Panic attacks can be defined as an intense fear or distress that begins suddenly, unexpectedly and rapidly intensifies, often accompanied by a strong sense of danger or thought of coming to an end, with a beginning and an end. Often not alone
It has the effect of almost completely disrupting the functionality of human life, accompanying many other psychological disorders. Panic attacks begin suddenly, gradually become more severe, reach the highest level within a few minutes, and usually go away after 10-30 minutes.
Panic attacks cause serious deterioration in the functionality of the person in many areas such as work, family, social relations, romantic relationships, and school. After experiencing recurring panic attacks, the person begins to feel the anxiety of having a panic attack in addition to his constant anxiety. This results in the panic attack becoming a vicious circle. Panic attacks bring with them what we call “avoidance behaviors”, the person constantly avoids certain situations, people, environments, places with the anxiety of experiencing panic attacks. Although this avoidance method, which is used to minimize the risk of experiencing a panic attack, seems innocent, it seriously interrupts the normal life flow of the person.
The presence of panic attacks that continue in the person’s life for a long time also brings along many mental problems. As a result of long-lasting attacks, the person; They begin to experience depressive states such as not being able to enjoy life, disruptions in eating patterns (eating less or excessively than normal), sleep disorders (sleeping less than normal or being unable to get out of bed), loss of motivation, struggling with thoughts of hopelessness, crying and tantrums. While the presence of panic attacks causes these depressive symptoms, the severity of depressive symptoms also increases the panic attacks. Ultimately, life becomes unlivable for the panic attack sufferer.
PANIC ATTACK SYMPTOMS
Automatic Arousal Symptoms
1. Palpitations, rapid heartbeat
3. Shaking, shaking
4. dry mouth
Chest and Abdominal Symptoms
5. Difficulty in breathing
6. A choking sensation
7. Pain or pressure in the breasts
8. Anxiety or abdominal discomfort
9. Dizziness, dizziness, feeling faint, unsteadiness
10. Derealization, depersonalization
11. Fear of losing control, going crazy, passing out
12. Fear of Death
13. Hot or cold flushes
WHAT IS PANIC DISORDER?
Persistent fear and anxiety that panic attacks will occur in the times between attacks due to unexpected and recurrent panic attacks, panic attacks such as “having a heart attack”, “going crazy, losing control, fainting”, “paralyzing, dying” avoidance and security measures as a precaution against attacks and possible consequences (not going to school, not going to work, sports, not doing housework, not being in shopping malls, public transportation vehicles, squares, staying away from certain foods and beverages, It is a mental disorder in which behavioral changes such as carrying medicine, water, food, and pharmaceutical equipment are seen.
HOW DOES PANIC DISORDER OCCUR?
First Attack Begins;sudden onset of heart palpitations, pain, tingling in the hands and feet, numbness and tremor, chills or chills, dizziness, nausea, fainting sensation, blackout, vomit, sweating, shortness of breath, palpitation, etc.
The symptoms are terrifying. The person has an intense fear of death or paralysis, thinking that he will have a “heart attack” or “paralysis” at that moment.
In some cases, he is afraid of harming himself or the people around him, thinking that he is “losing control” or “going crazy” with the emergence of feelings such as drowsiness, strangeness, seeing the environment and people around him in a strange way, feeling strange or different.
As a result of this first attack, the person seeks medical help and consults doctors especially for heart diseases. However, as a result of all the examinations, he will receive the answer “no problem, he was stressed” and will be sent home after being advised to give him a sedative injection and to talk to a psychologist.
After the first attack, the patient experiences a panic attack again and the same horror feelings emerge. This results in constant transport to emergency rooms. In his life, this becomes a vicious circle.
Each time, new doctors are tried and the reason for this situation is tried to be investigated by the patient. When the examinations performed by the doctors give the same result, the patient blames the doctors for incompetence and causes problems such as heart rate, blood pressure, diabetes, brain pathology, etc. that may exist in him. They begin to think that they do not understand such situations. This situation causes both material and moral losses to go from doctor to doctor, hospital to hospital.
In some cases, panic disorder becomes more severe as the patient starts drug treatment due to misdiagnosis and sees that the situation does not change.
