It is a disease characterized by spontaneous and unexpected panic attacks. You don’t have to be sad or angry at the moment for attacks to occur. It can occur even in the most pleasant moments. During a panic attack, our patients appear extremely anxious and fussy. They are in a state of intense fear. The fear can take the form of fear of death, of losing one’s mind or of losing control. During an attack, the person may perceive himself and his environment as different and alienated. Physical symptoms such as palpitations, sweating, tremors, choking or shortness of breath, chest pain or feeling of tightness in the chest, nausea, abdominal pain, dizziness, numbness, tingling, frequent urination, blurred vision, weakness, chills or hot flashes to name a few It can be seen together during a panic attack.
Panic attacks occur mostly in the evening or towards the evening, but they can also be seen at other times of the day. Panic attacks can also come on during sleep. Some of our patients have attacks only during sleep. They wake up with fear, palpitations and a feeling of not being able to breathe. Our patients, after having a panic attack once, experience fear that they will have another attack. Although the duration of the seizures varies from person to person, they usually last 5-10 minutes. Sometimes it can take up to several hours. They often apply to emergency services, thinking that they are having a heart attack or brain hemorrhage.
If panic attacks occur in crowded places such as shopping malls, marketplaces, buses, and cinemas, we can talk about panic attacks with agoraphobia. Our patients avoid such places to avoid panic attacks. In fact, some may not leave the house for a long time because of the fear of having a panic attack. Some of our patients, on the other hand, keep their medicines and their doctor’s phones with them wherever they go, and they say that this is a reassurance for them and that it is good for their fear of being alone and without help.
Panic disorder is twice as common in women as in men. Delayed initiation of treatment, alcohol and substance use, as well as the presence of another psychiatric disorder such as depression, ongoing family conflict or economic problems may adversely affect the treatment of the disease or cause it to recur. Caffeine can trigger panic attacks. In addition, alcohol can cause a panic attack 6-12 hours after ingestion.
Panic disorder also has familial features. The incidence of panic disorder in the families of people with panic disorder is many times higher than the normal population. Studies with twins also support the genetic aspect of panic disorder.
It can be treated with both drugs and various therapy methods. Antidepressant and anxiolytic drugs are used in the treatment. Within the scope of therapy, informative psycho-education, which introduces the patient to the patient in detail, has an important role. In addition, breathing and relaxation exercises from behavioral methods are also very useful.
It is not possible to apply the same treatment method to every patient. A special treatment method should be determined for that patient by looking at the personality characteristics of the patient, the presence of other diseases, familial, social and economic problems, if any, his work and daily activities, and the severity of panic attacks.
Another problem encountered in the treatment of panic disorder is that our patients who have not experienced panic attacks for a few months think that they have recovered and stop the treatment spontaneously. This is a condition that negatively affects the course of the disease and the risk of recurrence, even if treatment is started again. Medications should be reduced and left under the supervision of a doctor. Drug withdrawal symptoms that may occur due to abrupt drug discontinuation may be confused with panic attacks, and our patient may feel hopeless when the treatment is stopped despite adequate and effective treatment, thinking that the disease will recur. Therefore, the patient should be informed about every possible effect and necessary precautions should be taken. Despite all the precautions taken and adequate and adequate treatment, panic disorder is a disease that can recur in some periods of life. However, this does not mean that it will recur in every patient.