Panic attack Symptoms, Causes and Treatment - Self-Management Strategies for Panic Disorder

A panic attack is a sudden onset of intense fear that peaks within minutes and triggers severe physical reactions when there is no apparent cause or real danger. 
The panic disorder includes at least four of the following symptoms: Fast or quick heart rate or palpitations, trembling, sweating and sensations of shortness of breath, etc. 
When panic attacks occur, a person may think that he is having a heart attack, losing his control or even dying.
panic attack and panic disorder
Panic Attacks and Panic Disorder: Symptoms, causes, diagnosis, and treatment

Panic Attack and Panic Disorder: Symptoms, Causes, Diagnosis, and Treatment - Self-Management Strategies for Panic Disorder

Panic attack and Panic Disorder

A panic attack is a sudden onset of intense fear that stimulates intense physical reactions while there is no real danger or obvious cause of fear.

 Panic attacks can be very frightening. When panic attacks occur, you may think you are losing control, or have a heart attack or even die.

Many people experience panic attacks only once or twice throughout their lives. When a difficult situation is over, the problem is very clear but if you have frequent and unexpected panic attacks, and spent long periods of time in constant fear of another seizure, you may have a condition called panic disorder.

Panic disorder is a chronic and debilitating psychiatric condition. It is a very common anxiety disorder that many people do not know, even doctors from different disciplines and fields.

The patient suffers from a severe fear of death, wants to stay out of the house, and damages the consciousness of the mind.
The seizures are sudden, repetitive, synchronous, unexpected, coupled with a sense of danger and loss of control over the body or the soul without a real and clear source of danger or fear.

A panic disorder occurs as a result of brain dysfunction in the secretion of some nerve cells.
Although panic attacks themselves are not life-threatening, they can be scary and affect the quality of your life.

Symptoms of Panic Disorder

Panic episodes or panic attacks often occur suddenly, without introductions.
You may be injured at any time - while driving, in the mall, during deep sleep, or in the middle of a work interview.
Panic attacks may occur in certain circumstances or are always repeated.
The panic attacks differ from each other, but all of them peak in a few minutes.
You can feel tired or exhausted after the panic attack.

Panic episodes often include some of the following symptoms:
  • Fear of death or loss of control and consciousness
  • The sense of danger and threat
  • Accelerating heartbeat and increasing its strength
  • Vibration in the left chest muscle due to the intensity and acceleration of the heartbeat.
  • Feeling dizzy, nausea, unbalance, head heaviness and frequent headaches
  • Feeling confusion, anxiety, and tension
  • Feelings of coolness and heat in the human body
  • Feeling weak and numbness and sweating
  • Difficulty breathing or feeling suffocated
  • Gastrointestinal disorders
  • Tremors of the limbs or a sense of trembling
  • Loss of relevance to reality
  • The narrowness of the airway
  • Pain in the chest area
  • Abdominal cramps
One of the worst defects of panic attacks is the constant fear of a new seizure.
Your fear of having a panic attack can avoid many situations that you think will cause you seizures.

What Causes Panic Disorder?

panic disorder
Panic attack and Panic disorder- Symptoms and Causes 

Causes of Panic Disorder

There is no clear cause of panic disorder, but there are a number of factors that make a particular person more susceptible to this disorder.
The most important of these factors are:

Inheritance: The injury of a family member, especially first-degree relatives, increases the risk of panic disorder.
Age: This disease affects people in their early 20s.
Gender: Panic disorder is more common in women than in men.
Other factors: Taking drugs and alcohol increases the incidence of panic disorder, as they do exposure to trauma or stress.
Extreme psychological stress.
The mood is more sensitive to stress or prone to negative emotions.
Specific changes in the way the parts of the brain work.
Panic attacks may start suddenly and without warning, but over time, they are usually caused by certain situations.

In this regard, some research suggests that the body's natural response to resistance or escape, when faced with hazards, contributes to panic attacks.
For example, if the person is subjected to a haunting bear, the body will react instinctively to the situation.

The heart rate and breathing will accelerate as the body prepares itself to face a life-threatening situation.

Many similar reactions occur when a panic attack occurs. However, the causes of panic attacks have not yet been reached despite the absence of clear and present danger.

Risk Factors
Symptoms of panic disorder often begin in late teens or early adulthood and affect women more often than men.

