Every person experiences fear and anxiety at certain periods of his life for various reasons. Sometimes, in these moments of fear and anxiety, our body involuntarily undergoes some physiological changes. These changes may manifest themselves as tremors, heart palpitations, sudden sweating and numbness. In fact, these changes normally occur in every person during times of fear and anxiety. However, in patients with panic disorder, these physiological changes reach a level that negatively affects their daily life and become a serious health problem.
These physiological changes that occur in moments of crisis affect the patient so much that they experience every fear and anxiety that may arise in daily life. The fear that these physiological changes (such as sweating, heart palpitations, shortness of breath) may occur again makes the situation an inextricable vicious circle for them. We define this condition as Panic Disorder in psychology.
We can also call Panic Disorder as fear attacks that occur suddenly and repeatedly and are accompanied by physical and cognitive symptoms. Although these seizures are seen in many other anxiety disorders, the distinguishing feature of panic disorder is that these seizures occur unexpectedly. Attacks usually occur while the person is outdoors. For example; It can develop while shopping at the store, walking on the street, in the parking lot, while driving, or while watching television while lying on the couch at home. Symptoms appear suddenly and usually reach their peak within 10 minutes. Most attacks end within 20-30 minutes, rarely lasting more than an hour.
In the DSM-5, which psychiatrists and psychologists use as a diagnostic book, panic disorder is defined as follows:
Repetitive. and unexpected panic attacks. Panic Attack is a feeling of extreme fear and discomfort that suddenly rises and reaches its peak within a few minutes.
At least one panic attack in the last month has been experienced with one or both of the following situations:
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Fear of having a panic attack again or worry about the outcome of the attack (e.g. heart attack, going crazy, losing control, etc.)
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Significant negative behavioral change (avoidance behavior) due to attacks development of memory)
The problem cannot be explained by physiological symptoms that may occur due to substance use or a medical condition.
Attacks It cannot be explained by another mental illness.
For a definitive diagnosis, at least 4 of the following must be seen:
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Acceleration of heartbeat, palpitations
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Sweating
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Shivering
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Feeling of breathlessness
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Chest pain or chest discomfort
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Nausea or upset stomach
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Dizziness
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Colds or flushing
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Tingling, numbness, numbness
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Derealization (feeling unreal or imagined) or Depersonalization (feeling of separation from oneself)
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Fear of death
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Madness or Fear of losing control
The person constantly faces the worry of having a bigger attack along with recurrent attacks. This intense fear and anxiety is at a level that disrupts a person's daily life. Anxiety about physical symptoms increases sensitivity to normal physical symptoms. Therefore, situations and activities that cause such physical symptoms during the day trigger panic attacks. For example; Acceleration of heart rate due to fast walking, heart palpitations and tremors due to excessive caffeine consumption, sweating due to heat and humidity, and excitement while watching thriller movies. The person begins to avoid activities that will trigger these physical symptoms. The more one avoids these behaviors, the more the person involuntarily feeds his/her anxiety. Thus, a vicious circle is created. Due to physical symptoms, the person begins to avoid any situation that may trigger panic attacks.
When a person enters some situations where he would normally experience a panic attack with the objects, people and conditions that he has previously determined that make him feel safe, the anxiety he develops in these situations decreases. For example, going out with someone, carrying cologne, medicine, water and a paper bag with you, walking next to the wall, not going out without a mobile phone, frequently measuring blood pressure, taking pulse, being near hospitals and visiting the Emergency Department frequently. such as visiting frequently.
Although the cause of Panic Disorder has not yet been fully determined, malfunctioning of the alarm system in the human brain or very low alarm thresholds may be among the reasons. It has been proven that the trigger threshold of the limbic system and amygdala region, which are the regions that mediate this alarm reaction in the human brain, is low in some people. It can be said that these people are more prone to developing panic disorder.
Research has proven that genetic predisposition and family attitude also play an important role. For example, a pessimistic interpretation of events within the family and an overprotective and protective attitude of the family towards the child paves the way for panic disorder. In addition, panic disorder appears to be associated with important life transitions in a person's life, such as graduating from university, a new job, job loss, getting married, having a child, losing a relative, and divorce.
TREATMENT OF PANIC DISORDER
Panic Disorder is a treatable disorder. Generally, cognitive behavioral psychotherapy is the most effective method in the treatment of panic disorder, and medication should also be applied when necessary, depending on the severity of the disorder. The aim of drug treatment is to control the physiological changes that cause anxiety and distress in the person by increasing the level of the serotonin hormone (happiness hormone) in the brain and to make the person feel more energetic and happy. In psychotherapy, the goal is; It is to replace a person's negative thoughts and beliefs with more positive, realistic and balanced ones by using cognitive behavioral therapy methods. In this way, a permanent treatment is provided, regardless of the person's need to use medication in the future.
As a result; Cognitive Behavioral Therapy focuses on helping the person better understand their attacks and their causes and how to most easily cope with them. The nature of the fight or flight response experienced during panic is taught and it is explained that the physical symptoms experienced during the attack are normal and harmless. Anxiety and panic journaling and regular breathing exercises form part of the treatment plan and address the person's concerns and fears. It is aimed to take additional control.
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