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Panic attacks– these are attacks of intense fear that occur in the absence of real danger and lead to pronounced physiological reactions in the body. Many people experience panic attacks only once or twice in their lives, and they usually have a good reason, caused by some dangerous situation that causes severe anxiety.
If attacks of severe fear occur without apparent reason, by themselves, and this happens quite often, we can talk about panic disorder .
Panic attacks are not life-threatening, but they cause severe discomfort and excruciating sensations in a person. During an attack, a person may feel like they are “losing control of their body,” “dying,” or “having a heart attack.”
Panic attacks in numbers and facts:
- 36-46% of people have experienced a state of panic at least once in their lives.
- In 10% of people, panic attacks sometimes occur, but do not lead to obvious consequences.
- Panic disorder 2% of people suffer.
- Most often, the disease begins at the age of 20-30 years.
Panic attacks in men and women: definition, risk groups and types - video
Causes
Fear is a natural reaction of the human body to dangerous situations. She helped our ancestors survive. When a person is in danger, his body prepares to react to it: to fight or run away.Symptoms of a panic attack: blood pressure, pulse, breathing, choking, convulsions, temperature - video
Manifestations of panic attacks: sleep and insomnia, dizziness, loss of consciousness, headache, obsessive thoughts - video
Vegetative-vascular dystonia and panic attacks - similarities and differences. Differential diagnosis: panic attacks, vegetative-vascular dystonia, hypertensive crisis, etc. - video
How to diagnose panic attacks? Panic attack test
Only a doctor can make a definitive diagnosis, but if your condition meets certain criteria, it is highly likely that you suffer from panic disorder: - You are worried about frequent, unexpected attacks of panic fear.
- After at least one attack, you were constantly worried for a month or longer that the attack would happen again. You have fears that you cannot control your condition, that you are having a “heart attack,” or that you are “going crazy.” Your behavior may have changed: you try to avoid situations that you think lead to panic attacks.
- Are you sure that your seizures are not related to medication and psycho active substances, any diseases, mental health disorders (phobias, etc.).
Often the symptoms of panic attacks resemble symptoms of other, more serious illnesses. Pathologies from which panic attacks must be distinguished:
| Bronchial asthma | During panic attacks, as well as during attacks of bronchial asthma, increased breathing and a feeling of lack of air may occur. But some are missing characteristic features:
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| Angina pectoris | During panic attacks, pain may occur in the heart area, sometimes radiating to the arm. An attack is distinguished from a myocardial infarction and angina by the following symptoms:
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| Arrhythmia | Increased heart rate can occur both during a panic attack and during paroxysmal tachycardia. Understanding the real reason is often difficult. An ECG helps clarify the situation.  |
| Arterial hypertension | Hypertensive crisis– an attack of severe increase in blood pressure – often resembles a panic attack. Unlike a panic attack, with a hypertensive crisis:
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| Temporal lobe epilepsy | Differences between seizures in temporal lobe epilepsy and panic attacks:
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Panic attacks and hormones |
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| Pheochromocytoma | Patients with pheochromocytoma, a tumor of the adrenal gland that produces hormones, experience sympatho-adrenal crises, which can closely resemble panic attacks. Hormone tests and computed tomography of the adrenal glands help establish the correct diagnosis.  |
| Thyrotoxicosis | Patients suffering from thyroid pathologies often experience attacks resembling panic attacks. A correct diagnosis helps to establish a blood test for hormones thyroid gland. |
Diagnosis of panic attacks: criteria for diagnosis, tests, clinical picture - video
What types of panic attacks are there?
Depending on the number of manifestations:- Large (expanded) attack– four or more symptoms.
- Small attack– less than four symptoms.
- Typical (vegetative). Symptoms such as increased pulse and heart contractions, spasms, nausea, and fainting prevail.
- Hyperventilation. Main manifestations: increased breathing, reflex cessation of breathing. IN different parts body, unusual sensations arise in the form of tingling, “crawling”, muscle pain associated with changes in blood pH as a result of respiratory disorders.
- Phobic. Symptoms are dominated by phobias(obsessive fears). Fear arises in situations that, according to the patient, are dangerous and can provoke a panic attack.
- Affective. They manifest themselves in the form of depression, obsessive thoughts, constant internal tension, melancholy and angry states, and aggressiveness.
- Depersonalization-derealization. The main symptom is detachment, a feeling of unreality of what is happening.
Types and forms of panic attacks: morning, daytime, night, acute, chronic - video
Stages of panic disorder. How does the disease develop?
Over time, the manifestations of the disease change. This can happen at different rates, sometimes over months or even years, and sometimes over weeks. Typically, panic disorder goes through the following stages: - "Poor" attacks, in which the symptoms are not very pronounced.
- Full-blown panic attacks.
- Hypochondria. Unable to find a logical explanation for his condition, the patient believes that he has a serious pathology and begins to visit therapists, neurologists, cardiologists and other specialists.
- Limited phobic avoidance. The patient identifies situations that, in his opinion, provoke attacks, and tries to avoid them. On this and more late stages Many patients see a psychiatrist or psychotherapist for the first time.
- Extensive phobic avoidance (secondary agoraphobia). Symptoms that appeared in the previous stage become more pronounced.
- Secondary depression. A person becomes more and more convinced that he is not in control of the situation and does not know how to get rid of his illness. Attacks can happen anywhere, at any time, they destroy your personal life and career. All this leads to depression.
Stages, duration, exacerbation and severity of panic attacks. Panic attacks without panic - video
What diseases can panic attacks be associated with?
Panic attacks are often combined with other disorders:
| Panic attacks and phobias (obsessive fears) | The most difficult situation is in the situation with agoraphobia– fear of open spaces, being in public places, places where large numbers of people gather. Sometimes a person initially begins to be bothered by obsessive fears, and panic attacks occur against their background. In other cases, on the contrary, panic disorder leads to the fact that a person begins to fear a new attack and develops secondary agoraphobia. Panic attacks can also be combined with social anxiety(fear of public speaking, conversations with strangers and others social situations), some specific types of obsessive fears: fear of heights, darkness, claustrophobic(fear of being in a closed space), etc. |
| Panic attacks and generalized anxiety disorder | Generalized anxiety disorder– a condition that manifests itself in the form of constant anxiety, muscle tension, decreased concentration, and irritability. If panic attacks become frequent, the patient begins to constantly be afraid, expect a new attack, and experience anxiety. |
| Panic attacks and obsessive thoughts and actions | Panic disorder may cause obsessive movements, unpleasant intrusive thoughts, from which the patient wants, but cannot get rid of. These disturbances during panic attacks are not as pronounced as during obsessive neuroses. |
| Panic attacks and post-traumatic stress disorder | Post-traumatic stress disorder occurs after severe psychological trauma, such as disasters, accidents, violence, or being in places of military conflict. Subsequently, situations that are reminiscent of the traumatic event lead to panic attacks. At the same time, panic attacks may occur for no apparent reason. |
| Panic attacks and recurrent bouts of depression | Sometimes depression occurs against the background of panic attacks, but it is usually not very severe and goes away after the panic attacks disappear. Sometimes it happens the other way around: symptoms of depression appear first, followed by panic disorder. Recurrent attacks of depression occur in approximately 55% of people who suffer from panic attacks. |
| Panic attacks after drinking alcohol and with a hangover | About half of patients suffering from panic disorders tell doctors that they have abused alcohol in the past. Two different conditions can develop:
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| Panic attacks and cervical osteochondrosis | A number of experts believe that cervical osteochondrosis leads to increased anxiety and panic attacks. According to some, this occurs due to compression of the vessels supplying blood to the brain. There is an alternative point of view, according to which the main cause of panic attacks in osteochondrosis is work imbalance autonomic nervous system, which regulates the work internal organs, vessels.  |
| Panic attacks with VSD (vegetative-vascular dystonia) | Panic disorders are often combined with symptoms of vegetative-vascular dystonia. According to one theory, panic attacks themselves arise as a result of a mismatch in the work of two parts of the autonomic nervous system: the sympathetic and parasympathetic. |
| Panic attacks and smoking | On the one hand, smoking helps reduce anxiety. But it also increases it in the intervals between smoked cigarettes. Some people suffering from panic disorders begin to experience more intense cravings for cigarettes, as they help them relax, at least for a while.  |
| Panic attacks during pregnancy and after childbirth | Pregnancy can affect panic disorder in different ways. Sometimes the attacks intensify and become more frequent. For some women, on the contrary, the condition improves as their attention switches to caring for the unborn child. A previously healthy woman may experience panic attacks for the first time during pregnancy. IN postpartum period Depression is more common, but panic attacks can also occur.  |
| Panic attacks and menopause | Menopause can trigger panic attacks. This occurs due to hormonal changes in the woman’s body. The situation is aggravated by serious illnesses. |
| Taking certain stimulants | Drugs that, when abused, can lead to panic attacks:
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| "Withdrawal Syndrome" | Withdrawal syndrome occurs after abruptly stopping the use of certain substances, if before that the person took them frequently and in large quantities:
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| Sexual dysfunction in men | Failures in bed cause a lot of stress in many men and can become a provoking cause of panic attacks. The situation is aggravated if there is constant stress in a man’s life at work and in the family, if he meets with his mistress and is forced to have sex in a hurry, “quickly.” |
Is it possible to die from a panic attack?