Factors that can increase the risk of panic attacks or panic disorder include:
  • The family history of panic attacks or panic disorder
  • Large life pressures, such as the death of a loved one or serious illness
  • An event that causes trauma, such as sexual assault or serious accident
  • Major changes in your life, such as divorce or the birth of another child
  • Smoking or excessive coffee
  • History of physical or sexual abuse in childhood

Complications of Panic Disorder

Panic attacks and panic disorder can affect almost every area of your life if not treated.
You may be too afraid of more panic attacks to the extent that you live in constant fear, which corrupts the quality of your life.

Complications that may or may be associated with panic attacks include:
  • Specific phobias such as fear of driving or leaving home
  • Frequent medical care about health concerns and other medical conditions
  • Avoid social attitudes
  • Problems at work or school
  • Depression, anxiety disorder and other psychiatric disorders
  • Increase the risk of suicidal thoughts or suicide
  • Overuse of alcohol or other narcotic substances
  • Financial problems
For some people, panic disorder may include phobias - avoiding places or situations that cause you anxiety due to fear of being unable to escape or to get help if you have a panic attack.
Or you may become dependent on others to be with you to leave your home.

Diagnosis of Panic Disorder 

Your doctor or other health care professional should determine if you are experiencing panic attacks, panic disorder, or other conditions such as heart problems or thyroid disorders. 

It is necessary to make sure to check with a specialist; to examine and properly diagnose the condition, to distinguish between the seizure caused by the panic attack and those that have other causes such as thyroid hormone dysfunction, irregular heartbeat, and epilepsy.

To help diagnose, you may need to:

Complete physical examination
Blood tests to check the thyroid gland and other possible assessments and tests on your heart, such as an Echocardiogram (ECG) - (Heart Ultrasound).

A psychological assessment helps you talk about your symptoms, your situations, your fears or concerns, your social relationships, and any other problems that affect your life.

You may fill out a self-assessment or questionnaire. You may ask about drinking or taking drugs.

Diagnostic criteria for panic disorder
Not everyone with panic attacks has panic disorder. In order to diagnose panic disorder, the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), published by the American Psychiatric Association, lists these points:

Experiencing frequent, unexpected panic attacks.
At least one of your episodes has been followed by one or more months of persistent anxiety about another seizure and continued fear of the consequences of seizures, such as loss of control, a heart attack or changes in your behavior.

Panic attacks do not result from drug use or other substance use, medical condition, or other mental health illness, such as a social phobia or obsessive-compulsive disorder.

If you have panic attacks but you do not have a panic disorder that has been diagnosed, you can still benefit from the treatment.

If panic attacks are not treated, they can worsen and develop into panic disorder or phobia.

What is the Most Effective Treatment for Panic Disorder?

Panic attack and Panic disorder
Panic disorder treatment - Psychotherapy and Medication

Treatment of Panic Disorder

Treatment can help reduce the severity and frequency of panic attacks and improve the performance of your functions in your daily life.
The main treatment options are psychotherapy and medication.
One or both types of treatment can be recommended, depending on your preferences, history, panic disorder, and whether you have access to therapists who have undergone special training in panic disorder.

Psychotherapy, also called speech therapy, is the first effective treatment option for panic attacks and panic disorder. Psychotherapy can help you understand panic attacks and panic disorder and learn how to deal with them.

The doctor explains that increased heart rate and shortness of breath are not serious physical symptoms, but psychological symptoms that go away during the period of the seizure and can not lead to death or madness.
It is important to remember these facts during the seizure that can help the patient to overcome and reduce fear.

Treatment results can take time and effort. You may begin to notice symptoms of panic attacks decrease within several weeks, and symptoms often decrease significantly or disappear within several months.

Regular visits may be scheduled to help ensure that panic attacks remain under control or to treat recurrence.

Group therapy: This method has proven to be effective in treating panic disorder and control, by collective treatment of cases of the same disorder, and teaching the mechanisms of seizure control and techniques.

Biological feedback: This treatment depends on making the patient watches or hears what happens to him and his body while learning to relax, and how his body responds when he is relaxed, such as: hearing his heartbeat.

Behavioral cognitive therapy (CBT): Cognitive Behavioral Therapy can help you learn through your own experience that the symptoms of panic are not serious.

CBT modifies and changes the intellectual patterns that cause panic attacks. The patient suffers from malformations in the thoughts that cause him all the suffering he feels.

