About “self-healing” Panic Attacks

2024 Author: Harry Day | [email protected]. Last modified: 2023-12-17 15:43

I had a completely different note next in line, but over the past 10 days, more than ever, "panic attacks" have come down on me from literally everywhere. In individual consultations, in questions from colleagues and even in the life of loved ones. Questions of diagnosis and causes, help and self-help, prospects and treatment, etc., etc., etc. I am always willing to share information, and it is precisely because this information has become so concentrated that I have noted a number of troubles associated with these stories. I will not beat around the bush and come up with classifications, I will say right away that the notes will focus on the inadequacy of diagnostics and self-treatment of PA.

The general picture can be presented as follows. A person, with a heart rate and breathing of which something unusual and unpleasant has happened (say, a vegetative crisis), immediately goes to the Internet and finds a definition of the very PA, with a list of symptoms that, of course, he has. Then, 90% of the time, he learns:

- that the problem is not a medical one, but a psychological one (and even understands that his reason is personal, if not in a specific psychotrauma, then somewhere close to his perfectionism);

- that drug treatment does not help, but at best only temporarily relieves symptoms;

- that no one has ever died from panic attacks, and there is nothing better than strengthening this attack until it becomes clear that it is not dangerous. The main thing is no avoidance, emergency pills, help from relatives, etc.;

- that if it's not good at all, then you need to think about fishing or count crows, poles, breathe according to the algorithm, and so on.

And in fact, if a person is lucky enough not to get on the forums, in the discussion threads of those suffering from attacks for life, then until the next attack he calmly forgets about everything, and in every possible way discards thoughts about the disease, which is not a disease at all, not dangerous at all, and even more so " self-conceived" etc. All this drags on until he calls the psychotherapist and says: "Help, I can't leave the house!" etc.

And the whole trick is that various kinds of panic disorders and attacks have happened to almost every one of us, at least once in our life. But not all of us are "hooked", because only those who have their own weakness in this place are hooked. But about the weaknesses, let's go in order. And let's start with physiology.

Originally classic an attack of a panic attack may turn out to be not just a mental attack, but a symptom of a real physical illness or frustration / failure:

- respiratory system: an asthmatic attack, pulmonary embolism or exacerbation of other pulmonary diseases;

- of cardio-vascular system: angina pectoris, arrhythmias, hypertension and many others;

- endocrine system: starting from biological hormonal changes during pregnancy, lactation, menopause, menstrual irregularities, due to childbirth and abortion, onset of sexual activity and the like. And ending with hypoglycemia, Cushing's syndrome, thyrotoxicosis, etc.;

- central nervous system: epilepsy, Miniere's disease, hypothalamic syndrome, sleep apnea syndrome and even sluggish schizophrenia.

Also, PA can occur due to excessive physical exertion, alcohol intoxication or abuse of various stimulants, with the abolition of a number of drugs and simply as a side effect of any of them, with weather jumps in meteosensitive patients, etc.

Therefore, the first thing I recommend to do after a "hooked" panic attack is to visit a therapist, neurologist, cardiologist and endocrinologist. Accordingly, to undergo an examination, and only when they say that everything is clean in their profile, we can talk about the independent mental side of the issue. Of course, this does not mean that the disease excludes the presence of an attack, and vice versa. It means that the cause of a panic attack can be quite physiologically provoked, without any psychological tricks, and timely treatment can not only save us from more serious diseases, but also remove the physiological cause that triggers vegetative crisesand with them panic attacks.

There is another physiological side to this process. You may have come across information that many somatic patients (from 55% to 67%) with diabetes mellitus, diseases of the cardiovascular system, gastrointestinal tract and others, have a history of "panic attacks" (i.e. panic disorder). Is the disease itself then a kind of delayed response to suppressing panic attacks, or was it first an unrecognized somatic disorder that provoked this panic? As a specialist in psychosomatics, I cannot say for sure what is primary in this matter. If we take, for example, the same depression associated with PA, then a number of researchers say that at first there was depression, then PA appeared, others, on the contrary, insist that PA provoke depression. And, importantly, everyone provides their own evidence).

But be that as it may, I can give another example. We often say that women with demonstrative personality traits are more susceptible to PA, and men with hypochondriacs. In psychotherapeutic practice, I come across precisely the fact that men are not so much concerned about “finding diseases that do not exist in them”, but simply perceive the work with a psychotherapist as a manifestation of weakness and abnormality … Therefore, they endure to the last, while, no matter how much they ignore the problem, the hormonal imbalance in itself does not dissolve, but, on the contrary, somatizes.

Those. untreated psychological problems provoke excessive or insufficient production of certain hormones, which in turn accumulate in various organs, disabling them. It turns out there is no “disease”, but the organ does not work correctly (tingles, sips, aches, becomes numb, etc.) So doctors find nothing, but patients continue to complain that doctors will call hypochondria, and a psychosomatics specialist is a usual psychosomatic somatoform disorder).

So strong and self-confident men endure and learn to ignore manifestations of weakness in the form of PA, which ends with a real problem already on the physical plane. In turn, it is psychologically easier for many men to come to a psychotherapist for an appointment with the problem of an “incurable disease” or “difficult diagnosis” than to complain of confusion, fears, anxiety, panic, etc. Especially if the therapist is a woman. This is how the same chiefs-cores turn out, with a history of PA and a dispute, heart disease would have happened if he had come to a psychotherapist on time, or heart disease provoked PA and Co.

This is not so unimportant as it might seem at first glance, because at least, if the disease had been recognized in time, then it might not have reached PA with other mental disorders. And most importantly, on the issue of self-help in PA, imagine that a person who has suffered a hypertensive crisis takes him for PA, and after reading articles on the Internet, faced with the next crisis, refuses help and diligently strengthens his PA, how can this end?

Thus, the main thing that is important to understand is that not only a psychological problem can be hidden behind the symptoms of PA. Ignoring PA as a "trick of the imagination" can lead to untimely recognition of more serious diseases, on the one hand, and to the development of very real somatoform disorders and diseases, on the other.

But let's say we underwent an examination and it turned out that everything is in order with our body, and PA is the very psychological symptom that everyone is talking about. Are medications really so useless in PA therapy? Will those self-help recommendations that the Internet is replete with really help, or, on the contrary, will they aggravate the situation? Can we really get rid of PA once and for all by working with a psychologist-psychotherapist? In the next post, I will consider this on real cases from practice.

Continuation Panic attacks, psychological part.