2024 Author: Harry Day | [email protected]. Last modified: 2023-12-17 15:43
What is Panic and Panic Attack?
The word "panic" takes its origin from the name of the ancient Greek god Pan. According to myths, the unexpected appearance of Pan caused such horror that the man "headlong" rushed to run, not making out the road, not realizing that the flight itself could threaten him with death. The concepts of suddenness and unexpectedness of the onset of an attack, perhaps, are of fundamental importance for understanding the origin (pathogenesis) of a panic attack. Sigmund Freud at the end of the last century describes "anxiety attacks" in which a sudden anxiety was not provoked by any ideas, and was accompanied by disturbances in breathing, cardiac activity and other bodily functions. Similar states were described by Freud in terms of "anxiety neurosis" or "anxiety neurosis".
Panic attack (PA) is a common anxiety disorder in which there is a sudden onslaught of intense fear or horror (panic attack) accompanied by physical symptoms such as shortness of breath, dizziness, heart palpitations, chest pain, tingling (mainly in the limbs), trembling, sweating, and feeling unreality of what is happening.
Domestic doctors have long used and are now using the terms "vegetative crisis", "sympathoadrenal crisis", "cardioneurosis", "VVD (vegetative vascular dystonia) with a crisis course", "NCD - neurocirculatory dystonia", reflecting ideas about disorders of the autonomic nervous system.
The terms "panic attack" and "panic disorder" are recognized worldwide by the American Psychiatric Association's classification. Members of this Association in 1980 proposed a new guideline for the diagnosis of mental illness - DSM-III-R, which was based on specific, mainly phenomenological criteria.
How is panic attack diagnosed?
A panic attack is characterized by an attack of fear, panic, or anxiety and / or a feeling of inner tension combined with 4 or more symptoms:
- Throbbing, palpitations, rapid pulse.
- Sweating.
- Chills, tremors, feeling of inner trembling.
- Feeling of lack of air, 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 committing an uncontrollable act.
- Fear of death.
- Feeling of numbness or tingling (paresthesia) in the limbs.
- Feeling of heat or cold waves passing through the body.
There are other symptoms, such as: abdominal pain, upset stool, increased urination, lumpy sensation in the throat, gait disturbance, impaired vision or hearing, cramps in the arms or legs, and movement disorders. The onset of a panic attack is not due to the direct physiological effect of any substances (for example, drug dependence or medication) or somatic diseases (for example, thyrotoxicosis).
Thoughts that accompany the PA: “I’m losing control,” “I’m going crazy,” “I’m starting a heart attack,” “I’m dying,” “something unpleasant will happen to me now, and I will not be able to keep some physiological functions.
During an attack, there is always a strong anxiety, the intensity of which can vary from a pronounced state of panic to a feeling of internal tension. In the latter case, when the vegetative (somatic) component comes to the fore, they speak of a “non-insurance” panic attack or “panic without panic”. Attacks usually last only a few minutes and rarely last more than one hour. The frequency of attacks is from several a day to 1 - 2 times a month. Most people talk about surprise (that is, nothing foreshadowed it) attacks. However, observations make it possible to identify, along with unexpected attacks, attacks that occur in any "threatening" situation.
Such a situation can be a trip in transport, being in a crowd or confined space, going outside your own apartment, etc. A person who first encounters this condition is very frightened, begins to think about any serious disease of the heart, endocrine or nervous system, digestion problem, can call an ambulance. Begins to visit doctors to identify possible causes of "seizures". People think that these are manifestations of a disease, and seek advice from various specialists (therapists, cardiologists, neuropathologists, gastroenterologists, endocrinologists), undergo diagnostics and may conclude that they have some kind of complex, unique disease.
Such incorrect ideas of a person about the essence of the disease can lead to the so-called hypochondriac syndrome, i.e. to the conviction in the presence of a serious illness, which leads to a worsening of the condition and aggravates the course of the disease. Doctors, as a rule, do not find anything serious, at best they can recommend visiting a psychotherapist, or they begin to treat imaginary diseases (for example, vegetative-vascular dystonia), and sometimes they just shrug their shoulders and give "banal" advice to change your lifestyle, get more rest, more to be on the street, to play sports, not to be nervous, to drink soothing, vitamins.
