Panic attack syndrome treatment. Panic attacks: causes, symptoms and treatment

19.05.2020

(psychiatrist)

Panic attacks

01.06.2015

Maria Barnikova

Panic attack - an irrational, uncontrollable, intense, tormenting attack panic anxietyaccompanied by various somatic symptoms.

Panic attack - an irrational, uncontrollable, intense, torturing attack of panic anxiety, accompanied by various somatic, psychological symptoms, which has cognitive and behavioral effects. IN modern medicine an attack of a panic attack is also described by the terms: "vegetative crisis", "sympathoadrenal crisis", "vegetative dystonia with a crisis course", "neurocirculatory dystonia", "cardioneurosis", which reflects the variety of manifestations of disorders in the autonomic nervous system. Panic disorder introduced in ICD-10 (code F41.0).

To develop a strategy for getting rid of panic attacks, the severity of the disorder is assessed on a scale ( zanga scale for self-reported anxiety). Seizures can occur as a result of a real cause ( life-threatening situation), so they can be contrived ( formed under the influence of the work of the subconscious).

In the absence of a timely, adequate, complex treatment Panic attacks can lead to chronic distress or develop into more serious mental problems. With appropriate therapy, panic attacks can be successfully treated. It is possible to significantly reduce or completely eliminate the symptoms of the disease, allowing the patient to regain control over mental activity and lead a full life.

Panic attack symptoms

Signs of a panic attack in most cases are of a pronounced physical nature, symptomatically similar to a heart attack, so many are inclined to assume that they have heart pathology. However, even the strongest vegetative manifestations are the result of dysfunctions of the nervous system and the brain. A panic attack is characterized by an attack of panic fear ( phobic anxiety), accompanied by a feeling of internal tension, manifested by a variety of somatic ( bodily) symptoms:

Tachycardia (an increase in the number of heart contractions);
Hyperhidrosis (excessive sweating);
Chills, muscle tremors;
Hot flashes (instant hot sensations);
Physiological or dystonic tremor;
Dyspnea (shortness of breath, shortness of breath, feeling short of breath);
Asphyxia (suffocation);
Irradiation of pain to the left side of the chest;
Abdominal pain syndrome (abdominal pain);
Stool disorders (diarrhea, constipation);
Nausea, urge to vomit;
Frequent urination;
Feeling of a coma foreign body in the throat;
Paresthesia (feeling of numbness, tingling in the limbs);
Dysbasia (gait disorder);
Hearing and / or vision impairment;
Dizziness, lightheadedness;
Increased blood pressure.

Also, a panic attack in most cases is accompanied by psychological symptoms, cognitive and behavioral disorders:

(feeling of unreality, indistinctness, alienation of the surrounding reality);
(alienation from one's own mental processes);
Disorientation (lack of the ability to think clearly), confusion;
Obsessive fear of going crazy, fear of schizophrenia, fear of losing control of your actions ( in detail about);
(fear of death);
Insomnia (insomnia), interrupted sleep, nightmares;

The intensity of somatic ( bodily) symptoms vary in a wide range: from a feeling of slight internal tension to an overt state of panic anxiety. If somatic symptoms prevail over psychological components, there is a so-called "non-insurance" panic attack ("panic without panic"), and this problem able to resolve the neuropathologist together with the psychologist. If emotional manifestations come to the fore during panic attacks, it is recommended to undergo treatment with an experienced psychotherapist or psychiatrist.

The duration of an attack has a purely individual value, it can be several minutes or several hours (on average, 15-30 minutes). The frequency of vegetative crises varies from 2-3 per day to 1 time per month. One group of NCD sufferers describe the spontaneity of panic attacks. The second group of patients suffers from situational crises that arise in potentially "dangerous" situations for the individual. Panic triggers can be: movement in public transport, presence in crowded places, stay in confined spaces, the need to speak to the public.

Generally, panic attacks are not limited to a single panic attack. The experienced first episode of painful sensations is postponed in the subconscious of the person, which leads to the emergence of fear of "waiting" for the attack to recur, which, in turn, provokes the emergence of new attacks. A new repetition of an attack in similar conditions initiates the formation of chronic panic disorder, which leads to the formation of avoidance behavior ( deliberate limitation by a person to stay in places and situations in which the occurrence of painful symptoms of panic is potentially possible). Ultimately, constant intense develops into anxiety-phobic disorder, which is often joined by reactive depression.

Schematically, an attack of panic fear can be represented in the following sequence:

Feeling of internal tension, discomfort → illogical intense fear → adrenaline rush into the blood → panic anxiety → more adrenal production and adrenaline rush → panic attack.