During panic attacks, many people feel as if they are dying, but the condition is not life-threatening and never leads to death. However, panic disorder has Negative influence for all areas of life. Its main complications:- Panic attacks often lead to the development of phobias – obsessive fears. For example, a person may be afraid to leave the house or get behind the wheel.
- People suffering from panic attacks often begin to avoid society and stop participating in its life.
- Depression may develop over time increased anxiety and other disorders.
- Some patients begin to have suicidal thoughts and even attempt suicide.
- Panic disorder can lead to alcohol and substance abuse.
- All these disorders ultimately lead to problems at school, at work, and in personal life.
- Adult patients experience financial difficulties, and the disease can make them unable to work.
- Fear of night sleep develops. The patient is afraid that as soon as he lies down in bed he will have an attack. As a result, insomnia develops.
- If attacks occur very often, the patient gradually gets used to them and develops a deep neurosis. The disease becomes part of a person's personality. It is often extremely difficult to bring a patient out of this state. Sometimes this leads to the assignment of a disability group.
Complications and consequences of panic attacks: fear, madness, death - video
Treatment
Which doctor should I contact?
In order to understand which specialist you need to contact for panic attacks, you first need to understand what the difference is between a psychologist, psychiatrist and psychotherapist: What to do during a panic attack?
Correct breathing during an attack:- Try to breathe more slowly, this will reflexively reduce the force of heart contractions, lower blood pressure, and help you calm down at least a little.
- You need to inhale through your nose, then hold your breath for a while and exhale through pursed, pursed lips.
- While breathing, you need to count: inhale for 1-2-3, then pause for 1-2, then exhale for 1-2-3-4-5.
- You need to breathe not with your chest, but with your stomach. At the same time, nausea goes away, discomfort in the stomach.
- While breathing, you can practice self-hypnosis. Experts recommend saying to yourself as you inhale, “I”, and as you exhale, “I calm down.”
- You can breathe a little into a paper bag. At the same time, oxygen starvation is created in the body, which helps eliminate a panic attack.
Body-oriented therapy practices:
- The ability to relax muscles. Clench and tense your fists tightly, then relax them. Next, connect your legs: while clenching your fists, stretch them out and tense calf muscles, then relax. Several such movements lead to fatigue and relaxation of the muscles. This exercise can be combined with breathing: tension as you inhale and relaxation as you exhale.
- The above exercise can be used for the muscles of the anus. Squeeze your thighs and buttocks, while trying to pull your rectum up. Several repetitions of this movement help trigger a wave of relaxation of the intestines and muscles.
- Working with eyeballs. Pressing on them leads to a slowdown in heart rate.
- Massage ears. During panic attacks, it is recommended to wet the ears with water every morning and then wipe them with a terry towel. During the onset of an attack, you need to massage the lobe, the antitragus of the ear. While rubbing your ears, you can use the “Star” balm.
Algorithm of actions in certain situations:
- If a panic attack occurs on the subway. You need to take anti-motion sickness medications or mints in advance, chewing gum. Take your loved ones with you, don't go alone. Avoid rush hours. Take wet wipes and mineral water with you. The right attitude is important, you need to do it daily. Get ready in the morning for a good positive day.
- If a panic attack occurs while you are driving. Immediately begin to slow down and, without violating traffic rules, stop where this can be done. Turn off the car, sit in the passenger seat, open the door and sit there for a while, looking into the distance, at the horizon. Do not close your eyes.
- If a panic attack occurs in an elevator or other confined space. Knock on the door, shout, try to attract attention. Try to open the door slightly so that you can see the space and call for help. Call relatives and friends on the phone so that someone can come. If you carry medications with you, take them. Prepare yourself for the fact that help will arrive soon.
- If a panic attack occurs at work. You should not change jobs, as this is often associated with stress. Quitting your job is also not recommended. If precursors arise, do not wait for the expanded stage. Try to prevent attacks. Take time off and leave work early, try to have a good rest.
Is treating panic attacks effective with folk remedies?
Some dietary supplements and traditional medicine can improve the patient’s condition and increase the effectiveness of treatment for panic disorder. But before taking any such remedies, you should consult your doctor. Is homeopathy effective?
Homeopathic medicines are used to prevent and treat panic attacks in the early stages. It is believed that these medications must be taken for a long time to achieve the desired effect. However, the application homeopathic remedies lies outside the scope of evidence-based medicine.Is it possible to get rid of panic attacks completely?
Statistics collected over many years show that, with the right complex treatment Quite often, complete recovery occurs. However, because panic attacks have many causes, the treatment process usually presents some challenges. It is necessary to find an experienced, competent specialist, and the patient must be ready to fight the disease, cooperate with the doctor, and follow all recommendations.Panic attacks: methods and means of treatment, is treatment possible at home, features of treatment in hospitals. Can panic attacks go away without treatment (the opinion of a psychotherapist) - video
Hypnosis and cognitive behavioral therapy in the treatment of panic attacks - video
How to get rid of panic attacks: trainings, forums, traditional medicine, homeopathy - video
Gestalt therapy in the treatment of panic attacks: a diagram of the development and relief of a panic attack - video
Actions during a panic attack: proper breathing technique (recommendations of a psychotherapist) - video
How to calm down during a panic attack: muscle relaxation, pressure on the eyeball, ear massage - video
Help with a panic attack: immersion psychotherapy, help from family. Treatment of PA in pregnant women - video
Drugs for panic attacks: sedatives, adrenergic blockers, antidepressants, tranquilizers - video
How to cope with a panic attack on your own in the subway, while driving, in an elevator, in the workplace (recommendations from a psychotherapist) - video
Lifestyle during panic attacks
If you have attacks in transport, sit in the direction of travel, preferably by a window or closer to the door. While traveling, it is useful to do breathing practices. If panic attacks occur when you get motion sickness, take medications that help cope with this symptom on trips and travels.Spontaneous panic attacks cannot be prevented by leading a certain lifestyle. Treatment is needed.
Can seizures return after treatment?
According to statistics, with proper treatment, 80% of patients experience therapeutic remission - they understand how to manage their condition, and they no longer have attacks. 20% get disappointed when they don’t find help and continue to look for “their own method.”How to stop and prevent the development of a panic attack (doctor's advice) - video
Panic attacks in teenagers
During puberty, the risk of panic attacks is increased for two reasons: - Hormonal changes occur in the body of a teenager. In boys and girls who have hypersensitivity and sensitivity, this can lead to violent internal reactions.