But, unfortunately, the matter is not limited to attacks … The first attacks leave an indelible mark in the memory of a person, which leads to the appearance of an anxiety syndrome of "waiting" for an attack, which in turn reinforces the recurrence of attacks. Repetition of attacks in similar situations (traveling in transport, being in a crowd, etc.) contributes to the formation of avoidant behavior, i.e. a person avoids places and situations that are potentially dangerous for him. Anxiety that an attack may happen in a certain place (situation) and avoidance of such a place (situation) is called agoraphobia. The increase in the symptoms of agoraphobia leads to social maladjustment of a person. Due to attacks of fear, a person is not able to leave the house or remain alone, condemning himself to house arrest, thereby becoming a burden for loved ones. Reactive depression can also join these symptoms, especially if a person cannot understand what is happening to him for a long time, does not find help, support, does not receive relief. The main methods of treating panic attacks are psychotherapy and psychopharmacology. From the point of view of psychotherapy, the main cause of panic disorder is considered to be repressed psychological conflicts that do not find a way out, cannot be realized and accepted by a person due to various reasons. With the help of a psychotherapist, you can understand a psychological problem, see ways to solve it, work out a psychological conflict. In ICD-10, Panic Disorder is located in the Mental and Behavioral Disorders class and has the code F41.0. Panic attacks are more common during times of stress.
How to help yourself if a panic attack has begun
During an attack, a person is seized by the fear of death, or the fear of going crazy and committing uncontrollable actions and deeds. The body responds to panic with stressful symptoms, including rapid heart rate and breathing, blood flow, weakness, and dizziness. 10 rules for dealing with panic attacks
- remember, that feeling anxious is an exaggerated normal reaction Your body to stress. Take a note of such thoughts (or write them down on a piece of paper and carry with you) and repeat them "Nobody dies from a panic attack", "I'm fine, it's just a panic attack. I know it's not a heart attack and I am not in danger of death or insanity. It will end quickly."
- This condition does not harm you or worsen your medical condition seriously or permanently. Take a note of such thoughts (or write them down on a piece of paper and carry with you) and repeat them "Nobody dies from a panic attack", "I'm fine, it's just a panic attack. I know it's not a heart attack and I am not in danger of death or insanity. It will end quickly."
- Notice what's going on in your body. Stay here and now. Do not think about what will happen, it will not help you. What is happening at the moment matters. Consider the here and now.
- Accept your feelings, let them flow through you wave, so they leave faster.
- Control the level of anxiety. Imagine a scale from 0 to 10 and watch your anxiety decrease.
- Breathe in and out slowly and deeply. In a stressful situation, a person's breathing becomes shallow, and breaths are short, frequent, shallow, which leads to hyperventilation of the lungs. This, in the first place, can provoke the onset of panic. You need to pay attention to your breathing and get it under control. We begin to breathe deeply "inhale-exhale" in such a way as to achieve a calming effect, namely, inhale shorter, exhale longer and pause after it. According to physiologists, "inhalation is associated with the excitation of the nervous system, and exhalation is associated with its inhibition." Next, we lengthen the exhalation until it becomes twice as long as the inhalation, and then we lengthen the pause.
- Stay in the situation where the symptoms started (10 minutes), otherwise it will be more difficult to cope with the symptoms in the future.
- Deliberately relax your tense muscles. Feel the relaxation.
- Concentrate on what you were doing before the attack.
PA psychotherapy
PA symptoms can be triggered during periods of stress. If nothing terrible is happening around you, and you suddenly begin to experience physiological symptoms that are intensified by thoughts, then these are symptoms of past unliving fear. In order to seriously delay and reduce these symptoms, you will, of course, have to undergo in-depth psychotherapy.
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