What is a panic attack?
It is a period of intense fear or discomfort that starts suddenly and peaks within 10 minutes.
Panic attacks are characterized by four or more of the following symptoms at the same time;
- Palpitations, sensation of heartbeats,
- Sweating
- Trembling or jerking,
- Shortness of breath or feeling like you are suffocating,
- Breathlessness,
- Chest pain or chest tightness,
- Nausea or abdominal pain,
- Dizziness, lightheadedness, feeling like falling or fainting,
- Feeling that you or others around you have changed, are strange or different,
- Fear of losing control,
- Fear of death
- Numbness or tingling,
- Chills, shivering or hot flashes,
Many mental and physical disorders cause panic attacks and similar complaints. For this reason, a person who thinks that they have panic attack symptoms should first be evaluated by a physician to determine whether they have a panic disorder in order to avoid the risk of receiving the wrong treatment (they may have a heart attack, stroke, lose control...).
How do panic attacks occur?
Fear is a necessary emotion for us to survive, which gives us an advantage in dangerous situations. For example, we get scared when an animal (dog, cat...) appears in front of us. Then we have a system in our body called the sympathetic system, which alarms us in dangerous situations and fight or I'm not even sure escape for the system to kick in. Then;
1. We start breathing fast: This can cause us to feel as if we are short of breath or suffocating, gasping for air, chest pain or chest tightness.
2. Our heartbeat speeds up: We may feel palpitations or feel our heart beating.
3. Our blood pressure increases and our heart pumps a lot of blood, especially to our muscles: We feel sweating, shivering or shaking, hot flashes.
4. Less blood is pumped to our skin: We may feel numbness or tingling.
5. Less blood is pumped to our digestive system: We may feel nausea or abdominal pain.
6. Oxygen in our blood increases, carbon dioxide decreases and the blood circulation in the brain changes: This can make us feel that we or our surroundings have changed, are strange and different, and that we may lose control.
What is the prevalence of panic disorder?
In epidemiologic studies, the lifetime prevalence of panic disorder has been found to be 1.5-3.5%. Panic disorder more often starts in young adulthood. Although the age of onset is mostly in the 20s, it can start at any time of life. Panic disorder is approximately twice as common in women as in men.
How does panic disorder occur?
When panic attacks cause unpleasant bodily sensations and are misinterpreted, the person experiences a state of fear of recurrence and becomes alert (anticipatory anxiety). They start to pay more attention to their bodily sensations and monitor them. When he/she starts to feel similar sensations, he/she tries to develop various ways to relieve himself/herself. They may go to the hospital, take medication... Such behaviors cause the person to engage in avoidance behavior. It causes the panic attack to turn into panic disorder. People with panic disorder are thought to be hypersensitive to stress.
In which situations is a physical panic attack triggered?
- Poor eating habits, irregular diets, and irregular blood sugar levels that may occur as a result of strict diets can trigger attacks.
- Excessively frequent breathing can trigger panic symptoms. When under stress, breathing becomes more frequent without realizing it.
- Digestive problems and food allergies can cause panic.
- Antidepressant medication can cause panic attacks, especially in the first week of use.
- Caffeine, smoking, alcohol and certain drugs (such as LSD, cannabis and cocaine) can cause panic attacks.
- Suddenly stopping any medication with a sedative effect can cause a panic attack.
- Amphetamines, cortisone and some medications used to treat asthma can also trigger panic attacks.
- Difficulties with balance, coordination, hearing and vision can increase stress levels and trigger panic and agoraphobia.
- Physical pain can trigger panic attacks.
What is the prognosis if panic disorder is not treated?
If panic disorder is not detected and treated at an early stage, it can lead to depression and alcohol and substance abuse.
What is agoraphobia?
You may start to associate certain places and situations with having an attack. You may avoid being in places where previous attacks have occurred in order to prevent another attack. However, this starts to put more and more restrictions on your daily life and you may start to avoid being alone at home, entering closed places such as cinemas and elevators that cannot be escaped immediately, or going out on the street alone, thinking that you will not be able to get help if you have an attack. This is defined as fear of open spaces, also known as agoraphobia.
Is panic disorder treatable?
Panic disorder is a treatable disorder. There are medications that are effective in the treatment of panic disorder. It would be appropriate to get support from a psychiatrist for these treatments. However, although medication is effective, symptoms may recur after the treatment is over. For this reason, cognitive-behavioral therapy is recommended even if medication is used.
Many studies have investigated the effectiveness of cognitive-behavioral therapy in the treatment of panic disorder and agoraphobia. As a result of these studies, cognitive-behavioral therapies were found to be highly effective (75-90%).
Stress control is an important step in the treatment of panic disorder. Neurobiofeedback technique (learning to control stress by seeing one's own brain waves) is used for this purpose. Neurobiofeedback helps to understand and overcome bodily reactions.