- The appearance of a teenager changes. Many people at this age begin to experience self-dislike, psychological complexes, and internal conflicts arise.
Panic attacks in children
IN childhood Panic attacks are most often situational. Children are especially susceptible to insults, humiliation, pain, and insult. Emotional upheavals in childhood leave a deep imprint on a person’s entire subsequent life.The child cannot explain what is happening to him, but changes in his behavior can be noticed. He avoids certain places and situations, withdraws, and it is clear that in certain situations he experiences discomfort. In order to notice violations in time, parents and close relatives must be sensitive.
Measures to combat panic attacks in childhood:
- Creating a favorable atmosphere in the family. Parents should show their child their love.
- Play therapy: they try to switch the child’s attention to those activities that he likes.
- Dolphin therapy - indications and contraindications, benefits for children with cerebral palsy and autism, treatment of various pathologies and disorders, rehabilitation, how sessions are performed. Dolphin therapy in Moscow, Sochi, Evpatoria and other cities
Definition of disease. Causes of the disease
Panic attacks are sudden episodes of intense fear accompanied by palpitations, sweating, trembling, shortness of breath, numbness, or a feeling that something terrible is about to happen.
As a rule, symptoms manifest themselves maximally within a few minutes, on average up to half an hour, but can take from several seconds to an hour. Panic attacks do not pose any physical danger.
The causes of panic attacks are mental disorders (panic, social anxiety, post-traumatic), drug and alcohol abuse (the most common side effect of smoking marijuana, noted in 20-30% of cases). , cessation of use or a significant reduction in the dose of the substance (antidepressant withdrawal syndrome). Risk factors include smoking and psychological stress.
The main difference between panic disorder and other types of anxiety disorders is its sudden and unprovoked nature. Panic attacks experienced by people with panic disorder may also be associated with or intensified by certain places or situations, making daily life difficult. A person develops irrational fears (phobias), and as a result, a stable scenario of avoiding such situations is formed. Eventually, the avoidance pattern and level of worry about having another attack can escalate to the point where people are unable to move or even leave the house. When panic attacks occur repeatedly, severe anxiety that this situation will recur.
Short-term triggers for triggering a panic attack include the loss of a loved one, including emotional attachment to a romantic partner, crises, or significant life changes. Associating certain situations with panic attacks may create a cognitive or behavioral predisposition to such conditions.
Panic attacks usually begin early, although they can occur at any age. In adolescents, this may be partly due to puberty. Panic attacks are most common in women and people with above average intelligence.
When found similar symptoms consult your doctor. Do not self-medicate - it is dangerous for your health!
Symptoms of panic attacks
A panic attack is a reaction of the sympathetic nervous system. Manifested by tremors, shortness of breath, tachycardia, chest pain (or chest tightness), chills or fever, burning (especially in the face or neck), sweating, nausea, dizziness, pallor, hyperventilation, paresthesia (tingling sensations), suffocation , difficulty moving and derealization. These physical symptoms cause anxiety in people who are prone to panic attacks. This causes anxiety to build and a feedback loop to form. Panic attacks are often characterized by fear of death or a heart attack, weakness or numbness throughout the body, and loss of control over the body.
Often the cause of shortness of breath and chest pain are the predominant symptoms, which during a panic attack can be misinterpreted as a heart attack and a reason to seek emergency help.
Pathogenesis of panic attacks
During a panic attack, there is often a sudden feeling of fear. This leads to the release of adrenaline, which causes a response as the body prepares for a stressful physical activity. There is an increase in heart rate (tachycardia), hyperventilation, manifested by shortness of breath and sweating. Hyperventilation causes the level of carbon dioxide in the lungs and then in the blood to decrease. This leads to a shift in blood pH (respiratory alkalosis, or hypocapnia), causing compensatory metabolic acidosis, activating chemisorption mechanisms that translate this pH shift into autonomic and respiratory responses. A person himself may overlook hyperventilation, paying attention to somatic symptoms.
Moreover, this hypocapnia and the release of adrenaline during a panic attack causes vasoconstriction, resulting in slightly less blood flow to the brain, which causes dizziness. A panic attack can cause your blood glucose levels to rise. Neuroimaging suggests increased activity in the areas of the amygdala, thalamus, hypothalamus, parabrachial nucleus and Locus coeruleus. In particular, the amygdala is thought to play an important role. The combination of high arousal in the amygdala and brainstem, along with decreased blood flow and blood sugar, can lead to dramatically reduced activity in the prefrontal cortex.
The neuroanatomy of panic disorder is largely similar to that of most anxiety disorders. Neuropsychological, neurosurgical, and neuroimaging studies have identified the role of the amygdala, hippocampus, and lateral prefrontal cortex in panic attacks. During acute attacks panic, most studies find increased blood flow or metabolism. Hippocampal hyperactivity was observed during rest and viewing emotionally charged images, which was hypothesized to be associated with memory bias toward distressing memories.
Some panic disorder researchers suggest that it is caused by a chemical imbalance in the limbic system and one of its regulatory chemical substances GABA-A. Reduced production of GABA-A sends false information to the amygdala, which regulates the stress response mechanism and, in turn, causes physiological symptoms which lead to frustration.
Classification and stages of development of panic attacks
Because panic attacks are key to the diagnosis of panic disorder, they are well defined and quite specific.
Panic attacks are classified into three categories :
- situationally tied/bound;
- situationally predisposed;
- unexpected/unrelated.
Can be simplified into two very clear categories:
- expected;
- unexpected panic attacks.
Anticipated panic attacks are those that are associated with a specific fear (such as flying). Unexpected panic attacks have no visible trigger or may appear unexpectedly.
Complications of panic attacks
Panic attacks provoke 2 types of consequences.
Psychological and social:
- fear of repeated attacks and their subconscious expectation;
- restriction of movement;
- fear of loneliness;
- avoiding noisy crowded places;
- fear of going far from home;
- fear of being in places where medical care is not available.
Therapeutic:
- depressive symptoms;
- impaired ability to concentrate;
- loss of interest in life;
- loss of ability to work, disability, complications in personal and family life(in severe cases).
Diagnosis of panic attacks
Diagnostic criteria require sudden, recurrent episodes of panic attacks, at least a month after a significant and associated change in the person's behavior, persistent concern about the episode of a new attack.
ICD-10 diagnostic criteria: An essential feature is recurrent attacks of severe anxiety (panic) that are not limited to any specific situation or set of circumstances and are therefore unpredictable.
The main symptoms are:
- sudden onset;
- heartbeat;
- chest pain;
- suffocation;
- dizziness;
- feelings of unreality (depersonalization or derealization);
- fear of death, losing control or going crazy.
Panic disorder should not be listed as the primary diagnosis if the person has a depressive disorder at the time of the onset of the attacks; in these circumstances, panic attacks are likely secondary to depression. Also used for diagnosis is the Panic Disorder Severity Scale (PDSS), which is a questionnaire that measures the severity of panic disorder.
It is important to note that the diagnosis of panic disorder must rule out other potential causes of panic attacks. These attacks must not be associated with direct physiological effects of the substance (such as drug use or medication) or general condition health, social phobia or other types of phobias, obsessive-compulsive disorder, post-traumatic stress disorder or anxiety disorder.
Treatment of panic attacks
Treatment for panic attacks should be aimed at eliminating the underlying cause.
Panic disorder can be effectively treated with a variety of interventions, including psychological therapy and drug treatment. The effectiveness of cognitive behavioral therapy in combination with medications containing selective serotonin reuptake inhibitors has been confirmed. The term "anxiolytic" has become almost synonymous with benzodiazepines because these compounds have been the drugs of choice for stress anxiety for almost 40 years.
