2023-12-21 15:01:58
Panic attacks and disorders…symptoms and treatment
Panic attacks are sudden attacks of intense fear or extreme discomfort that reach their peak within minutes. Panic disorder is diagnosed – according to the criteria of the American Psychiatric Association – when there are recurrent panic attacks and persistent anxiety regarding having attacks. future or its consequences.
Epidemiological studies indicate that the lifetime prevalence of panic attacks ranges between 1.4 and 4.1 percent in the general adult population worldwide.
Panic attacks
On average, panic attacks begin in your mid- to late 20s, although their onset can occur at any time from childhood to late life, and it is thought that panic attacks tend to decrease with age. With increasing age, panic attacks and panic disorder become more difficult to diagnose and treat, perhaps because symptoms differ among older people that are not accurately captured by standard criteria and tools designed for younger adults.
Most cases of late-onset panic attacks are associated with psychiatric and medical comorbidities, which may hinder correct diagnosis. Age-related changes in brain structures, functions, and peripheral physiology can also have an impact on the tendency for autonomic responses, reducing the likelihood of developing the disease among older people.
Because females are exposed to stressful life events early in their lives, they are vulnerable to general psychological disorders and personality disorders in adulthood, youth, and middle age. Psychological and physical comorbidity are frequently observed among patients with panic attacks and disorders.
Depression, substance abuse and dependence, agoraphobia, and suicidal behavior have been reported to be associated with an increased incidence of panic attacks. Certain medical conditions, such as cardiovascular disease or respiratory disease, are also commonly associated with panic disorder.
Despite the evidence, risk factors may have different effects on the likelihood of experiencing panic attacks over the lifespan. For example: hormonal changes or psychological and social stresses in women, throughout their lives, may affect their psychological vulnerability differently. Investigating the different effects of many risk factors during adulthood and late life can help discover potential targets for early detection and prevention.
Regarding the epidemiology of the disease, Dr. Craig N. Sawchuk, a consultant psychologist in Rochester, Minnesota, says that many people have a panic attack only once or twice throughout their lives, and then the problem goes away, perhaps when a stressful situation ends. But if the attacks are repeated and unexpected, and lead to constant fear of having another attack for long periods of time, the condition is diagnosed with panic disorder.
Although panic attacks themselves are not life-threatening, they can be frightening and significantly impact quality of life. But treatment can be very effective.
Symptoms
Panic attacks usually begin suddenly, without warning. It can occur at any time, while driving a car, sleeping, being in a mall, or in the middle of a business meeting. You may experience panic attacks from time to time, or they may occur frequently.
Panic attacks have many forms; But symptoms usually peak within minutes. You may feel exhausted and exhausted following the panic attack subsides.
Panic attacks usually include some of the following signs or symptoms: Feeling of impending doom or danger – Fear of losing control or death – Rapid heart rate – Sweating – Trembling or shaking – Shortness of breath or tightness in the throat – Chills – Hot flashes – Nausea – Spasms In the abdomen – Chest pain – Headache – Dizziness, lightheadedness, or fainting – Numbness or tingling sensation – Feeling unreal or disconnected.
One of the worst things regarding panic attacks is that you are so afraid of having another attack that you avoid certain situations in which one might occur.
You should seek medical help as soon as possible if you experience symptoms of a panic attack. Panic attacks are not dangerous, although they are extremely annoying; But it cannot be treated alone, and it may get worse without treatment. The symptoms of panic attacks are similar to those of other serious health problems, such as a heart attack; That’s why it’s important to get evaluated by a medical care provider.
Causes and risk factors
– Reasons: Research indicates that the body’s natural response of fight or flight in situations in which it is exposed to danger contributes to the occurrence of panic attacks. For example, if you are chased by a bear, your body will respond instinctively, speeding up your heart rate and breathing; As the body prepares to face a life-threatening situation. Many similar responses occur in a panic attack. But it is not known why a panic attack occurs when there is no obvious danger. The following factors may play a role in causing a seizure:
• Genetic genes.
• Extreme stress.
• A mood that is more sensitive to stress or prone to negative emotions.
• Some changes in the way parts of the brain work.
Panic attacks may occur suddenly and without warning, but over time, they are usually triggered by certain situations.
– Risk factors: Panic disorder symptoms often begin in late adolescence or early adulthood, and affect women at a greater rate than men.
Factors that can increase your risk of developing panic attacks or disorder include:
• Family history of panic attacks or disorder.
• Major life stresses, such as the death of a loved one or a serious illness.
