Panic disorder and panic attacks have become one of the situations we frequently encounter today. Even if you do not experience it personally, you are likely to have heard information about the physical symptoms of panic disorder from your friends and family. At this point, it is important to distinguish between the concepts of "panic disorder" and "panic attack". Panic disorder is a clinical condition characterized by spontaneous and sudden panic attacks.
Panic attack is a period of intense fear and discomfort in which anxiety symptoms begin suddenly and reach their highest level within 10 minutes. . These attacks usually end within 10-30 minutes. It rarely lasts longer than 30 minutes. Not every panic attack means panic disorder.
What are the Criteria for Panic Disorder and Panic Attack?
Panic Attack Criteria;
- Palpitation, sensation of heartbeat
- Sweating
- Trembling/shaking
- Shortness of breath/feeling like choking
- Shortness of breath >
- Chest pain/chest tightness
- Nausea/abdominal pain
- Dizziness, lightheadedness, fainting
- Feelings of unreality or Sensation of being separated from oneself
- Fear of losing control
- Fear of death
- Paresthesias (numbness and numbness)
- Coldness, shivering/hot flushes
According to these criteria, at least 4 of them start suddenly and reach the highest level in the 10th minute.
Panic Disorder Criteria;
- At least one of the following:
- Other attacks Constant anxiety about what will happen (at least 1 month)
- Anxiety about the possible consequences of the attack (losing control, heart attack, "going crazy", death) Loss of functionality in social and private life
A person who encounters a panic attack for the first time cannot make sense of the situation. He does not know why and experiences intense fear. The first panic attack may occur 1/3 of the time in a crowd, 1/3 of the time at home, and 1/4 of the time while driving/in the car. In the first attack, the general thing to do is to go to the emergency room. The person thinks that he has a physical illness by focusing on the changes he feels in his body (such as a heart attack). When a physical cause cannot be found, he tries to make sense of what he is experiencing.
After the first attack, the person focuses on what he feels in his body and begins to avoid environments that are likely to cause panic. It tries to find changes that will affect the quality of life as a result of the fear and anxiety created by the thoughts of "I will have an attack", "I will faint", "I will be disgraced", "I will die". The person exhibits avoidance behaviors and begins to change and reduce the environments, activities, and means of transportation with the thought that "I will have a panic attack." Thoughts and intense fear and anxiety negatively affect a person's work, social and private life.
Prevalence of Panic Disorder
It is more common in women than in men. can be seen. The first attack usually occurs in the 20s
. Rarely, the first attack can be seen in people under the age of 16 and over the age of 45.
Panic Attack Cycle
The person experiences physical symptoms. (shortness of breath, palpitations, numbness, etc.)
Interprets physical symptoms negatively. (I'm drowning, I'm going to die, something will happen to me)
Feels fear, worry and anxiety.
Exhibits avoidance behavior. (getting off the bus, opening a window, going to the emergency room, taking medication, etc.)
Thoughts During a Panic Attack
- I won't be able to control myself
- I will faint
- I will go crazy, I will go crazy
- I will die
- I will be paralyzed
- I will have a heart attack
- I will scream
- I'm going to talk meaningless
- I'm going to act stupid
- I'm going to vomit
Come now, think of some of these thoughts. Let's check it out.
I'm going to love it! :When symptoms such as dizziness, numbness, and blurred vision are combined, the person may think that he will faint, but he does not faint. A sudden drop in blood pressure is required for fainting to occur, but blood pressure does not drop during an attack.
I will die! :The person may suffocate or have a heart attack during the attack. He thinks he will die by crying out loud. When he feels difficulty in breathing and pressure in his chest, he interprets it as meaning that he is going to die. There is severe chest pain in a heart attack. In an attack, only an increase in heart rate is observed. There is no report in the literature of anyone dying from suffocation during a panic attack.
I'm going crazy! :During the attack, a feeling of not being able to collect your thoughts and not being yourself may occur. The person describes this as going crazy.
I'll be paralyzed! :The contractions, numbness and loss of strength that occur in the body during an attack trigger people to think that they will be paralyzed. But these are short-term changes that you experience during the attack. Paralysis is out of the question.
TREATMENT METHODS
Psychotherapy:
Cognitive behavioral therapy methods Effective results are obtained with . By working with the person's emotions, thoughts and behaviors, coping skills are gained.
Things and Recommendations During a Panic Attack
- Focus on the present moment: your mind will produce negative thoughts about the future when you become anxious. To avoid worrying about what will happen next, ask, “What's going on right now? Am I safe here? Is there anything I should do right now?” Try to bring your mind to the moment by asking questions like this.
- Try to control your breathing: It is important to breathe through your nose and diaphragm 9-16 times per minute. It is important to reduce your breathing rate. (you can keep your hand on the abdomen to control its inflation and deflation)
- Keep yourself busy: Keep yourself busy with a small walk or a physical activity that will distract you. The important thing is to get away from the thoughts that bother you.
- Stay away from sugary foods during an attack: You can drink a glass of water instead.
- Stand up and stand upright: Do not bend over and put pressure on the upper part of your heart or lungs. .
- Do not go to the emergency room because of an attack: During the first attack, you may have evaluated the situation differently and went to the emergency room. Do not repeat this.
- Panic is just a natural warning mechanism of your body that occurs when it is not necessary. Say to yourself: “This is wrong one stimulus, one mistake! There is no danger!”
- Stay away from or reduce the amount of alcohol and caffeine-containing drinks. (such as coffee, cola)
- Definitely consult a psychiatrist or psychologist. Thinking that this will pass or ignoring it will cause the problem to take root. Remember that this problem is treatable.
- It is important that your relatives are also informed about the issue. It is necessary to be informed about the symptoms and physical changes during the attack so that they can help.
- If possible, take at least half-hour walks every day.
- Remind yourself that you are not alone.
- Find activities that give you pleasure. Make this a routine. Fill your free time with daily chores and activities.
- Make small changes in your room.
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