Causes of Panic Attacks

The exact cause of the panic attacks has not yet been established. Factors conducive to the occurrence include:

Genetic predisposition ( mental pathologies from close relatives);
Improper upbringing (especially inconsistency, excessive exactingness and criticism on the part of parents) in childhood;
Being in childhood in an unfavorable environment (for example: alcoholic parents, frequent quarrels in the family);
Features of the functioning of the nervous system, temperament;
Personal characteristics of the patient (suspiciousness, impressionability, impulsivity, vulnerability, tendency to fixate on experiences);
, exposure to significant stressors, both negative and positive (for example: death of a close relative or birth of a child);
Chronic somatic illness, disability or recent infectious disease with a severe course, surgery;
Borderline conditions (for example: neurasthenia).

To make the diagnosis "vegetative-vascular dystonia with a crisis course" ( medical diagnosis for panic attacks) you should undergo a full examination by a cardiologist, endocrinologist, oncologist and other narrow specialists in order to exclude the following diseases:

Mitral valve prolapse (dysfunction of the valve located between the left atrium and ventricle);
Hyperthyroidism (hyperthyroidism syndrome);
Hypoglycemia (abnormally low blood glucose).
Organic mental disorder.
Schizophrenia, affective and somatoform disorders, phobias.

You should also exclude the negative effects on the nervous system of stimulants such as cocaine, amphetamine, caffeine and make sure that panic attacks are not a consequence side effects drugs.

Modern medicine has in its arsenal effective means for the complete cure of panic attacks. Various treatments are described below.

Hypnosuggestative psychotherapy

Hypno-suggestive psychotherapy combines hypnosis and suggestion. In the process of work, the specialist forms new attitudes from the client that allow him to look differently and react to somatic manifestations crisis. In a state of hypnotic trance, the patient does not have an artificially created defense, and with the help of verbal and non-verbal influence, the client receives certain information. Read more about hypnosis treatment on the hypnotherapist's website https://hypnosis.ru/

Cognitive behavioral psychotherapy

Cognitively - behavioral psychotherapy recognized as the most effective method of treating panic attacks that have arisen both with VSD and with anxiety-phobic disorders. The focus of this technique is aimed at realizing in a realistic light, correcting thinking patterns and behavioral habits, triggering a panic attack. During the sessions, the client develops and fixes in the subconscious a new model of beliefs, the essence of which is: during a crisis, nothing catastrophic can happen. As a result of therapy for the patient, panic attacks become less terrible, the fear of death loses its significance, the symptoms gradually disappear. Using methods of cognitive therapy with consulting psychologist Irakli Pozharsky http://psyhoterapy.info/

Drug treatment

In case of panic attacks, pharmacological agents are used to relieve ( quick withdrawal ) symptoms of an attack. Medication used in severe cases, however, they are not a panacea and do not completely eliminate the existing psychological problem. The following groups of drugs are used to treat panic attacks:

Tranquilizers benzodiazepine series. Show an excellent therapeutic response very quickly (from 30 minutes to 1 hour). They provide a qualitative reduction in vegetative manifestations of panic. However, drugs in this group are used for a short time, since they are addictive and, in case of refusal after long-term use, demonstrate serious withdrawal symptoms.
Antidepressantsthat do not have a stimulating effect on the nervous system. They show the result 2-3 weeks after the start of their intake. The course of treatment is from 3 to 6 months. Drugs of this class must be taken regularly, not only at the onset of a critical moment.
B vitamins. They have a strengthening effect on the functioning of the nervous system.

None of the green pharmacy products (valerian, lemon balm, motherwort) can help with a panic attack, since they have insufficient sedative effect in comparison with pharmacological agents, and their use for stopping an attack is useless. Soothing herbal preparations can be used in combination with chemical psychotropic drugs to prevent panic attacks in neurocircular dystonia.

Panic attacks: how to fight? Effective self-help tools

For both regular and isolated cases of panic attacks, a professionally selected program drug treatment and psychotherapy techniques are necessary and irreplaceable. In order to cope with panic completely and completely, a person must make every effort of his own. Anyone with an autonomic disorder needs to follow a few simple steps.

Step 1. Study as much information as possible from authoritative sources about panic attacks: symptoms, precursors, ways of dealing. In addition to mastering new knowledge and skills, a person will gain confidence that the sensations and manifestations of panic in most people are the same, they are not evidence of mental abnormality and can be completely eliminated.

Step 2. Quit smoking and drinking alcohol completely. Eliminate or minimize the consumption of drinks and foods containing caffeine. With caution, take pharmacological drugs that have a stimulating effect on the central nervous system.

Step 3. Learn specially designed breathing and relaxation techniques to relieve symptoms.

Step 4. Observe the mode of work and rest. Avoid mental and physical stress. Get an adequate amount of sleep at night.

Step 5. It is possible to eliminate the onset of an attack of a panic attack without taking medication. You must clearly know: during such critical situations, a lethal outcome is impossible. A person experiences a fear of death created by the subconscious, but there are no real prerequisites for a premature death. The main emphasis during an attack is to break the chain between the illusion of the subconscious and reality, not to unwind anxiety, but to take measures to calm down.