• An event that causes trauma, such as a sexual assault or serious accident.
• A history of physical or sexual abuse in childhood.
• Major changes in your life, such as divorce or the birth of another child.
• Smoking or drinking excessive coffee.
Untreated, panic attacks and panic disorder can affect all aspects of life. The person may have a fear of having more panic attacks. He lives in a constant state of fear, which spoils the quality of life he lives.
Complications: Complications that may be caused by or associated with panic attacks include:
• Having specific types of phobias, such as fear of driving or leaving the house.
• Seek frequent medical care for health concerns and other conditions.
• Avoid social situations.
• Problems at work or school.
• Depression, anxiety disorders and other psychological disorders.
• Increased risk of committing suicide or suicidal thoughts.
• Addiction to alcohol or other narcotic substances.
• Financial problems.
In some people, panic disorder may involve agoraphobia, which is the avoidance of places or situations that cause anxiety because of fear of not being able to escape or get help if a panic attack occurs. Or you may depend on others being with you until you can leave the house.
– Prevention: There is no sure way to prevent panic attacks. However, the following recommendations may help:
• Get treatment for panic attacks as soon as possible to avoid the possibility of them getting worse or recurring periodically.
• Adherence to the treatment plan, to avoid relapses or increased severity of symptoms.
• Maintaining physical activities; Because it helps relieve anxiety.
Diagnosis and treatment
Diagnosis: Your primary care provider will determine if the condition is a panic attack, panic disorder or another condition, such as heart or thyroid problems, along with symptoms that resemble panic attacks. To help determine the diagnosis, the following is done:
• Complete physical examination.
• Blood tests to check for possible conditions such as thyroid and others, and perform some tests on the heart, such as electrocardiogram (ECG or EKG).
• A psychological evaluation to talk regarding symptoms, fears, stressful situations, sexual relationship problems, situations you might avoid, and family history. You may need to fill out a psychological self-assessment or questionnaire. You may be asked regarding alcohol or other drug use.
As for the criteria for diagnosing panic disorder, the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) published by the American Psychiatric Association lists the following points for diagnosing panic disorder:
• The presence of frequent and unexpected panic attacks.
• At least one panic attack was followed by a month or more of persistent worry regarding having another attack, or a persistent fear of the consequences of the attack, such as losing control, having a heart attack, “acting crazy,” or having major changes in behavior, Such as avoiding situations that are thought to trigger panic attacks.
• Panic attacks are not caused by drugs or other substance use, medical conditions, or other mental health conditions, such as social phobia or obsessive-compulsive disorder.
– Treatment: Treatment may help reduce the severity and frequency of panic attacks that affect a person and improve his performance in daily life. The primary treatment options are psychotherapy and medications. One or more types of treatment may be suggested, depending on: preference, medical history, severity of panic disorder, and whether there is access to therapists experienced in treating panic disorders.
First – Psychotherapy: Psychotherapy is an effective option in treating panic attacks and panic disorder. Psychotherapy can help you understand panic attacks and panic disorder and learn how to cope with them.
Treatment results can take time and effort to appear. You may begin to feel that the symptoms of panic attacks decrease within several weeks, and the symptoms often decrease significantly or end within several months. You may schedule occasional follow-up visits to help make sure your panic attacks remain under control, or to treat recurrences.
Second – Medications: Medications can help reduce the symptoms associated with panic attacks and depression if you suffer from either of them. A variety of medications have been shown to be effective in calming the symptoms of panic attacks, such as:
• Selective serotonin reuptake inhibitors (SSRIs): SSRIs are usually safe, have few serious side effects, and are the first recommended drug choice for treating panic attacks. The US Food and Drug Administration has approved selective serotonin reuptake inhibitors (SSRIs) as medications to treat panic disorder, which include: Fluoxetine Prozac, Paroxetine Paxil, Pexeva, and Sertraline Zoloft.
• Serotonin and norepinephrine reuptake inhibitors (SNRI): These medications are another class of antidepressants. The US Food and Drug Administration has approved venlafaxine (Effexor
• Benzodiazepines: These tranquilizers depress the central nervous system. The US Food and Drug Administration has approved benzodiazepines such as Alprazolam, Xanax, and Clonazepam Klonopin as a treatment for panic disorder. Benzodiazepines are generally used only short-term; Because it may cause addiction and habituation to it, which leads to physical or mental dependence on it. These medications are not recommended if you have alcohol or drug abuse problems. It may also interact with other drugs, causing serious side effects.
* Community medicine consultant
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