Developing Anticipatory Anxiety;
Continuing to experience the attacks constantly and persistently causes the patient to feel tense, fearful, restless and anxious all the time, and these negative feelings become more intense. The patient begins to constantly fear that a new attack will come. This condition is called anticipatory anxiety. The increase in the severity and repetition of panic attacks after a while is due to anticipatory anxiety.
Experiencing Intense Negative Emotions;
The mood of the patient experiencing panic attacks is constantly filled with anxiety, tension, fear, and sadness. The functionality of life deteriorates for the person who is constantly exposed to attacks that come at unexpected times and cause intense fear. The person becomes unable to enjoy life. His belief that this situation will pass and that he can get better begins to fade.
Behaviors are Changing;
After a while, patients take a series of precautions against attacks and disasters that they believe may occur during attacks, and begin to change some of their behaviors.
The most common of these “security measures” are; to stay away from places and places where attacks can come, to stay away from food and drinks that they think may cause attacks, to drink drugs, alcohol, etc. while leaving the house against attacks.
As they stay away from many places where they believe attacks will come, they take their bags full of tools and equipment to meet their security needs when they go out. There are warning cards with addresses and telephone numbers of their relatives in case they need water, salty-sweet dry foods, blood pressure monitor, glucometer, cologne, against a possible fainting.
The person who thinks that he will have a panic attack starts to spend his time in the hospital gardens or near the polyclinic. He does not prefer to go out alone, he thinks that in case of a possible panic, there should be someone he knows with him.
Since they think that they may harm someone during their attacks, they remove the sharp tools at home, and they have iron railings made, considering the possibility of throwing themselves out of the window or balcony during the attack.
This list may go on and on, but in summary, panic disorder patients rearrange and reshape their lives according to panic attacks. These security measures and avoidance behaviors facilitate the continuation of panic attacks.
Psychopathological Disorders Associated with Panic Disorder
Panic disorder often coexists with other anxiety disorders and depression. Major depressive episode is seen in 35-91% of panic disorder patients.
In patients with panic disorder, hypochondriasis, in which the fear of having a serious illness and the tendency to medically confirm the belief in this direction, is observed at rates not as low as 20%.
The incidence of alcoholism in panic disorder patients was found to be 17%.
Why Does Panic Disorder Occur?
1. Panic Disorder occurs as a result of abnormal functioning of some brain hormones, which are secreted from nerve cells called neurons in our brain, which regulate our excitement and emotional lives.
2. Panic attacks are assumed to result from a catastrophic misinterpretation of certain bodily sensations.
Misinterpreted sensations mainly include somatic symptoms such as dizziness, palpitations, and difficulty in breathing that occur in normal anxiety states. Catastrophic misinterpretation is expressed as perceiving bodily sensations as more dangerous than they actually are, such as seeing a heart attack with palpitations, difficulty in breathing as a harbinger of dying.
According to this view, anxiety is not always responsible for the emergence of sensations, for example, in cases such as drinking too much coffee or simply getting excited, a person may experience a panic attack by misinterpreting his own physiological arousal as a sign of internal danger.
Is Panic Disorder Treatable?
Panic disorder is a treatable psychological disorder. There are two treatment methods with proven effectiveness in the treatment of the disease today.
1. Drug Treatment
2. Cognitive Behavioral Therapy
CBT in panic disorder was developed by considering the cognitive model, which assumes that panic attacks result from catastrophic interpretation of bodily sensations, and the view that hyperventilation plays a role in the occurrence of attacks.
Cognitive therapy in panic disorder is based on correcting cognitive misinterpretations by enabling the patient to cognitively reattribute somatic symptoms to a harmless and controllable state.
In behavioral therapy, which is based on the control of breathing, excessive breathing exercises are performed, the appearance of symptoms similar to a panic attack in the patient and then the disappearance of these symptoms by regulating breathing. Here, the interpretation is given that the bodily symptoms that occur during a panic attack are not simply the result of hyperventilation, not the result of catastrophic circumstances such as having a heart attack.
The next step is to teach breathing control as a coping technique to be used when panic attacks are felt to begin.