Rinse your face, neck, hands with cold water.
Drink a glass of still cool water, after dissolving two teaspoons of sugar in it.
Take a comfortable sitting position.
Take ten sharp breaths and deep breaths into any available container (plastic bag, plastic bottlefolded in a handful of palms).
Try to smile, or just pretend to smile.
To yourself, either say out loud beforehand compiled and learned affirmations (positive statements) or a prayer.
Try to switch attention from internal sensations to external objects: to think about them, analyze, compare.

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Emotions and vegetation

Why do panic attacks happen? Probably, in order to understand the origin of the pathology, given its versatility, it is better to divide the causes of its occurrence into two groups: predisposing and causing.

To the premises which cause the appearance of panic attacks, include:

List of factors causing and forming panic fears, includes:

Psycho-traumatic circumstances, emotional stress.
Excessive physical activity, high sexual activity.
Great mental stress, a long stay in the virtual space, excessive hobby for computer games.
Lack of fresh air, physical inactivity, deficiency of vitamins and minerals, malnutrition.
Climatic conditions that are not suitable for a specific person elevated level background radiation and the environmental situation in general.
Chronic infections.
Diseases of the respiratory system, gastrointestinal tract, cardiovascular pathology, hormonal imbalance, nervous diseases.
Traumatic brain injury.
Excessive alcohol consumption, psychotropic drugs on their own initiative, drug addiction, addiction to drinks containing caffeine.

In addition, panic fears can be caused by long-standing events in a person's life that have left a mental wound (separation, betrayal, betrayal) or nostalgic experiences.

scheme of occurrence and "looping" of panic attacks

Phobias formed by various reasons (a fall from a height, a failure in an exam, a stopped elevator, a thunderstorm, etc.) leave somewhere in the depths of consciousness a focus of panic attacks, although the case itself is erased from memory. For example, having fallen in childhood even from an insignificant height, but at the same time, being very frightened, a person will be afraid of her for life. Thunderclaps, followed by a fire seen in early childhood, will cause panic even when the impending black cloud appears.

Failure to pass exams also sometimes falls into this category of reasons. Panic begins even before entering the auditorium, all the material learned disappears from the head. Unfortunately, some people do not manage to get rid of the panic state that occurs at certain periods, and they stop studying in higher educational institutions, not looking at the wonderful natural data.

Is it a symptom, a syndrome, or a single disease?

What can mean "panic attack" - already follows from the name of this concept: panic, fear, anxiety, occurring sporadically without warning. That is why it is an attack, so as not to depend on a person's desire, but to arise spontaneously, starting somewhere from the inside, behind the sternum or in the throat. Panic attacks can also occur situationally, when a person finds himself in an environment that creates discomfort, for example, in a room without windows, from which he wants to escape faster, because a sudden surging feeling of anxiety and tension prevents him from being there. Perhaps, after reading about the symptoms of panic attack, some of us will try it on ourselves.

When there is no reason to worry

Panic attacks start sometime (not for everyone, of course). And if this happened for the first time in a person who is confident in his health, then the feeling of discomfort during an incomprehensible attack is considered by some as an accidental episode that has nothing to do with pathology. True, when the attack is repeated, the patient states that "this has already happened to him."

An attack of a panic attack can occur, as they say, out of the blue, but it only seems. Lay down, say, a person calmly watch TV before going to bed and suddenly thoughts of recently experienced troubles crept in or some trifle prompted memories of days gone by. My heart pounded, squeezed in my chest, a lump came up to my throat….
Panic fear seizes suddenly: pulse quickens, throws up in sweat, it is difficult to breathe, the whole body trembles, breaks cold sweat, the dizziness may end. Noise in the ears, detachment from reality and loss of it, anxiety, fear for the outcome of what happened knocks a person out of the usual rhythm of life, however, in most cases, not for long. Most often, this condition is qualified as, since the involvement of the autonomic nervous system is obvious.
Often, such panic conditions occur in women after childbirth. Fear for the baby, especially if a young mother is left alone for a long time, leads to the point that she begins to fear for her actions ("the child is defenseless, it is easy to throw him out the window, scald, drown ..."). Of course, these thoughts are caused by fear for the life of the little man, the mother will not harm him, but she begins to panic fear of losing her mind and losing control of herself. By the way, the fear of insanity and loss of control is quite often a companion of a panic state, therefore it pursues not only women on maternity leave, but also patients with different kinds neuroses.
Some patients cannot tolerate a specific environment: an elevator, a bus, a crowd, a subway, that is, situations that cause far-hidden phobias, which the patient usually knows about, and therefore tries to avoid them or break free faster if they are caused by unforeseen circumstances. Under other, comfortable conditions for themselves, they consider themselves to be absolutely healthy people.
Anxiety accompanied by anxiety of unknown origin (like everything is normal in life?), often appears at night. A person abruptly wakes up from fear and horror, which subsequently does not allow sleep for a long time, or in the morning, providing bad mood... The attack lasts from a few minutes to an hour, and even when it releases, the patient continues to be afraid and wait for the next attack, which are sometimes quite frequent.

