symptoms of panic disorder.
There is a possibility that a man will have panic attacks without developing a panic disorder. Panic attacks can be caused by:

  • ingestion of a large quantity of alcohol or abrupt interruption of alcohol consumption
  • ingestion of large quantities of caffeinated beverages
  • Excessive smoking (increases the amount of nicotine in the blood)
  • the use of medicines (such as for the treatment of asthma and heart disease) or the abrupt discontinuation of a drug treatment (for anxiety and insomnia)
  • drug use, cocaine or marijuana
  • a high level of long-term stress (chronic stress)
  • a birth in the near past
  • an operation with general anesthesia
    Panic attacks may be associated or may be caused by a certain medical condition:
  • thyroid dysfunction (hyperthyroidism - excess thyroid hormones)
  • heart disease, prolapse of mitral valve (mitral valve presents a defect that damages its normal functioning)
  • neurological disorders (epilepsy)
  • bronchial asthma (a pathological condition in which there is an intense need for air, its discharge from the lungs becoming heavy)
  • pulmonary diseases (chronic obstructive pulmonary disease)
  • discontinuation of medication for heart disease
  • depression
  • anxiety, post-traumatic stress or obsessive-compulsive disorder
    symptoms
    The main symptom of panic attacks is the overwhelming feeling of fear and anxiety along with other physical reactions. The symptoms appear suddenly, surprising and the maximum intensity lasts about 10 minutes. While most symptoms disappear within 30 minutes, others take an hour to completely disappear. It is possible for a person to have panic attacks one after another for a longer period of time and to appear as a continuous attack. If the symptoms are continuous and do not disappear within an hour, there is the possibility that there will be a panic attack and then you should consult your specialist doctor immediately.
    Panic attacks can start as a result of a stressful event or no apparent cause. They may be associated with medications (such as heart disease) or with certain medical conditions (hyperthyroidism):
  • rapid breathing (hyperventilation), dyspnoea (difficulty breathing) or choking sensation
  • fast, strong or irregular beats of the heart
  • angina pectoris (chest pain)
  • sweating
  • nausea or epigastric pain (stomach pain)
  • dizziness (dizziness), tremor, insecurity
  • tinnitus (ear drops)
  • chills or heat waves
  • fear of death and loss of control
  • sensation of detachment from one's own person or reality
    Panic attacks can start without a cause or can be linked to certain situations, such as a crowded restaurant or stadium. Sometimes just the thought of a particular situation can cause severe anxiety. People who have frequent panic attacks learn to avoid situations that they are afraid will trigger an attack or those from which they cannot easily escape if an attack occurs. If the pattern of avoidance and anxiety is severe, it can turn into agoraphobia (phobia of open spaces). The symptoms of panic attack may be similar to those of myocardial infarction. For this reason, many people seek emergency medical treatment. If someone has angina (chest pain) or other symptoms of myocardial infarction, they should be taken immediately to the emergency department for specific treatment.
    Panic attacks are not common in children or adolescents. Children who have panic disorder or panic attacks have symptoms other than those listed above. They may be afraid of common things, such as insects or worry about monsters or going to bed alone. These children may refuse to go to school or become very upset when they break away from their parents.
    Panic disorders consist of episodes of panic attacks. Not everyone who has panic attacks develops a disorder. A person is diagnosed with the disorder if he has at least two unexpected attacks plus the fear or concern that he may have others avoiding situations that could trigger them.
  • Treatment


    Panic disorders can be controlled by medication (antidepressants) and counseling (behavioral therapy). Effective treatment reduces the number and frequency of panic attacks, decreases anxiety and improves quality of life. If panic attacks have a particular causal factor (drug reaction), treatment is not necessarily required, they stop after the cause has been removed (stopping the medication with the help of the doctor). Sometimes panic attacks can continue even after the causal factor is removed and can cause panic disorder.
    Maintenance treatment
    It consists in the continuation or change of the measures taken initially, counseling and medication. During the initial treatment, a short-term medication such as benzodiazepines may be prescribed to resolve immediate symptoms. Short-term medication will most likely stop when long-term medication occurs and the general condition improves.
    The patient will continue to be monitored for other problems associated with panic disorders (depression, drug or alcohol problems). These situations will require treatment.
    An important part of the maintenance treatment is the administration of medicines as prescribed. Often people who feel better after a period of time give up treatment without seeing its usefulness. Once the medication has stopped, the symptoms return, so it is important to continue the treatment plan.
    Recurrent panic attacks can range from mild to severe and may continue for years, especially when agoraphobia is present. There may be long periods without panic attacks or times when they are frequent. Even after stopping treatment, the attacks appearing to be under control, they may return. It is important for a person to identify predictive signs and factors that trigger panic attacks and seek treatment as early as possible.
    Treatment in case of aggravation of the disease
    If the attacks become severe and continue to return, hospitalization is required until they can be controlled. Also, a short hospitalization may be necessary if the panic attack overlaps with another medical problem, such as agoraphobia and depression, because this combination is difficult to treat.
    If the medication does not help, the doctor may prescribe other drugs or a combination of several drugs.
    Counseling can be added to treatment. This includes behavioral therapy that focuses on modifying the pattern of thinking and behavior or masking therapy, which is a type of behavioral therapy that is based on confronting the object or situation that causes fear. If counseling does not work, more intense, more frequent or other counseling is needed. And if counseling is the only treatment, add medication.
    Help for family members
    When a person has a panic attack, the whole family suffers. Other members feel frustrated, tired (because they take on some responsibilities) or socially isolated because the sick person restricts family activities. Family therapy, a type of counseling that involves the whole family, can help all family members.
    Other treatments
  • counseling: Cognitive-behavioral therapy is most effective in treating panic attacks.
  • Exposure therapy, a type of cognitive-behavioral therapy
  • family therapy, helps those close to understand what panic attacks mean and maintain good relationships. Helping materials such as video cassettes, books and audio material help in the fight against panic attacks and anxiety
  • Support groups are usually good places to share information, problem solving ideas and emotions in relation to panic attacks. There are also discussion forums, created online on the Internet.
  • relaxation exercises. They can be useful in reducing anxiety and stress.
    These include:
  • breathing exercises
  • progressive muscle relaxation, which reduces muscle tension by relaxing individual muscle groups
  • massage on the shoulders and neck
  • aromatherapy, which uses aromatic oils (essential oils) from herbs and promotes relaxation
  • Yoga, tai chi, and qi-gong are forms of meditation exercises. These usually require special training.
  • psychic relaxation activities help to relax the mind and are usually combined with those of muscle relaxation.
    These include:
  • Autogenous workouts are used to bring the body into a normal state after stress
  • hypnosis prepares the brain for suggestions that relieve stress or change the reaction to stressful situations
  • meditation involves regular low frequency breathing and lasts 15-20 minutes
  • guided artistic images (visualization): By the power of the imagination, relaxation and reduction of nervous tension caused by stress are reached. The body responds to the images projected in the mind. Simple exercises are used for relaxation and reinvigoration.
  • music therapy, relaxes the body, improves mood and changes the day.
  • Humor therapy has become increasingly accepted as a way to reduce stress and stimulate the body's immune system.
    Source: Sfatulmedicului.ro