Panic Attacks As A Symptom

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

The topic of panic attacks matured in me after the group supervision in which I took part. The attention and interest in the topic among colleagues surprised me extremely. In this article I will try to tell you why and what I think about PA and PA treatment

Panic attack (PA) or vegetative crisis is an unexplained, painful for the patient, an attack of severe anxiety accompanied by fear, in combination with various vegetative (somatic) symptoms.

Russian-speaking doctors use the terms "vegetative crisis", "sympathoadrenal crisis", "cardioneurosis", "VSD (vegetative vascular dystonia) with a crisis course", "NCD - neurocirculatory dystonia", reflecting ideas about disorders of the autonomic nervous system, depending on the leading symptom. The terms "panic attack" and "panic disorder" have worldwide recognition and are included in the 10th revision of the International Classification of Diseases. At the same time, the presence of panic attacks does not necessarily mean that the patient has panic disorder. Panic attacks can be symptoms of pheochromocytoma, somatoform dysfunctions, phobias, depressive disorders, endocrinological diseases, heart disease, mitochondrial diseases, etc. Or they can occur as a result of taking any drugs (for example, "Erespal"). Wikipedia.

In this article, I am talking only about those PAs that have purely psychological reasons. For clients who do not know what the reason for their PA is, I strongly recommend to undergo an examination, to pass tests in order to exclude another, somatic, hormonal, drug-induced nature of panic.

A panic attack is characterized by an attack of fear, panic, or anxiety and / or a feeling of inner tension combined with four or more of the following symptoms associated with panic:

Palpitations, rapid pulse

Sweating

Chills, tremors, inner tremors

Feeling of shortness of breath, shortness of breath

Choking or shortness of breath

Pain or discomfort in the left side of the chest

Nausea or abdominal discomfort

Feeling dizzy, unsteady, lightheaded, or lightheaded

Feeling of derealization, depersonalization

Fear of going crazy or doing something out of control

· Fear of death

Feeling of numbness or tingling (paresthesia) in the limbs

· Insomnia

Confusion of thoughts (reduced volatility of thinking)

There are other symptoms not included in the list: abdominal pain, upset stool, frequent urination, a lump in the throat, gait disturbance, impaired vision or hearing, cramps in the arms or legs, movement disorder, high blood pressure.

The number of clients with panic attacks has been growing exponentially lately.

Obviously, this phenomenon has its own reasons

An increasingly stressful life increases anxiety, the number of decisions that must be taken is growing rapidly, not everyone is taught to relax and calm themselves. The imbalance within the autonomic nervous system is increasing. Overtrained by constant stress, the sympathetic nervous system is in imbalance with the parasympathetic undertrained.

Now I would like to talk not about the PA itself, but about how to stop an attack, what to do when the PA is approaching, quite a lot has been said about this. I would like to talk about how the client's life leads him to PA, what is a breeding ground for PA and what can be prevention.

If we consider PA as a symptom, then it is obvious that there is something behind this symptom, that this is a symptom of some general unhappiness, a symptom that something is going wrong in the client's life.

How do you make sense of all this?

Clients with PA have some peculiarities. Among them - alexithymia - the inability to understand what you feel and name this feeling; repression and avoidance of problems and conflicts, ignoring body signals in the form of ailments; perfectionism is the desire to be perfect and to do everything perfect. Clients with PA are often very strong people, not whining or whining, as they say about themselves.

Of course, this typing is very conditional, and people who have this problem are different.

The beginning of therapy for clients with PA is a simple conversation with the client about his life, about what this life consists of, what conflicts there are, what resources, what is the client's value system, what concepts he adheres to. Gradually, a picture is formed and an understanding of where the "dog is buried" comes.

The clients themselves, as a rule, ask simply to "cure them of PA" and that's it, they have no other complaints about their lives. In any case, they think so.

Let me give you a recent example from my practice

The client, a young woman, a Muslim woman, mother of 4 children, the youngest of whom is several months old, asked to be relieved of the PA. She began her story by saying that she had a wonderful, hard-working husband, a two-story large house, and her own business. And in general, life is wonderful. Her voice and facial expression spoke of something else.

After an hour of work, the client was able to admit that she did not want to live, again because of the PA … A little later. she said that her husband, hard-working and loving, does not like even the slightest disorder, drops of water on the bathroom floor, scattered things (there are four children in the family!), and other horrors of life. When this happens, he begins to tell his wife that now it is very simple to work on the household - there is a washing machine, a stove, a vacuum cleaner. But before, women plowed in the fields and so on, so on …

Conflict found. Her understanding of herself as an obedient wife and mistress, gleaned from religious concepts and upbringing, does not even give her the opportunity to realize that she is terribly tired. Only during PA can she count on condescension and acceptance, only during PA can she be herself (how strange and scary it sounds).

Often, an attack of panic is the body's only opportunity to shout to the "owner", to draw his attention to the depletion of internal resources, to problems in his life. Sometimes the fact that the life that the client lives is not his life and he is just an extra in it, the performance itself is directed by someone else - the husband, the parents …

For me, as I said at the beginning of the article, the most important thing is not to cling to the symptom, and not to give pain relievers in the form of numerous techniques that will not replace real treatment, although they can be an accompaniment, symptomatic treatment.

Understanding the conflicts in the client's life that lead to PA and the peculiarities of his mental functioning make it possible to reliably and permanently save a person from PA and to establish, harmonize his life.

Although for this you need to do a lot of joint work, rethink and reconfigure your life, learn to feel and talk about your problems, ask for help, and accept it, say "no" when they violate your boundaries.

This work has a lot of its subtleties and its own tools.

I have already talked about some of them in a series of articles: "Technical tools of a practical psychologist."