In a state of panic, the patient is agitated, worried, he says that he anticipates an impending disaster, seeks help and understanding from loved ones, but at first (or even never at all) does not turn to medicine, trying to fight on his own.

The patient knows what he is afraid of

Patients in this category, with the exception of adolescents who have entered the age of hormonal changes, are experienced people. They know exactly what they are waiting for and what they are afraid of. In such cases, it is very difficult to differentiate a panic attack from an anxiety disorder. An ordinary person (and even a doctor of another profession), being weak in psychiatry, is unlikely to draw a line between these concepts, because they are so similar. However, this is the business of specialists, and our task is to recognize the symptoms of a panic attack.

Panic attacks are often associated with chronic pathology. different systems: respiratory ( bronchial asthma), endocrine (, thyrotoxicosis, adrenal cortex tumor), digestive (irritable bowel syndrome), nervous and cardiovascular. (a wide range of diseases). The expectation of a relapse, constant internal tension leads to the occurrence of panic attacks, which in a similar situation are the only complaint (and symptom) of the underlying disease without exacerbation.
Such attacks are very characteristic for the pathology of the cardiovascular system. First of all, panic attacks pursue patients who are diagnosed, which is completely natural and understandable. Meanwhile, such diseases, as well, often have companions anxiety and panic fear, which come along with the symptoms of cardialgia. Horror, panic, a feeling of impending death, or insanity (different for each) are rather unpleasant symptoms of an attack.
Transient states of anxiety and fear are very common in adolescence or climacteric, which is primarily due to the influence of hormones. Attacks of tachycardia, dizziness, racing, choking, bad mood and disturbed sleep - all this fits into the clinical manifestations of vegetative-vascular paroxysms. Complaints made during the visit to the doctor are the basis for the appropriate therapy. With regard to panic attack, its symptoms and individual treatment, such issues are rarely considered, only in severe cases. Since it can be very difficult to distinguish between these states, and the drugs prescribed by the therapist, as a rule, help, then not everyone is appointed to the consultation of the psychotherapist.
The symptoms of a panic attack acquire a special, most striking, color in alcoholics with abstinence. There they are all gathered together: trembling, tachycardia, melancholy, pessimistic assessment of the future, self-pity, a premonition of death (“my heart is about to stop”) and a firm belief that “if I manage to survive, then I’ll quit drinking”. Panic attacks associated with such a causative factor soon pass, but they are repeated with a new binge or when alcohol has already caused significant harm to the body, even if the person has "tied up" with a bad habit.

Thus, autonomic disorders (episodes general weakness, non-systemic dizziness, light-headedness, internal tremors, spastic pain in the stomach, and), as well as emotional-affective symptoms of a panic attack, manifested by the fear of death, insanity, and committing a rash act are signs of one pathology, but this does not mean that they will all be manifest at the same time.

A sign linking different psychopathological conditions

Many patients who are pursued by attacks, panics and fears already have a record in the card about their presence (dystonia, neurosis, panic disorder or depressive syndrome. In general, there is no clear border between these diagnoses, so only specialists in this field can separate them. In the American classification of mental illness, these concepts are summed up and under the name "panic disorder" are included in the class of "anxiety states."

Among the listed pathological disorders, panic attack often appears, which is a syndrome that is often called sympathoadrenal or vegetative crisis, which, however, does not reflect the mental origin of paroxysm. In most cases, such patients are treated for NCD and require mainly emotional correction. However, episodic panic attacks should still be distinguished from panic disorders and depressive conditions, where a panic attack is one of the signs (symptoms) of the disease that requires a strictly individual approach and treatment by a psychotherapist.

Panic disorder

Panic disorder is characterized by the concentration of the patient's attention on any one problem, for example, they fear for "their heart." This often happens after the postponed. Fear of sudden death due to untimely delivery medical care forces a person to be in tension all the time, not to go far from home and constantly monitor their condition. As a result - panic, attacks of weakness, palpitations, suffocation, which really begin to poison a person's life.

Fear for "your gut" is probably the second leading cause of panic disorder. Everyone knows that the famous, plan-destroying and life-poisoning "bear disease" arises on the basis of nerves, and on the basis of the "bear disease" fears and anxieties arise that cause indigestion. Vicious circle.

The cause of concern is often the undergone surgery on the organs of the gastrointestinal tract and their consequence - adhesive disease. Anxiously listening to your feelings, panicky afraid intestinal obstruction, the person experiences severe discomfort and thus unwittingly contributes to the fact that attacks become even more frequent.

Panic disorder quite often accompanies other psychopathological conditions (alcoholism, taking certain psychotropic drugs, depressive syndrome).

Neurotic conditions

Without the accompaniment of a panic attack, where it is also a symptom of the underlying disease, it is difficult to imagine such a psychogenic disorder as neurosis... Similar neurotic disorders arise on the basis of various traumatic situations people who are naturally endowed with certain personality traits (psychotype). The worst thing is that it is your own character that does not allow you to overcome these situations. A personal conflict formed under such circumstances is manifested by a violation of the function of the emotional-vegetative-somatic sphere.

