Panic attacks can be defined as an intense fear or distress that begins suddenly, unexpectedly and intensifies rapidly, and has a beginning and an end, often accompanied by a feeling of intense danger or the thought that the end is coming. Most of the time, it has the effect of almost completely disrupting the functionality of human life, not only on its own, but also accompanied by many other psychological disorders. Panic attacks begin suddenly, become increasingly severe, reach their peak within a few minutes, and often last for 10-30 minutes before disappearing on their own.
Panic attacks cause serious disruptions in a person's functionality 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 cycle. Panic attacks bring with them what we call "avoidance behaviors"; the person constantly avoids certain situations, people, environments and places with the anxiety of experiencing a panic attack. Although this avoidance method, which is used to minimize the risk of experiencing a panic attack, may seem innocent, it seriously disrupts the person's normal life flow.
The presence of panic attacks that continue in a person's life for a long time also brings with it many psychological problems. As a result of long-standing attacks, the person; People begin to experience depressive states such as inability to enjoy life, disruptions in eating patterns (eating less than normal or overeating), disruptions in sleep patterns (sleeping less than normal or not being able to get out of bed), loss of motivation, struggling with thoughts of hopelessness, crying and tantrums. Just as the presence of panic attacks causes depressive symptoms, the severity of depressive symptoms also increases panic attacks. Ultimately, life becomes unlivable for the panic attack patient.
PANIC ATTACK SYMPTOMS
Auto-Arousal Symptoms
1. Palpitations, rapid heartbeat
2. Sweating
3. Tremors, tremors
4. Dry mouth
Chest and Abdominal Symptoms
5. Difficulty breathing
6. Feeling of suffocation
7. Pain or pressure in the breasts
8. Anxiety or abdominal discomfort
Mental Symptoms
9. Dizziness, dizziness, feeling faint, unsteadiness
10. Derealization, depersonalization
11. Fear of losing control, going crazy, passing out
12. Fear of Death
General Symptoms
13. Hot or cold flashes
14. Numbness
WHAT IS PANIC DISORDER?
A constant fear-anxiety that panic attacks will occur in the times between attacks due to unexpected, recurring panic attacks, panic attacks such as "having a heart attack", "going crazy, losing control, Feeling sad because of constant thoughts that it will lead to bad consequences such as "fainting", "being paralyzed, dying", avoiding attacks and taking precautions against their possible consequences (not going to school, work, doing sports, not doing housework, shopping malls, public transportation). It is a mental disorder in which behavioral changes such as not being in public places, staying away from certain foods and beverages, carrying medicine, water, food, and pharmaceutical equipment are observed.
HOW DOES PANIC DISORDER OCCUR?
First Attack Begins; Heart palpitations, pain, tingling in the hands and feet, numbness and tremors, chills or chills, dizziness, nausea, feeling of fainting, blackout, desire to vomit, sweating, inability to breathe, palpitations, etc., without any valid reason. >
The symptoms terrify the person. At that moment, the person experiences an intense fear of death or paralysis, thinking that he will "have a heart attack" or "be paralyzed".
In some cases, feelings such as dizziness, strangeness, seeing the environment and people around him in a strange way, feeling strange or strange occur, causing him to "lose control" or think that he is "going crazy" and start to think that he or he is going crazy. He is afraid of causing harm.
As a result of this first attack, the person seeks medical help and consults doctors, especially about heart diseases. However, as a result of all the examinations, he will receive the answer that "there is no problem, it is due to stress" and he will be given a sedative injection and sent home with a recommendation to see a psychologist.
Attacks Recur;
The patient experiences a panic attack again after the first attack and the same feelings of terror arise. This results in constant transportation to emergency rooms. This situation becomes a vicious circle in your life.
New doctors are tried each time and the patient tries to find out the reason for this situation. When the examinations performed by the doctors give the same result, the patient begins to accuse the doctors of inadequacy and blames the patients for blood pressure, blood pressure, diabetes, brain pathology, etc. They begin to think that they cannot understand situations such as these. This situation causes him to travel from doctor to doctor and from hospital to hospital, causing both material and moral losses.