Breathing exercises. In the vast majority of cases, hyperventilation is associated with worsening the consequences of a panic attack. Breathing exercises help balance oxygen and CO2 levels in the blood. One such exercise is 5-2-5. You need to breathe through the diaphragm for 5 seconds. Once the maximum point of inhalation is reached, the breath is held for 2 seconds, then slowly exhaled for more than 5 seconds. This cycle should be repeated twice and then inhaled “normally” for 5 cycles (1 cycle = 1 inhalation + 1 exhalation).
Most experts agree that a combination of cognitive and behavioral treatments is the best treatment for panic disorder. The first part of therapy is mainly informational; It helps a lot of people to simply understand what panic disorder is and how many others suffer from it. Panic disorder sufferers worry that their panic attacks mean they are "going crazy" or that panicking may cause a heart attack. Cognitive restructuring helps people replace these thoughts with more realistic and positive ones. Drug therapy Helps reduce anxious reactions to external and internal stimuli and reinforce realistic viewing patterns panic symptoms.
In addition, meditation, dietary changes (eliminating caffeine-containing foods, as this can trigger or worsen panic), and aerobic exercise such as running can help treat panic disorder. There is evidence that this releases endorphins and subsequently reduces cortisol (the stress hormone).
Forecast. Prevention
To prevent panic attacks, it is necessary to strengthen the body’s ability to deal with stress:
- get rid of depression, neuroses, stress;
- develop stress resistance;
- lead a correct lifestyle;
- treat somatic diseases;
- monitor your medications (sedatives) , antidepressants, hormonal).
Should be maintained normally mental health, since panic attacks are provoked by chronic emotional stress, anxiety and depression.
Panic attack is an unexplained sudden attack feeling unwell, in which the patient is bothered by a feeling of anxiety, combined with various vegetative symptoms. To define this term, doctors often use a number of other terms: vegetative crisis , VSD with a crisis course , cardioneurosis etc. With panic attacks, clear symptoms appear. Treatment this state must be carried out by a specialist.
How does a panic attack manifest?
Probably every person has experienced an acute, sudden feeling of unreasonable anxiety at least once. Such panic disorders are usually accompanied by sudden onset strong heartbeat, feeling of lightheadedness and trembling in the knees. Such a reaction is normal if a person really reacts to a threat or danger. But if such a condition is observed regularly, then we are talking about a psychoneurological disorder called a panic attack. This pathological condition manifests itself without cause and affects a person in completely different life situations. This can happen in transport or in other places with a large number of people, as well as in confined spaces. Initially, it seems that there are no reasons for such a reaction. According to modern psychologists, panic attacks are observed in approximately 5% of people who live in big cities.
Causes
Experts assure that panic attacks manifest themselves in a person as attacks in response to stressful situations and reflect a kind of internal struggle of consciousness with aggression from the outside world. Another reason why a person is bothered by the symptoms of a panic attack is the presence of certain psychological conflicts that the person cannot recognize and resolve. Of course, people susceptible to such attacks are primarily concerned with questions about whether such disorders are dangerous and how to cope with the manifestations of VSD. There is more than one forum on the Internet where people susceptible to such attacks are looking for an answer on how to get rid of such manifestations.
Most often, panic attacks, which are sometimes defined by doctors as heart attacks, etc., occur in people who have poor protection against the effects of stress due to a lack of norepinephrine . It is these substances that effectively prevent the effects of emotional and physical discomfort on the body. Such people can maintain composure for some time, but when the stress is too strong and prolonged, they are overcome by a wave of panic attacks. Women are more susceptible to such manifestations. Panic attacks often occur during pregnancy, as well as in people who frequently drink alcohol.
Anything can serve as a trigger for a panic attack: stress , emotional fluctuations , lack of sleep . In this case, a panic attack overcomes the patient not at the moment when there is an objective danger, but at usual time. Accordingly, it is difficult for a person to explain to himself what the cause of such nervousness is.
Symptoms
As a rule, the first attack of a panic attack is most pronounced. Nervousness in a person is accompanied by a sharp rise, a pronounced affect. The patient's heart beats rapidly, and sometimes he may even lose consciousness. All subsequent manifestations of panic attacks are less pronounced in most cases.
After the first severe attack, a person should consult a doctor about how to deal with such manifestations. It is advisable to begin treatment of panic attacks immediately after the first cases of neuroses. A specialist will also tell you how to treat the disease and which methods are preferable in an individual case.
People prone to panic attacks tend to have elevated blood pressure during the daytime, which is the period of highest social activity.
Both during the first panic attack and during subsequent attacks, a person experiences pronounced autonomic symptoms : sweating, palpitations, throat pressure, headache, etc. Such an attack lasts about ten to fifteen minutes, but sometimes can last about an hour. After the symptoms subside, the patient feels very weak and depressed.
A panic attack is a separate disease in which a person may not exhibit other symptoms. phobias . Despite this, patients susceptible to such attacks often also experience various emotional and affective disorders. Thus, panic attacks can be combined with Agarophobia (fear of open space), claustrophobic (fear of closed spaces), fear of crowds .
Sometimes panic disorder can be mistaken by a person for other diseases. Such misconceptions are most often present among those who have only recently begun to experience panic attacks. Such attacks are easily confused with manifestations of somatic diseases, with neurological diseases, as well as with some mental disorders.
How to spot a panic attack
There are objective criteria to determine whether a person is truly susceptible to panic attacks. You should accurately assess your condition and determine whether the symptoms described above are occurring, and also make sure that the following points are present.
In people prone to panic attacks, attacks occur suddenly and unexpectedly, with about four attacks per month. During at least one of the attacks, the person feels the fear of another panic attack. During an attack, there is a feeling of unreality of what is happening, the person experiences fear of dying or getting sick. It can be assumed that a person is developing a panic attack if he has at least four of the following symptoms: strong pulse and heartbeat; tremors and chills; sweating; difficulty breathing; painful or difficulty breathing; discomfort in the chest on the left; nausea; and a state close to fainting; a feeling of fear of going crazy or committing an inappropriate act; numbness or tingling in the arms and legs, sudden flashes of cold or heat.
Diagnostics
After a person complains of the symptoms described above, doctors initially conduct all the necessary studies to exclude pathologies of internal organs - blood vessels, brain, etc.
Diagnosis is based on the definition clinical manifestations illness, as well as determining the degree of anxiety of a person. For this purpose, a special scale for assessing panic attacks and anxiety attacks is used.
Treatment
The optimal way to overcome panic attacks today is considered to be a competent combination of drug and non-drug therapy. The doctor adequately assesses the patient’s condition and selects an appropriate antidepressant drug. It should be taken for long period. Sometimes this treatment lasts up to a year. In this way, you can regulate the content in the patient’s body. serotonin And norepinephrine . Modern antidepressants can positively affect the patient’s quality of life without causing unwanted side effects. side effects. A person’s frequency and intensity of attacks decreases, fear disappears, and their general psychological state and mood improve. In addition, patients are prescribed tranquilizers and antipsychotics if necessary. If a patient is diagnosed with a vestibular form of panic attacks, then he is also indicated to take sedative neurometabolic stimulants.
Non-drug therapy methods include psychotherapy sessions and lifestyle changes. It is important that as few stressful situations as possible occur in a person’s life and more positive emotions are observed.
In addition to these methods of treatment for panic attacks, it is sometimes advisable for the patient to undergo some physiotherapeutic procedures. MDM therapy (mesodiencephalic modulation of the cerebral cortex), electrosleep, color therapy, and aromatherapy are practiced. Also sometimes prescribed are reflexology, a course of relaxing massage, physical therapy aimed at relaxation, and later - to increase tone. However, exercises should be moderately intense and dosed, since heavy loads can worsen the patient’s condition.
Auxiliary herbal treatment is also practiced, in which patients are advised to take decoctions of certain herbs every day with a calming effect. You can prepare decoctions of veronica, oregano, nettle, lemon balm, mint, chamomile, hops, etc.
You should also pay attention to nutritional features. It is better to exclude spicy seasonings and foods, strong coffee and tea, and alcoholic drinks from the diet, as they have a stimulating effect on nervous system.