The therapist and the patient collaborate in individual sessions to modify these ideas and control through the behavioral model of knowledge followed by the patient and can be through the understanding of what is suffering correctly. 

During treatment sessions, the therapist will help you to gradually re-create the symptoms of a panic attack in a safe and repetitive way. When the physical sensations of panic are not threatened, recovery begins.

Successful treatment can help you overcome the fears of situations that you have avoided because of panic attacks.

Relaxation and breathing exercises: Teaching the patient to calm himself through relaxation and breathing exercises may help regulate breathing, overcome and ease the seizure. Relaxation reduces the tension associated with it.

The patient feels self-confident and able to control himself. Breathing exercises calm the symptoms.

The patient and the doctor to talk, determine their expectations for this type of treatment, and inform the patient that he should learn these exercises and exercise daily without interruption; until fully mastered, and can control his fits of panic.

Medicines can help reduce the symptoms associated with panic attacks as well as depression if they cause a problem for you.
Several types of medications have been shown to be effective in controlling the symptoms of panic attacks, including:

Antidepressants: Antidepressants increase the level of serotonin in the human body, controlling the function of the autonomic central nervous system in the body.
In general, doctors recommend different types of antidepressants such as benzodiazepines, common beta-blockers that reduce heart palpitations and chronic panic disorders.

Benzodiazepines: These sedatives are analgesics of the central nervous system. Benzodiazepines may be addictive when ingested for a long time and in large doses in particular.
FDA-approved benzodiazepines include the treatment of the panic disorder.
If you are looking for care in the emergency room for a panic attack, you may be given benzodiazepines to help stop the seizure.
Benzodiazepines are usually generally only used for a short period. Because they can cause addiction, they are not a good option if you have problems with drug and alcohol addiction.
It can also interact with other drugs, causing serious side effects.

Selective serotonin reuptake inhibitors (SSRIs): SSRIs, generally safe with limited risk of serious side effects, are generally recommended as the first choice of drugs to treat panic attacks.
The FDA-approved SSRIs for the treatment of panic disorder include fluoxetine (Prozac), Paroxetine (Paxil, Pexeva) and Sertraline (Zoloft).

Serotonin and Norepinephrine Reuptake Inhibitors (SNRIs): These drugs are another class of antidepressants.
SNRIs such as Effexor XR (venlafaxine hydrochloride) are approved by the Food and Drug Administration (FDA) to treat panic disorder.

If none of these medicines suit you, your doctor may recommend taking another medicine or combining certain medications to enhance their effectiveness.
Keep in mind that it may take several weeks after starting your medication for the first time for symptoms to appear.

Note: All the medication details given here are general information purpose only. We do not recommend any kind of medicines or drugs for self-treatment of panic disorder. 
All drugs have side effects, and may not be recommended in certain cases, such as pregnancy.
Talk to your doctor about possible side effects and risks before taking them.

Self-Management Strategies for Panic Disorder
There is no sure and easy way to prevent panic attacks; they require specialized help to control the difficult situation.
However, there is a set of guidelines and recommendations that may help you overcome attacks in simple cases, including:

Avoid caffeine, alcohol, etc: Stay away from alcohol, drugs, and any of the addictive substances. All of this can trigger or increase panic attacks.

Reduce stress with breathing exercises: Try to slow down breathing, control it, and breathe as quietly as possible.

Increase awareness of medical conditions: Increase the patient's awareness of his condition, and ask the doctor concerned about the cause of the bout; it may be purely organic.

Join a support group: Joining a group prepared for people with panic attacks or anxiety disorders can connect you with others who have the same problems.

Observe thoughts during a seizure: remember that this is a casual fit, and it will go away in minutes, so you do not have to worry.

Consult your doctor and get help: Try to get treatment for panic attacks as soon as possible to avoid the possibility of recurrence periodically. 

Commit to your treatment plan: Follow the treatment plan to avoid relapses or exacerbate the symptoms. 
Confronting your fears can be difficult, but treatment can be helpful to make you feel you are not a hostage at home. 

Keep up the physical activities: Aerobic sports may have a calming effect on your mood and help to relieve anxiety.

Practice stress management and relaxation techniques: For example, yoga may have deep breathing and progressive muscle relaxation - tightening one muscle at a time, and then releasing the tension completely until each muscle is relaxed in the body - is also beneficial.

Get enough sleep: Get enough sleep, so do not feel sleepy during the day.
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