Manifold clinical manifestations neuroses often complicates their differentiation among themselves and a clear distinction with other similar pathology.

Neurosis is called a specific module of response to various life events., but the fact that neurotic disorders of any origin are accompanied by the occurrence of panic attacks does not raise doubts either among psychiatrists or specialists in related professions. Psychovegetative syndrome in these cases is also a response to stress and a traumatic situation.

Depression

Panic attacks do not leave even if depressive states... Patients understand that their bad mood is not an ordinary sadness, because "the soul hurts" so much that it does not allow them to sleep, eat and just live fully. Early awakenings with an already strong sense of anxiety, which are considered to be characteristic signs of depression, despondency, irritability or apathy, loss of appetite and therefore weight loss, as well as many other symptoms. The patient (he does not fall asleep without sleeping pills), his eyes do not dry out from tears, his face expresses universal grief, the present and the future are seen in gloomy tones.

With depression without therapy, the patient quickly loses interest in life and work, focuses on his problems, “withdraws into himself” and admits suicidal thoughts. Stifling frequent bouts of mental pain with an accidental drug, alcohol (which is even worse) or, God forbid, drugs, the patient only aggravates his condition. Such phenomena require the mandatory intervention of specialists if they last more than two weeks. By the way, oddly enough, but patients with severe forms of depression respond better to treatment than people with a mild degree.

How to deal with panic attacks yourself?

Attempts to get rid of panic attack syndrome, its symptoms and manifestations on their own, give results in 50% of patients. In 20% of cases, attacks continue occasionally, but there are no special changes in the condition of the patients. However, 30% of sufferers may develop depression, which is in no hurry to leave without treatment. At the same time, attacks of anxiety also do not leave the person and are still visited, but already as a symptom of another disease.

Often, a person turns to a doctor when he has already diagnosed himself with depression or neurosis, in general, he knows and has heard a lot, but only a specialist psychotherapist can do this. Unfortunately, a doctor's professional referral often scares patients away. In addition to suddenly rolling panic fears and anxieties, the patient may be afraid of doctors of this profile. But in vain, because from a panic attack, only by noticing its symptoms, you can get rid of by taking appropriate treatment.

The ideal option for starting treatment for panic attacks is still considered to be the consultation of a psychotherapist. Considering the problem in the psychiatric plane, you can quickly achieve success, since the doctor, having indicated the psychogenic origin of the disorders, will prescribe therapy in accordance with the degree of emotional-vegetative disorders.

Therapy without "serious" drugs

When everything has not gone very far, a thoughtful and experienced doctor in this area will try to do without the influence of strong psychotropic drugs, and if he prescribes pharmaceuticalsthen they will be from the group of mild tranquilizers and mild sleeping pills.

Initial therapy for mild forms of panic disorder includes:

Psychotherapy, able to bring out the cause of anxiety and panic attacks and change the attitude towards them.
Help in regulation of work and rest regime, propaganda healthy way life, exception bad habits, limiting the use of strong coffee and tea.
Auto trainings:self-regulation of psychoemotional and autonomic disorders, suppression of negative emotions, mental relaxation. The elimination of panic disorders is achieved through special exercises to relax skeletal muscles, breathing exercisesregulating the rhythm of heart contractions and vascular blood flow, as well as verbal formulas pronounced in strict sequence.
Ayurvedic traditions,the source of which is Indian yoga, of course, are good, but mastering knowledge in this area is a difficult and time-consuming exercise, therefore it is unlikely that it will be possible to deal with panic attacks on your own in this way. However, if a person “knows a lot about this,” then why not try it?
Transcendental Meditation by modern ideas able to help a person get rid of panic fears, anxieties, overcome fatigue and gain new health. To do this, you only need to find a good teacher (guru) who has deep knowledge and really knows how to help.
Swimming pool, massages and various physiotherapy treatments.
Acupuncture- a wonderful method of dealing with negative emotions and vegetative disorders: soothes, relaxes, improves mood.
Spa treatment,to describe the merits of which hardly makes sense, everything is already clear: such therapy, in fact, can change life for the better for a long time.
Light sedatives: sedative collection (valerian, peppermint, trefoil watch, hop cones), tincture of motherwort, valerian, valerian tablets, adaptol, afobazol, novo-passit and other drugs sold without a prescription.

The criterion for the effectiveness of the treatment passed is a decrease in the frequency of panic attacks and vegetative crises, or even their complete disappearance.

Video: exercises for stopping an attack of panic attacks

The necessary medications will be prescribed by a doctor

While maintaining a feeling of anxiety and fear (after the conducted health-improving and therapeutic measures), the need for treatment with stronger drugs becomes obvious, however, in this case, the doctor goes from less to more:

Strong psychotropic drugs with antidepressant effects are not intended to treat panic attacks as an isolated syndrome, they are used in the treatment of severe forms of depressive conditions. Appointed, discharged and canceled similar medicines exclusively a psychotherapistwhile patients are taking medication long time according to the scheme, designated by the doctor... It should be recalled that these medicines are not easy, they do not tolerate self-activity, therefore, it is better for the patient himself not to try to use them on his own initiative, because they have a lot of contraindications, restrictions and precautions.