How to reduce the intensity of an attack?
A patient who periodically experiences panic attacks must learn to cope with the situation independently, reducing the severity of the symptoms. Sometimes following simple recommendations can completely prevent the development of a panic attack.
So, initially, a person should always be aware of the fact that a panic attack does not threaten his health. This simple thought, however, is very difficult to comprehend during an attack. But if you try to master this method, then over time you can learn to control your consciousness even during a panic attack.
To stop panic, you need to try to take control of the situation that supposedly threatens the person. A simple paper bag is suitable for this; breathing into it will help you control the functioning of your internal organs with your eyes.
It will also help to have a person next to the patient who is aware of his problems and can help at any time. Even those people who are used to coping with all problems on their own should seek help. A person suffering from panic attacks should at least mentally give himself permission to seek help from other people if necessary, and not consider this rude behavior. You also need to remember that it is always possible to quickly call a doctor.
For a patient who is susceptible to panic attacks, awareness greatly eases the situation: the more he knows about the disease, about ways to overcome it and reduce symptoms, the calmer he will be about its manifestations and behave adequately during attacks.
The doctors
Medicines
Education: Graduated from Rivne State Basic Medical College majoring in Pharmacy. Graduated from Vinnytsia State medical University them. M.I. Pirogov and internship at his base.
Experience: From 2003 to 2013, she worked as a pharmacist and manager of a pharmacy kiosk. She was awarded diplomas and decorations for many years of conscientious work. Articles on medical topics were published in local publications (newspapers) and on various Internet portals.
Comments
If it’s just the beginning, then it can be stopped by quickly taking a sedative with a quick effect. Valocordin maybe (but 30 drops at once). In general, such problems need to be resolved with a specialist, a panic attack is a serious matter, because in an attack you can harm yourself and others
Something unpleasant happened in the family. We invested money in a fashion franchise, but it did not bring any profit, only losses. The store had to be closed and the car sold for debts. After this, three weeks passed, my mother was worried all the time, my father closed in on himself, and I developed an anxiety disorder against the backdrop of what was happening. One evening, when we were already, as usual, gloomily digesting what had happened, each in our own room, I decided that we needed to do something to relieve this terrible state, otherwise we would also lose each other. So we got an appointment with a wonderful psychotherapist who helped us a lot both morally and with a prescription. We went to family psychotherapy sessions and the whole family took Grandaxin. It was this medicine that helped us come to our senses and understand what happened objectively, and not through the prism of our own guilt and anger, which each of us experienced within ourselves. It really became better mentally, we started having dinner together again in the evenings, watching entertaining videos on YouTube, and it also became easier to fall asleep. Good pills help you put your thoughts in order, improve your sleep and generally reconsider your outlook on life with a fresh look. And the car...we'll earn more money, only now we'll do it wisely.
Very useful article. I’m drinking Ciprolex, everything is fine, but... I’m planning on pregnancy, how to stop drinking it, because pregnant women can’t, and if you don’t drink, everything goes back to normal (I tried it)
Panic attack (or episodic paroxysmal anxiety) is a subtype anxiety disorder, which refers to stress-related neurotic level disorders. A panic attack is a well-defined episode of intense anxiety or discomfort that comes on suddenly, peaks within a few minutes, and lasts no more than 10 to 20 minutes.
A characteristic feature is the unpredictability of the occurrence and huge difference between severity subjective feelings and the objective status of the patient. According to modern psychologists, panic attacks are observed in approximately 5% of people who live in big cities.
What is a panic attack?
A panic attack is an unpredictably occurring attack of severe fear or anxiety, combined with a variety of vegetative multiorgan symptoms. During an attack, a combination of several of the following symptoms may occur:
- hyperhidrosis,
- heartbeat,
- labored breathing,
- chills,
- tides,
- fear of madness or death,
- nausea,
- dizziness, etc.
Signs of panic attacks are expressed in attacks of fear that arise completely unpredictably; the individual is also very anxious, she is afraid of dying, and sometimes thinks that she will become crazy. In this case, the person experiences unpleasant symptoms from the physical side of the body. They are unable to explain the reasons and cannot control the timing or severity of the attack.
Step-by-step mechanism for the development of a panic attack:
- release of adrenaline and other catecholamines following stress;
- narrowing of blood vessels;
- increased strength and heart rate;
- increased breathing rate;
- decreased concentration of carbon dioxide in the blood;
- accumulation of lactic acid in peripheral tissues.
Panic attacks are a common condition. Every fifth person suffered from it at least once in their life, and frequent and recurring disorders longer than a year, affects no more than 1% of people. Women are 5 times more likely to get sick, and the peak incidence occurs at the age of 25-35 years. But the attack can occur in a child over 3 years of age, in a teenager, and in people over 60 years of age.
Causes
Today, there are many theories about the occurrence of panic attacks. They affect both physiological and social levels. However, the root cause of a panic attack is considered to be physiological processes occurring in the human body under the influence of stress factors.
The condition can be triggered by any illness, fear, or surgery that the person was worried about. Most often, an attack develops against the background of mental pathologies, but it can also be caused by:
- transferred;
- coronary heart disease;
- mitral valve prolapse;
- childbirth;
- pregnancy;
- the beginning of sexual activity;
- pheochromocytoma (a tumor of the adrenal glands that produces too much adrenaline);
- taking cholecystokinin drugs, glucocorticoid hormones, anabolic steroids.
U healthy people Without bad habits, the appearance of panic attacks usually provokes a psychological conflict. If a person constantly lives in a state of stress, suppressed desire, fear for the future (for children), a feeling of personal inadequacy or failure, this can result in panic disorder.
Besides, predisposition panic attacks have a genetic basis, approximately 15-17% of first-degree relatives have similar symptoms.
In men, panic attacks are much less common. This, according to research findings, is explained by the complex hormonal changes at menstrual cycle. No one will be surprised by the presence of sharp emotional leaps in women. There is a possibility that men are less willing to ask for help due to their feigned masculinity. They would rather turn to drugs or drink to avoid obsessive symptoms.
Risk factors:
- Psychological trauma.
- Chronic stress.
- Disturbed sleep-wake pattern.
- Lack of physical activity.
- Bad habits (drinking alcohol, smoking).
- Psychological conflicts (suppression of desires, complexes, etc.).
Kinds
Modern medicine allows us to combine PA into several groups:
- Spontaneous PAs. They appear without any reason.
- Situational. They are a reaction to a specific situation, for example, a person is afraid of speaking in public or crossing a bridge.
- Conditional situational. They appear in most cases after exposure of the body to stimulants of a biological or chemical nature (drugs, alcohol, hormonal changes).
Symptoms of panic attacks in adults
During a panic attack, severe fear (phobia) arises - fear of losing consciousness, fear of “going crazy,” fear of death. Control over the situation, understanding of the place and time of stay, and sometimes awareness of one’s own personality are lost (derealization and depersonalization).
Panic attacks can plague healthy and optimistic people. At the same time, they occasionally experience attacks of anxiety and fear, which end when they leave the “problematic” situation. But there are other cases when the attacks themselves are not as dangerous as the disease that caused them. For example, panic disorder or severe depression.
Symptoms that most often occur during panic attacks:
- The main symptom that sends an alarm bell to the brain is dizziness. Panic attacks contribute to the release of adrenaline, a person feels the danger of the situation and escalates it even more.
- If this onset of an attack is not overcome, shortness of breath appears, the heart begins to beat rapidly, blood pressure rises, and rapid sweating is observed.
- Throbbing pain in the temples, a state of suffocation, sometimes heart pain, tightness of the diaphragm, poor coordination of movements, a foggy mind, nausea and vomiting, thirst, loss of real time, severe anxiety and a persistent feeling of fear.
Psychological symptoms of PA:
- Confusion or narrowing of consciousness.
- Feeling of a “lump in the throat.”
- Derealization: the feeling that everything around is unreal or is happening somewhere far from the person.