In some cases, panic disorder becomes more severe as the patient who starts drug treatment due to incorrect diagnoses sees that the situation does not change.
Anticipation Anxiety Develops;
Continuous, persistent attacks cause the patient to constantly feel tense, fearful, restless and anxious, and these negative emotions intensify. The patient begins to experience constant fear of a new attack. This condition is called anticipatory anxiety. After a while, the severity and recurrence of panic attacks increase due to anticipatory anxiety.
Intense Negative Emotions Are Experienced;
The emotional state of the patient experiencing panic attacks is constantly full of anxiety, tension, fear and sadness. The functionality of life is disrupted for a 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 gradually begins to disappear.
Behaviors Are Changing;
After a while, patients take a series of precautions against attacks and disasters that they believe may occur during attacks, and they begin to change some of their behaviors.
The most common among these “security measures” are; Staying away from places and places where attacks may occur, staying away from foods and drinks that they think may cause attacks, and drinking drugs, alcohol, etc. when leaving the house to prevent attacks.
Not only do they stay away from many places where they believe attacks will come, but when they go out, they take with them bags filled with a lot of equipment to meet their security needs. There are water, salty-sweet dry foods, blood pressure monitor, glucometer, cologne, and warning cards with the addresses and telephone numbers of the relatives in case of a possible fainting.
The person who thinks he will have a panic attack starts spending time with his child in hospital gardens or near outpatient clinics. He does not prefer to go out alone, he thinks that he should have someone he knows with him in case of a possible panic.
Since they think there is a possibility of harming someone during their attacks, they put away cutting tools at home, and they have iron railings made, thinking about the possibility of throwing themselves from windows or balconies during the attack.
This list can go on and on, but in summary, panic disorder patients rearrange and shape their lives according to their panic attacks. These security measures and avoidance behaviors make it easier for panic attacks to continue.
Psychopathological Disorders Accompanying Panic Disorder
Panic disorder is often found together with other anxiety disorders and depression. A major depressive episode is observed in 35-91% of panic disorder patients.
In patients with panic disorder, hypochondriasis, which is a persistent fear of having a serious illness and the tendency to medically confirm this belief, is observed at rates not lower than 20%.
Alcohol in patients with panic disorder The incidence rate of lysis was found to be 17%.
Why Does Panic Disorder Occur?
1. Panic Disorder occurs as a result of the abnormal functioning of some brain hormones that are secreted from nerve cells called neurons in our brain and regulate our excitement and emotional lives.
2. It is assumed that panic attacks arise from the catastrophizing misinterpretation of some bodily sensations.
Misinterpreted sensations mainly include physical symptoms such as dizziness, palpitations, and difficulty breathing, which occur in normal anxiety states. Catastrophizing misinterpretation is expressed as perceiving bodily sensations as more dangerous than they actually are, such as seeing palpitations as a harbinger of a possible heart attack or breathing difficulties as a sign of breathlessness and dying.
According to this view, anxiety is not always responsible for the emergence of sensations, for example, in situations such as drinking too much coffee or simply getting excited, the person may experience a panic attack by misinterpreting his own physiological arousal as a sign of internal danger.
Is It Possible to Treat Panic Disorder?
Panic disorder is a treatable psychological disorder. There are two treatment methods with proven effectiveness in the treatment of the disorder today.
1. Drug Treatment
2. Cognitive Behavioral Treatment
CBT in panic disorder, the cognitive model that assumes that panic attacks arise from the catastrophizing interpretation of bodily sensations, and that hyperventilation plays a role in the formation of attacks. The views were developed by taking them together.
Cognitive therapy in panic disorder is based on the principle of correcting cognitive misinterpretations by enabling the patient to cognitively re-attribute his/her physical symptoms to a harmless and controllable situation.
In behavioral therapy, which is based on breathing control, excessive breathing exercises are performed.
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