Video: doctor's opinion on panic attacks

The exact causes of panic attacks have not yet been established. The following factors are believed to play a role:

Severe stress or trauma. But not all people who have been in such situations then began to suffer from panic attacks.
Heredity. The innate features of the nervous system are important. Such people usually suffer from increased anxiety, suspiciousness, impressionability.
Features of work endocrine system... The adrenal cortex hormones are actively involved in the onset of fear: they also release other stress hormones.
General condition of the body. For example, people who tolerate worse physical exerciseare more likely to suffer from panic attacks.
Diseases internal organs... Unmotivated fear often occurs with heart pathologies.
Alcohol abuse. Panic attacks are especially common during a hangover.

Manifestations

People with panic attacks constantly experience a sense of inner tension. They feel helpless, unadapted to the outside world and society. Most often, anxiety attacks occur in the evening and at night. How to distinguish normal fear from panic attacks? How can you tell if you have this problem? A special list of features has been developed. If you have at least 4 of them, then it is worth visiting your doctor:

Inner trembling, trembling hands, chills.
Excessive sweating, cold clammy sweat.
Rapid pulse, rapid and increased heart rate.
Abdominal discomfort, nausea.
Pain or discomfort in the region of the heart.
Difficulty breathing, feeling of suffocation.
Fear of doing something, going crazy.
Perception of the surrounding world as distant, not real.
Perception of yourself as if from the outside, the feeling that you are not able to control yourself at a given moment.
Dizziness, a feeling of imbalance,.
Inability to sleep.
Unpleasant sensations in the hands and feet: cold snap, tingling, numbness.
Fear of dying.
Confusion of thoughts, inability to concentrate.

In this case, seizures occur without apparent reason, there is no real threat. Panic attacks often occur in certain situations: in transport, in the subway, during public speaking, etc. They can last from 15 minutes to several hours. The frequency of attacks also varies.

What can you do?

Dealing with panic attacks on your own is nearly impossible. They always appear unexpectedly and cause great suffering. Over time, the patient begins to constantly be in a state of anxiety, is afraid of another attack. The quality of life and working capacity decrease. You need to contact a specialist -.

What can a doctor do?

Panic attacks are treated with psychotherapy and medications. At the moment, there are a large number of psychotherapeutic techniques. Most often, auto-training is used: the patient is taught special self-hypnosis techniques, using which he can cope with panic attacks.

Of the drugs for a relatively mild course, sedatives are prescribed: motherwort. In more severe cases, the doctor prescribes tranquilizers.

Prevention

It is not always possible to cope with panic attacks with the help of psychotherapy and medication alone. Lifestyle changes are important: eating well, getting enough sleep and rest, exercising, and being outdoors often. You also need to exclude conflicts, traumatic situations from your life.

Panic attacks are present in 6-8% of people suffering from neuroses ... This disorder belongs to the group of psychosomatic diseases.

That is, both the psyche and the physiology of a person are involved in the manifestation of panic attacks. Below we will figure out why panic attacks occur and how to overcome them.

Knowing the causes of a panic attack contributes to its speedy overcoming

It is difficult for an ordinary person to understand why panic attacks and fear occur, as well as in his condition during such an attack.

In order to determine for what reason a person is experiencing this condition, it is important to know how panic manifests itself physiologically, what the patient is experiencing during this period.

So, panic attacks are a sudden state of fear, panic, anxiety that cannot be controlled, suppressed or healed on their own... It occurs without previous symptoms, does not last long, but intensely. An attack even in this short time (5-15 minutes on average) significantly exhausts a person, affects his behavior, the work of cognitive processes and well-being.

Since not everyone is susceptible to attacks, and those who have them note the frequency of such manifestations, the condition is defined as a disease and included in ICD-10 (F41.0).

From the physiological point of view, this state - sudden powerful adrenaline rush into the blood which provokes the sympathetic nervous system.

And until the parasympathetic NS begins to act, the person feels an increase in anxiety. These two mechanisms of the autonomic nervous system begin to operate from the "feed" of the brain.

The main body, when faced with a threatening danger, gives signals to activate the National Assembly.

Basically, a panic attack is a defense for our body. But with frequent manifestation, it prevents a person from fully functioning.

Causes of anxiety and fear attacks

What causes panic attacks?

There are several reasons for the appearance of this condition, they are almost always psychogenic ... It is difficult to call them even the exact reasons, rather, these are events or changes in a person's life, leading to similar psychosomatic manifestations.

Frequent quarrels between parents contribute to the appearance of a child's predilection for PA

The factors conducive to its occurrence are well known.

So what causes panic attacks?