- Depersonalization: the patient’s own actions are perceived as if “from the outside.”
- Fear of death.
- Anxiety about some unknown danger.
- Fear of going crazy or doing something inappropriate (screaming, fainting, throwing yourself at a person, wetting yourself, etc.).
A panic attack is characterized by a sudden, unpredictable onset unrelated to the existence of a real danger, an avalanche-like increase and gradual subsidence of symptoms, and the presence of a post-attack period.
On average, a paroxysm lasts about 15 minutes, but its duration can vary from 10 minutes to 1 hour.
After suffering a panic attack, a person is constantly thinking about what happened and pays attention to his well-being. This behavior can lead to panic attacks in the future.
The frequency of panic attacks in panic disorder can vary: from several per day to several per year. It is noteworthy that attacks can also develop during sleep. So, a person wakes up in the middle of the night in horror and cold sweat, not understanding what is happening to him.
What should a person do during a panic attack?
If control over oneself is maintained and self-control is not lost, then, sensing an approaching attack, the patient needs to try to “distract himself.” There are many ways to do this:
- counting - you can start counting the number of chairs in the hall or seats on the bus, the number of people without headwear in a subway car, etc.;
- singing or reading poetry- try to remember your favorite song and hum it “to yourself”, carry a verse written on a piece of paper in your pocket and start reading it when the attack begins;
- Know and actively use breathing relaxation techniques: deep belly breathing so that the exhalation is slower than the inhalation, use a paper bag or your own palms folded in a boat to eliminate hyperventilation.
- Self-hypnosis techniques: convince yourself that you are relaxed, calm, etc.
- Physical activity: helps get rid of spasms and cramps, relax muscles, eliminate shortness of breath, calm down and take your mind off an attack.
- Make it a habit to massage your palms when panic strikes you by surprise. Press on the membrane that is located between your index finger and thumb. Press down, count to 5, release.
- Help in relaxation can be provided by massage or rubbing certain parts of the body: the ears, neck area, shoulders, as well as the little fingers and the bases of the thumbs on both hands.
- Cold and hot shower . Every 20-30 seconds, you should alternate between dousing with cold and hot water, in order to trigger a response from the hormonal system that will extinguish the anxiety attack. It is necessary to direct water to all parts of the body and head.
- Relax. If the attacks appear against the background of chronic fatigue, it’s time to get some rest. Take a bath with aromatic oils more often, sleep more, go on vacation. Psychologists say that 80% of people are cured in this way.
Often, over time, patients develop a fear of a new attack, they anxiously await it and try to avoid provoking situations. Naturally, such constant tension does not lead to anything good and attacks become more frequent. Without proper treatment such patients often turn into recluses and hypochondriacs who are constantly searching for new symptoms, and they will not fail to appear in such a situation.
Consequences of PA for humans
Among the consequences it should be noted:
- Social isolation;
- The emergence of phobias (including agoraphobia);
- Hypochondria;
- The emergence of problems in personal and professional spheres of life;
- Violation of interpersonal relationships;
- Development of secondary depression;
- The emergence of chemical dependencies.
How to treat panic attacks?
As a rule, after the first panic attack occurs, the patient is sent to a therapist, neurologist, or cardiologist, and each of these specialists does not identify disorders according to their profile. The patient usually sees a psychotherapist, who is needed initially, at the moment when he or she reaches a significant deterioration in the quality of life.
At the appointment, the psychotherapist explains to the patient what exactly is happening to him, revealing the characteristics of the disease, then a selection of tactics for the subsequent management of the disease is made.
The main goal of treating panic attacks is to reduce the number of attacks and alleviate the severity of symptoms. Treatment is always carried out in two directions - medicinal and psychological. Depending on the individual characteristics one of the directions can be used or both at the same time.
Psychotherapy
The ideal option for starting treatment for panic attacks is still considered to be a consultation with a psychotherapist. By considering the problem from a psychiatric perspective, success can be achieved more quickly, since the doctor, having identified the psychogenic origin of the disorders, will prescribe therapy in accordance with the degree of emotional and vegetative disorders.
- Cognitive behavioral therapy is one of the most common treatments for panic attacks. Therapy consists of several steps, the goal of which is to change the patient’s thinking and attitude towards anxiety states. The doctor explains the pattern of panic attacks, which allows the patient to understand the mechanism of the phenomena occurring to him.
- A very popular, relatively new type is neurolinguistic programming. In this case, a special type of conversation is used, the person finds frightening situations and experiences them. He replays them so many times that the fear simply disappears.
- Gestalt therapy is a modern approach to the treatment of panic attacks. The patient analyzes in detail the situations and events that cause him anxiety and discomfort. During treatment, the therapist pushes him to search for solutions and methods for eliminating such situations.
Auxiliary herbal treatment is also practiced, in which patients are advised to take decoctions of certain herbs every day with a calming effect. You can prepare decoctions and infusions from valerian, speedwell, oregano, nettle, lemon balm, mint, wormwood, motherwort, chamomile, hops, etc.
Medications for the treatment of panic attacks
Duration medication course, as a rule, is at least six months. Discontinuation of the drug is possible against the background of complete reduction of anticipatory anxiety, if a panic attack has not been observed for 30-40 days.
For a panic attack, your doctor may prescribe the following medications:
- Sibazon (diazepam, Relanium, Seduxen) relieves feelings of anxiety, general tension, and increased emotional excitability.
- Medazepam (rudotel) is a daytime tranquilizer that relieves panic fears, but does not cause drowsiness.
- Grandaxin (antidepressant) does not have a hypnotic or muscle relaxant effect and is used as a daytime tranquilizer.
- Tazepam, phenazepam - relax muscles, give a moderate sedative effect.
- Zopiclone (Sonnat, Sonex) is a fairly popular mild hypnotic that provides complete healthy sleep within 7-8 hours.
- Antidepressants (mild - amitriptyline, grandaxin, azafen, imizin).
Some of the listed drugs cannot be taken for more than 2-3 weeks, because... possible side effects.
Feelings of anxiety and panic when starting to take certain medications can become stronger. In most cases this is a temporary phenomenon. If you feel that improvement does not occur a few days after starting to take them, be sure to tell your doctor about this.
There are also drugs that are not considered potent, like tranquilizers. They are sold without a prescription, and with their help it is possible to alleviate the patient’s condition in the event of an attack. Among these are:
- medicinal herbs,
- chamomile,
- birch leaves,
- motherwort.
For a patient who is susceptible to panic attacks, awareness greatly eases the situation: the more he knows about the disease, about ways to overcome it and reduce symptoms, the calmer he will be about its manifestations and behave adequately during attacks.
The use of herbal preparations
- To take a medicinal herbal tincture, you can prepare the following mixture: take 100 g of tea rose fruits and chamomile flowers; then 50 g of lemon balm leaves, yarrow, angelica root and St. John's wort; add 20 g each of hop cones, valerian root and peppermint leaves. Brew with boiling water, infuse and drink slightly warm 2 times a day
- Peppermint should be brewed in this way: pour two tablespoons of mint (dry or fresh) with a glass of boiling water. After this you need to insist Mint tea covered for two hours. Then we filter the infusion and drink a glass at a time. To calm the nervous system and treat panic attacks. It is recommended to drink three glasses of mint tea per day.
Prevention
Methods for preventing PA include:
- Physical activity is the best prevention in the fight against panic attacks. The more intense your lifestyle, the less likely you are to experience panic attacks.
- Walking on fresh air- another way to prevent panic attacks. Such walks are very effective and have a long-lasting positive effect.
- Meditation. This method suitable for those who can cope with their habits and perform complex exercises daily;
- Peripheral vision will help you relax, and therefore minimize the risk of a panic attack.
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Frightening panic attacks: methods of relief
Sudden feeling of anxiety and fear of death, feeling as if the heart is jumping out of the chest, lack of air and internal trembling, and most importantly - all this for no apparent reason... This is how a panic attack manifests itself - a condition that brings a lot of inconvenience and affects a person’s quality of life.
