Panic Attacks: Causes, Symptoms and Treatment

Panic attack is a sudden onset of severe anxiety, which lasts for a short time and is accompanied by vegetative manifestations. Panic attack is a neurotic disorder provoked by a psychotrauma. A characteristic feature is the unpredictability of occurrence and a huge difference between the severity of subjective sensations and the objective status of the patient. Similar states are developing in statistics in 4-5% of the world's population, but there is evidence that every 10th inhabitant of our planet encountered a panic attack at least once in his life. About the causes, symptoms and methods of treatment of panic attacks, we'll talk in this article.

Causes

Expressed emotional experiences and various conflict situations can lead to the development of panic attacks in predisposed persons.

The first panic attack always develops under the influence of a stressful situation (conflicts in the family, problems at work, information about the illness of a loved one, examination, public speaking, etc.). Those. the main cause of this condition is overexertion of the body. Subsequent attacks no longer have any direct connection with external influences and often develop without a provoking factor. But we all live in conditions of almost constant stress, but panic attacks do not develop in most people. What is the reason?

The fact is that for the development of panic attacks a special "background" in the nervous system is needed. Here this "background" can be:

• hereditary predisposition;
• biochemical disorders in the metabolism in the nervous system, in particular the imbalance of the mediators of serotonin and norepinephrine;
• transferred in childhood mental trauma (physical abuse, fear of school, alcoholism of parents, quarrels in the presence of children, etc.);
• abuse of coffee and other stimulants (including energy drinks);
• psychological features of the individual - anxiety, suspiciousness, suggestibility, the need for increased attention, excessive fixation on their sensations.
• It is noted that panic attacks are 2 times more common in women. For both sexes, the risk of development is higher in adolescence and during adolescence.
• Provoke the development of panic attacks may excessive consumption of alcohol, lack of sleep, physical overload.

How does a panic attack develop?

Under stress, the brain commands a general "mobilization". In the body, the adrenal glands secrete hormones that promote the rapid growth of respiration and palpitations, increase arterial pressure, acceleration of metabolism, increased muscle tone, increased sweating. These physiological measures help the body cope with a stressful situation. This is normal, when the "danger" really is. In a panic attack, the hormones released by the adrenal glands are carried out without a real threat to the body. Subconsciously there is a feeling that the reaction of the organism in its severity does not correspond to the force of the causative factor (ie, the organism "overstrains the stick"). It begins to search for the cause of the condition that has arisen, usually it is not, resulting in fear and anxiety, vegetative reactions. Fear promotes the repeated release of hormones, and so the "vicious circle" is formed. All this happens in a matter of seconds. With the depletion of hormones, the "vicious circle" is interrupted, and the person calms down.

Symptoms

In a panic attack, there arises a pronounced fear (phobia) - a fear of losing consciousness, a fear of "going crazy," a fear of death. Loss of control over the situation, understanding the place and time of finding, sometimes - awareness of one's own personality (derealization and depersonalization). Of course, the severity of such disorders is individual, but there is a tendency to progress as the duration of the panic attack lasts.
In connection with the panic, a person seeks to leave the place of the attack - public transport, metro, tribune, etc. Because the the transferred panic attack leaves an indelible mark in the memory of patients, then there is a secondary fear of recurrence of such a situation. There is a so-called agoraphobia, which aggravates the disease. Because of this, patients avoid places in which they have an attack, stop using public transport, in severe cases do not leave the house at all. Fears accrue like a snowball, and so-called restrictive behavior is formed (when the patient himself sharply limits his living space). However, despite these measures, panic attacks are repeated. There is a risk of depression.
Usually a panic attack develops within a few minutes, lasts an average of 10-30 minutes, sometimes several hours. The frequency varies from one a month to several times a day. As the disease develops, the duration and frequency of attacks increase.
From a vegetative disturbance a panic attack can be accompanied by:

• palpitation or increased heart rate, irregular heart activity, increased blood pressure;
• sweating;
• trembling of limbs (tremor), a feeling of inner trembling;
• dry mouth;
• difficulty breathing (shortness of breath), a feeling of suffocation;
• chest pain, discomfort during breathing;
• nausea, vomiting, increased peristalsis, flatulence, diarrhea;
• dizziness, headache, pre-stupor, unstable standing and walking;
• feeling of heat or cold (chills);
• numbness, tingling sensation, numbness of various parts of the body.