High probability of occurrence of the phenomenon with a genetic predisposition ... If relatives have had mental disorders, a person may feel sudden attacks of fear and anxiety.
With the wrong upbringing in childhood : too high requirements of parents, inconsistency in requirements, criticism of actions.
Unfavorable emotional conditions in childhood : frequent quarrels between parents, children, alcoholism and other addictions in the family.
Features of temperament and work of the National Assembly , people with a melancholic and choleric type of temperament are prone to panic attacks.
Features of a person's character (getting stuck on experiences, impressionability, suspiciousness and others).
Severe stress factor , it can be both positive and negative, but for the National Assembly it is a shock.
Long-term somatic disorders , diseases, surgical interventions, infectious diseases with complications or severe course.
With neurasthenia a person can also be overcome by attacks of anxiety, fear, anxiety.

In addition to these factors, there are a number of physiological reasons why there are panic attacks. Sometimes panic attacks of fear and anxiety accompany such diseases, as mitral valve prolapse, hypoglycemia, hyperthyroidism... In some cases, taking certain medical supplies leads to symptoms of panic attacks.

Also why do panic attacks happen?

They appear when the central nervous system is stimulated by caffeine and chemical stimulants.
It is also a concomitant phenomenon in depression.

Manifestation of panic attacks

Attack episodes cannot be predicted, they are spontaneous.

Objectively, they are not preceded by a real threat to human health or life. ... But the brain "turns on" the body's defenses.

Panic is a kind of defense reaction of the body

You can recognize it by the following symptoms:

strong (deep) or frequent heart sounds
the person sweats;
there are tremors or tremors in the limbs;
dryness in the mouth;
attacks are accompanied by shortness of breath;
often a person feels either suffocation, or "lump" in the mouth;
sometimes pain in the chest area may begin;
a state of nausea or burning in the stomach, not provoked by food intake;
dizziness, lightheadedness;
disorientation;
feeling that the surrounding objects are not real, unreal;
the feeling of one's own “separation”, when a person feels his own I somewhere nearby;
fear of death, going crazy or losing control of what is happening;
with increasing anxiety, a person feels a surge of warmth in the body or chills;
insomnia, as a result, decreased thinking functions;
also in the limbs there is a feeling of numbness or tingling.

It's good to know what causes panic attacks, but what to do with such a psychosomatic illness?

After all, an attack can overcome a person at the most inopportune moment, what actions should be taken to reduce the duration and reduce the number of its manifestations?

Treatment principles for spontaneous attacks of anxiety and fear

When acute attacks Panic attacks treatment of this condition consists in the use of pharmacological agents and accompanying psychotherapy.

Medicines for treatment the doctor prescribes.

He prescribes a regimen for taking drugs, the form of their release.

The patient can be administered drugs through droppers, it is also possible oral administration medicines.

In the latter case, the improvement occurs much later (about a month later).

To stabilize the state after an attack of spontaneous panic and anxiety, psychotherapists prescribe drugs that improve the metabolism in the brain, increase the level of serotonin in the blood, and restore the balance between inhibition and arousal of the central nervous system.

Regular communication with a psychotherapist can help in the treatment of the disease.

The main therapeutic effect in removing the causes of panic attacks possesses psychotherapy ... In a conversation with a psychologist (psychotherapist), the patient is aware of the reasons for such psychosomatic manifestations. Understands how to behave during attacks of fear and anxiety, learns to overcome them.

There are several areas of psychotherapy that help a person get rid of this syndrome.

All of them are aimed at identifying the causes of the disease, and teaching a person how to behave during such a phenomenon.

Classical hypnosis (directive to get rid of somatic manifestations).
Ericksonian hypnosis (training to reduce the level of anxiety, fear).
Body-oriented therapy (techniques are used that reduce the level of anxiety, work with breathing).
Family psychotherapy (family relationships are assessed, working with all family members to improve relationships).
Psychoanalysis (working with unconscious conflicts and childhood is not always an effective method in dealing with panic attacks).
Cognitive behavioral psychotherapy (most effective in treating this disorder, there is a gradual change in the person's thinking, work with the causes of fear).

Panic attacks make a person unbalanced and require treatment

Panic attacks cause a lot of inconvenience to a person.

The psychotherapist will help determine what causes panic attacks.

You should not delay visiting him with the symptoms described above.

A panic attack is an unforeseen and unexplained attack of intense fear. Panic attacks are very often manifested in people suffering from VSD, phobias or alcoholism (in a state of a hangover after a large amount of alcohol consumed, the risk of developing PA increases 2-3 times).

Signs and symptoms of PA

A panic attack always comes on suddenly. This is the main distinctive feature, by which an attack of PA can be distinguished from other disorders.

Why is it so difficult to identify a panic attack and initiate a timely qualified treatment? The problem is that the symptoms of PA are disguised as various diseases (tachycardia, VSD, diabetes) or emotional disorders (depression, phobias).

A panic attack is usually not an isolated attack. If after nightmare at night a person has an attack, then with a high degree of probability the panic attack will repeat after another nightmare. But it also happens that there is no apparent reason for fear and panic. A person is sitting on the couch at home, doing what he loves or making planned purchases, when suddenly unbridled fear envelops the whole body.