What it is
A panic attack is a causeless, debilitating attack of panic or anxiety, accompanied by a feeling of fear and various physiological symptoms.
To understand what a person feels at such moments, imagine the situation. You are walking down the street and suddenly notice that a huge dog is rushing towards you at a frantic pace. There is an ominous grin on his face, his gums are exposed and his sharp, huge fangs are visible. Drool splashes in all directions, and rage and malice are visible in his eyes. How do you feel?
Of course, you will experience incredible fear, you will feel that your heart has stopped, your legs have become weak, and sweat has appeared on your forehead. People experiencing a panic attack feel about the same thing. But there is a colossal difference between you and them: in your case there is real threat life, while there is no objective danger for them. That is, their fears are not supported by anything.
However, this is only at first glance; such individuals can say that the attack began suddenly. In further conversation with them, it turns out that panic was preceded by traveling in an elevator or public transport, being in a place with a large crowd of people or on an airplane, or other similar reasons.
The concept of “panic” originates from the name of the god Pan, the lord of fields, forests and herds. According to legends, he suddenly appeared in front of a person covered in wool and with goat legs, plunging the latter into uncontrollable fear. The man started to run, not knowing where, along the edge of a cliff, not realizing that flight could also threaten death.
In the literature one can find the concepts of vegetative or sympathoadrenal crisis, cardioneurosis. They are identical to the term “panic attack.”
Why does a panic attack happen?
The reasons for this condition have not been fully elucidated. There are many prerequisites and provoking factors that can theoretically cause such a hypertrophied feeling of anxiety.
They are divided into biological, psychological and physiological.
TO biological reasons include:
- hormonal changes during puberty, menopause, childbirth;
- beginning of sexual life;
- menstrual irregularities;
- heredity.
Panic attacks develop against the background of certain disorders:
- pheochromocytoma – hormonal tumor;
- psychosomatic disorders;
- phobias;
- depression;
- post-traumatic stress disorder;
- endocrine diseases;
- heart pathologies.
Among the psychological precursors of the condition are:
- acute stress - death of a loved one, divorce, any negative sudden situation;
- identification or opposition of oneself to any subject - the hero of a film, book, etc.;
- isolation from society;
- character traits;
- childhood experience.
As for character traits, most often panic attacks accompany women with a hysterical, demonstrative personality type. They constantly attract attention and crave recognition. Such women often have an extravagant appearance, are pretentious and very expressive. If they notice that they are not of interest to the “victim,” they very quickly switch to another object.
Men suffering from this disease exhibit traits called “health hypochondria.” They care very much about their own appearance and strive to always look perfect.
Stress experienced in childhood also contributes to the development of attacks of fear already at a conscious age. One of common reasons alcoholism develops in the family, provoking situations of aggression. It could be a fight, a risk of murder. The situation becomes so acute that they have to flee home, often at night. In this case, fear is fixed, and in adulthood, in similar situations, it is repeated in such an impartial manner, intensified several times.
Another example is families where children grow up in conditions of emotional poverty and coldness. When parents or a parent (if we are talking about a single-parent family) are so passionate about themselves and their work that they simply don’t get around to the child. Or in the case when someone close to you suffers from a serious illness, everything revolves around the sick person, and they simply forget about the child.
Emotional coldness towards a child is present where too great demands are placed on him. At the same time, parents can keep the child under super control, but, at the same time, not show warmth and kindness towards him. Adults raised in such circumstances constantly seek approval and emotional support. Their stress resistance is significantly reduced.
The third model of family behavior is the opposite of the previous one and is based on overprotection of the child. At the same time, his parents are constantly worried about his condition, regarding any situation as potentially dangerous. They control literally all areas of their “blood” and try to accompany him everywhere. By doing this, they support the child’s infantilism, which leads to difficulties in social adaptation.
Constant conflicts in the family develop in a child emotional lability. The inability to influence the situation provokes confidence in one’s helplessness.
Any of the listed models lead to the fact that such a child grows into an adult who is emotionally unstable, insecure, and has difficulty interacting with society. This reduces his resistance to stress, exposing him to all sorts of mental disorders.
In addition to family conflicts, violence experienced in childhood, sexual or physical, contributes to the development of panic attack syndrome.
TO physiological factors, which provoke an attack include abuse of alcoholic beverages and psychostimulants, physical fatigue, weather changes, and excess solar radiation.
The incredibly talented actor Johnny Depp suffers from panic attacks. According to him, since childhood he has experienced anxiety in any non-standard situation. And the choice of his eccentric roles is nothing more than an attempt to hide his essence in front of millions of viewers.
Signs of the syndrome
A panic attack usually develops suddenly. And he can find the patient anywhere, at any time of the day. Its manifestations vary: from an uncontrollable, painful feeling of fear and anxiety to internal discomfort. Panic attack with faint severe symptoms called “panic without panic.” In this case, physiological symptoms dominate.
The duration of the attack may be only a few minutes, in other cases it lasts several hours. But on average its duration is 20–30 minutes. PAs are repeated in one situation 1–2 times a day, in others – several times a month. Having experienced such sensations for the first time, a person retains the memory of them for the rest of his life.
There is an incredible accident when a patient experiences attacks only a couple of times in his entire life. They disappear without a trace, presumably after the stress factor ends.
A panic attack is accompanied by the following symptoms:
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Psychological |
Physiological (vegetative) |
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The first case of a panic attack is expressed by an extremely strong fear of dying. Its power is so powerful that it can drive the patient into a state of passion. In subsequent cases, the feeling of imminent death is transformed into a specific phobia. This could be a fear of going crazy, suffocating, etc.
There are situations when the condition is not accompanied by an anxiety-phobic complex. Emotional symptoms come to the fore: apathy, a feeling of uselessness, aggression, nervousness.
After a paroxysm, patients feel exhausted and overwhelmed.
Panic attacks most often occur between the ages of 25 and 50. Approximately 5% of humanity suffers from the pathology. And what’s interesting is that mostly residents major cities. In old age, such paroxysms occur rarely, have an erased character and become remnants of attacks that occurred in youth. 
Those who have experienced a similar condition at least once in their lives describe it with horror and excitement.
For example, a girl had an attack while she was driving in a car with her husband and child. There was a feeling of lack of air, an unreal horror ran through from head to toe. In an instant there was a desire to open the door and jump out of the salon. The busy highway held me back.
Another patient was seized with fear when certain sounds appeared. I felt a nasty tingling sensation in my palms. Excitement sets in, causing your thoughts to become confused and your tongue to be taken away.
A woman described her husband experiencing a panic attack while they were walking in the park and talking about a relative who had recently had a heart attack. She noticed that her husband's arms and shoulders suddenly began to shake. He was covered in sweat, it was even dripping. His face turned pale, he practically stopped breathing (he couldn’t take a breath), his gaze was wandering and unconscious. The man was sure he was dying. It took almost 2 hours to get home, whereas it usually took 20 minutes. He constantly stopped, sat down on the ground, and the attack repeated.
Development mechanism
No one can reliably explain the pathogenesis of a panic attack. But there is a theory according to which the trigger is negative thoughts when they accidentally visit a person. Their action, akin to an objective threat, provokes the release of adrenaline and similar substances. They constrict blood vessels, causing increased heart rate and breathing. Blood pressure increases, and even in those who, in principle, do not suffer from this, the indicators reach 200 mm Hg. Art.
The amount of carbon dioxide in the blood decreases, and symptoms of hyperventilation, that is, breathing problems, increase. Receptors that cause excitation are stimulated and those responsible for inhibition are blocked. Thus, there is an increase in anxiety and panic symptoms and feelings of fear.
Many patients suffering from this disease are very afraid of losing consciousness. But in a panic crisis this is unlikely. All its development mechanisms indicate the opposite. In this state it is activated unconditioned reflex“fight or flight” that accompanies a frightening situation. In addition, high blood pressure and intense heartbeat simply will not allow you to do this.