In connection with the occurrence of such feelings at the time of fear, the patient may have an idea about the development of a terrible disease: stroke, heart attack, cancer, etc. That is why patients with a panic attack first of all are sent to therapists, cardiologists, oncologists, gastroenterologists, who, of course, do not find such diseases. But because the situations are repeated, the patients go to other specialists in search of more "competent", in the hope that one of them will "find a terrible disease". And this can continue for a long time until the correct diagnosis is made.
Sometimes people try to cope on their own with such "awkward", in their opinion, problem by using soothing or large doses of alcohol. This is the wrong way. Trying to "pull yourself together", ignoring panic attacks also does not lead to a solution of the problem. A panic attack is a pathological condition requiring treatment by a therapist.

How to help at the time of the panic attack?

If self-control is preserved, and self-control is not lost, then, feeling the approaching attack, the patient should try to "distract". There are many ways to do this:

• account - you can start counting the number of chairs in the hall or seats in the bus, the number of people without a headdress in the subway car, etc .;
• singing or reading poetry - try to remember your favorite song and sing it "about yourself", carry a poem written on a leaf with you in your pocket and begin to read it with the beginning of an attack;
• rituals of prevention - for example, fastening buttons or lacing shoes, changing the ring from one finger to another;
• pain stimulation - pinching under the knee, needle sticking, etc .;
• "Thoughts of the other" - in some cases, helps to imagine yourself in a pleasant environment on vacation (that is, you need to try "Move" to an imaginary place), plan the menu, recall the taste of your favorite food and imagine its absorption, etc .;
• a change in the type of activity - for example, go to a bath, start sweeping, and do needlework. The main thing is that the kind of activity should be ordinary, familiar and calm;
• The respiratory method is a common way of stopping the onset of an attack. Is in slow breathing in a bag or folded together and pressed tightly to the face of the palm, you can try to breathe "belly" or on the account (by , ,3 - inhalation, , ,6 - exhalation).

These simple, seemingly ridiculous, at first glance, ways, can prevent or alleviate a panic attack. You should not call a family member at the beginning of an attack (thereby increasing panic), try to calculate the pulse or heartbeat, measure the temperature. Thus. it is necessary to avoid "fixation" on the condition itself.

Treatment

Treatment of such patients should begin with a conversation with a psychotherapist.

The most effective method of treatment is the combination of psychotherapeutic techniques with the intake of medications.
Among the methods of psychotherapy are successfully used behavioral and cognitive-behavioral psychotherapy, neuro-linguistic programming, methods of suggestion, training in relaxation (relaxation), autogenic training.
Of the medicines currently used:

• selective serotonin reuptake inhibitors - fluoxetine (Prozac) for 10-40 mg per day, paroxetine (paxil) for 5-10-20mg in the morning, sertraline (zoloft, serlift) 50mg in the morning or in the evening, fluvoxamine (fevarin) 50-100mg per day. Start taking medications with a half dose (compared with doses for treating depression);
• benzodiazepines - alprazolam at 0.25 mg 3p / day, maintaining a dose of 1.5-4 mg per day; clonazepam - 0.5 mg 2p / day, maintaining a dose of 1-4 mg per day;
• monoamine oxidase inhibitors - moclobemide (aurorix) the initial dose of 75 mg 3p / d, maintaining a dose of 300-600 mg per day.

The duration of use of most of these drugs is 6-8-12 months.
Such drugs as β-adrenoblockers (anaprilin, atenolol, etc.) can be used to stop the already developed panic attack. This is due to their ability to block the action of adrenaline on the body. But they can not prevent the development of subsequent attacks.

Panic attack - this is hard to tolerate the patient, but not life-threatening condition. Attentive approach, complex treatment, patience and understanding on the part of relatives (including awareness of the problem as a disease) ultimately lead to recovery and return to a full life of all patients suffering from this ailment.