Panic attack symptoms and signs:

Any fear: death, open or closed space, increasing every second and having no apparent reason.
Nausea, pain in the abdomen, a strong urge to empty.
Pain in the region of the heart (after the attack ends, it goes away)
Shortness of breath, shortness of breath, choking (difficulties arise if you want to inhale).
Tachycardia, palpitations (heart jumps out of the chest, every heartbeat is heard in the ears).
Limb tremor. Their numbness, tingling sensation may also be observed.
Dizziness , light-headedness and profuse sweating, the patient is thrown into the heat, then into the cold.
Consciousness is changed, a certain unreality of what is happening is felt.

These symptoms cause concern for their health, because people invariably confuse panic attack syndrome with heart attack. The symptomatology is really similar, with PA it can also increase blood pressuretinnitus appear. Therefore, it is very important to exclude serious illnesses by contacting a specialist!

The attack itself rarely lasts more than an hour, the average duration is 20 minutes, depending on the individual indicators of the body.

There is also an atypical course of panic attacks. , when the following symptoms appear during an attack:

Hearing and / or vision impairment, rarely complete loss.
Headache, pain in the back or heart, and pain strong and difficult to stop.
An inexplicable feeling of weakness in the limbs, severe cramps are possible.
Loss of consciousness.
Violation of speech function, loss of voice, "lump" in the throat.
Gait disorder.
Severe nausea, even vomiting.

It should be noted that with an atypical course of PA, there is no feeling of fear. There is a "panic without panic". Irritation may be present, gaining momentum and escalating to aggression.

If a panic attack happened once, then there is a high probability of its recurrence in the future (especially if a person suffers from VSD).

Systematic recurrence of panic attacks is called panic disorder, and the period between attacks also has its own symptoms.

You can diagnose panic disorder if you have:

Obsessive thoughts about a new panic attack.
Every minute the horror of the experience arises in memory.
A persistent fear appears, haunting both day and night that the attack will repeat again and at the most inopportune moment.
A more scrupulous attitude to the signals of the body. Spills over into excessive pathological concern for health, heart drops or sedatives are always at hand. Tranquilizers are often used.

These are the reasons for the emergence of "phobic avoidance": a person avoids those situations in which the panic attack caught him the last time. After that, he does not want to go outside without an urgent need, since the panic attack syndrome can be taken by surprise anywhere. Visits to friends are becoming rare, holidays and drinking together become impossible. Depression and a number of serious phobias can develop against the background of a change in lifestyle.

Internal causes of PA

Panic attacks occur at a socially active age. Moreover, women experience PA more often than men. In about a 1: 2 ratio. IN mild form 10% of the adult population suffers from panic attacks. About a quarter of them suffer from PA while being hungover.

An interesting and paradoxical point: an attack of fear arises from a fit of fear. The reasons for this lie in the following: during the active period of the attack itself, a person's thoughts are reduced to fear of dying (“what if it’s a heart attack”), fear of falling (“I’ll look stupid, I’m afraid to faint”), fear of an enclosed space (“ bad, and people will not be able to call an ambulance, I will die ”). Such frightening and uncontrollable thoughts further fuel the symptoms of panic attacks and cause panic next time.

It should be noted that the clear causes of the panic outbreak are unclear. Many experts tend to believe that panic attacks, like VSD, are more likely hereditary diseaseprovoked by a genetic predisposition. But why does it happen that unreasonable panic affects people who do not meet this criterion?

In such cases, the reasons may be as follows:

Panic attack as a symptom of VSD

Panic attack is a symptom of vegetative vascular dystonia. With rare exceptions, these two concepts are not related.

The term "VSD" is most often understood as any symptoms that can be attributed to a deviant psycho-emotional state. Such symptoms sometimes appear "quietly": insomnia, nausea, dizziness, drowsiness, profuse sweating, tinnitus, pain in the heart.

But in especially severe cases of the manifestation of VSD, the symptoms cause terrible discomfort, and banal suspiciousness develops into a severe panic attack, with all the ensuing circumstances.

It must be remembered that VSD and alcohol intake are two diametrically opposite things. The fact is that even after taking a small amount of alcohol, the nervous system is under attack, and then such innocent symptoms of VSD as dizziness, suspiciousness or sweating turn into a real attack. This can happen in the morning, during a hangover, and maybe at night, at the time of active drinking.

What provokes PA?

It is very easy to provoke an attack of a panic attack in people who have already encountered this once. This is due to constant obsessive and depressive thoughts and fear.

A panic attack can be triggered by:

After the end of the panic attack, the body feels weak and drowsy. Sometimes people who have undergone PA report a state of rest.

When identifying signs of a panic attack in yourself, you should contact a neurologist and psychologist. It is very important to remember that the problems of the occurrence of an unreasonable feeling of fear in the head, and the rest of the somatic symptoms are only an indicator of the problem that has stuck in the thoughts.