Fear of fainting causes the patient to experience numbness in the limbs and dizziness. They are what confuse you.
Night PA
A panic attack can strike a person at any moment, even at night. At night, in silence and in the dark, when the patient has nothing to distract himself with, he concentrates on his thoughts of a varied nature, including negative ones.
Another reason is nightmares. But do not confuse the attack itself with a terrifying dream. Paroxysm develops after a nightmare has been seen. And it cannot be forgotten, unlike a dream.
If we are talking about panic attacks of falling asleep, then they most often occur between 00.00–4.00 in the morning. The attack can also awaken its victim in the middle of sleep.
Nighttime PA significantly undermines human health. He suffers from sleep disorders, usually insomnia or problems falling asleep.
Insufficient rest at night provokes headache, chronic fatigue during the day. The patient's productive activity decreases. He becomes nervous and irritable. The mood becomes depressive.
The symptoms of night attacks repeat the typical manifestations of the condition and also contribute to the development of phobias. So, after the death of her father, the girl began to have panic attacks. She noted that she experienced respiratory spasms at night. Often the thought appeared that he might not wake up. She even asked her friends to call in the morning to check if she was alive.
If a person, during a paroxysm at night, feels disconnected from reality and does not understand what is happening to him, then this feeling persists during the day. An exhausted nervous system that did not have time to recover overnight does not perceive objective reality. The patient does not understand who he is and what is happening to him.
A panic attack of awakening occurs early in the morning. The patient wakes up from a sudden and overwhelming feeling of anxiety. Gradually, other symptoms join in. It is natural that more to a person unable to sleep, and feeling exhausted and unrested.
How to recognize the disease
Panic attacks, given the variety of its somatic symptoms, can masquerade as various organ diseases.
Most often, the patient feels like he is having a heart attack. Discomfort in the heart area is one of the most common phenomena among “alarmists”. They feel pain and tingling in the chest on the left side, palpitations. A pressing feeling appears, the heart seems to stop. But a regular ECG, echocardiography, ultrasound of the heart, 24-hour ECG and blood pressure monitoring can help rule out heart disease.
As for tachycardia, it is indeed present. But the reason for this is the activation of the sympathetic nervous system as a result of stress.
Another common condition that patients suspect is a stroke. Headaches, increased blood pressure, paresthesia in the form of tingling in the limbs, as well as changes in gait confuse him. The person gets very scared and even calls an ambulance.
The unrealistic fear that accompanies a patient with an attack separates him from reality. A person gets lost in space and does not perceive his surroundings. He fears that he will lose control of himself and do something unacceptable. He feels like he's going crazy. Because of this, such patients often fear that they are developing a mental disorder. Although mental problems can indeed appear. They are the result of a disorder.
Increased concern about one's health causes such a patient to develop hypochondria. He constantly visits all kinds of doctors, takes a whole bunch of tests. When specialists try to explain to him that the cause of his bodily discomfort is more psychological than physiological, they become irritated. And they go to another doctor in the hope that he will help them and get to the bottom of it.
Against the background of the disorder, depressive thoughts appear, since the person is really seriously concerned about his condition and does not know how to help himself.
Agoraphobia is a fear of open spaces or a specific place, literally “fear of the market square” can also become a complication of a panic attack. If the patient associates its occurrence with a certain place, then in the future he will avoid visiting it. A person may even be afraid to leave the house so as not to experience this painful feeling again.
Continuous, complicated attacks of PA can develop into panic disorder. To establish a diagnosis, the following criteria must be present:
An important symptom of panic disorder is the constant anticipation of the next attack. In addition, the absence of the influence of psychostimulants (drugs, alcohol) is taken into account. Phobias and obsessive-compulsive disorder are excluded.
To confirm that the patient is really experiencing an attack of PA, and is not suffering from some real disease of the internal organs, the doctor is obliged to prescribe a series of examinations:
- ECG, ECG – monitoring; EEG;
- Ultrasound of the heart and other organs;
- radiography;
- CT, MRI;
- stomach examinations;
- blood test: CBC, liver tests, hormones:
- consultation of narrow specialists.
help yourself
At the moment when you are overtaken by an attack, it is very difficult to control yourself. But you can try to pull yourself together and help yourself get rid of it quickly:
- Go out into the fresh air or open the windows, unbutton tight clothes. Pour cool water over your face.
- It is important to switch to breathing. Try to breathe deeply, slowly and full breasts. To increase the level of carbon dioxide in the blood, breathe into a bag or cupped palms (imitate the position of breathing into them, trying to warm them up).
- Try to think about something positive or talk to someone. Try counting to 100 or count passing cars or trees if fear catches you in transport or on the street. All this helps to shift attention away from anxious feelings. If the cause of alarm is a certain place, hurry to leave it.
- To stabilize your body, place your hands on a stable surface or press your feet into the floor. This position will give you a feeling of confidence and control.
- Keep telling yourself that this will all end now. The anxiety that arises will not harm you, it is simply a figment of your imagination.
If you witness an attack on someone, you can help the person cope with the problem. The main thing: do not panic yourself! You must be calm. And with your calmness set an example for him.
Talk to him, hug him on the shoulder or squeeze his hand. Show me how to breathe correctly. If conditions permit, give the person water or warm tea.
The main thing is not to get confused in this situation. Remember, your behavior can significantly alleviate the panicker’s condition.
How to eradicate the disease
Treatment for PA begins with acknowledging the condition and realizing that the person truly needs medical help. After consulting a doctor and ruling out real diseases, he can prescribe a consultation with a neurologist, psychologist or psychiatrist.
Therapy for the condition combines medication and psychotherapy.
Medicines prescribed:
- Sedatives. They are quite effective, but only if mild degree attack. They are based on herbs and have a low concentration of active substances. Tinctures begin to act faster than tablet forms.
- Antidepressants (serotonin reuptake inhibitors) for 6 months.
- Tranquilizers. They exhibit several effects: anti-anxiety, sedative, hypnotic, anticonvulsant, antispasmodic, vegetative stabilizing, eliminate fear. The course of treatment is 2 weeks, no more, so as not to cause addiction.
- Neuroleptics. Used as additional therapy. Filming psychomotor agitation, eliminate fear, reduce sensitivity to irritants.
- Nootropic drugs. They stimulate the central nervous system and activate mental activity. Improves cognitive functions: memory, attention. Prescribed in combination with the main therapy.
Of the methods of psychotherapy, cognitive behavioral therapy is the most effective. During her sessions, the therapist will help her client recreate the symptoms of PA in a safe environment, and after a while they will not seem so threatening to the person. The fear of being in a certain situation or place can also be overcome.
In addition, the patient will be able to understand the causes of his anxiety and fears and learn to control them. For example, it may happen that a patient receives a so-called secondary benefit from his condition. That is, the subconscious deliberately performs such tricks in order not to work, to attract attention, to receive care, etc. There can be a lot of reasons.
In addition to cognitive behavioral therapy, family therapy and psychoanalysis are also used.
Both methods, both drug treatment and psychotherapy, are effective in their own way. The earlier treatment for panic attacks is started, the greater the likelihood of getting rid of them once and for all.
There are some tricks that will reduce the frequency of attacks, becoming a kind of prevention of the process. First, avoid taking substances that excite the nervous system: strong tea, coffee, alcohol, drugs. Secondly, it is necessary to harmonize your nervous system, normalize your daily routine: get enough sleep, exercise, walk in the fresh air, eat right. Attend support groups designed for people with this type of disorder.
Last but most important, follow the treatment prescribed by your doctor.
Panic attacks will not cause you to die, but they will significantly distort your existence. Most effective method combat them - early, timely treatment. You should not put it off, trying to overcome the disease on your own. Such attempts will only aggravate the process, transforming it into deeper and more severe disorders.
