Panic Disorder/ What is Panic Attacks?
Panic disorder is a disorder caused by repeated and unexpected panic attacks (not triggered by any object or situation
). It is psychopathology.
These attacks are intense anxiety accompanied by physical symptoms. Panic attacks can occur in all
anxiety disorders or other psychological disorders. However,
panic disorder is an anxiety disorder with spontaneous and unexpected panic attacks.
What are the Symptoms?
Panic attacks Apart from this, there is no disorder in the general appearance and behavior of the person,
in speech, in establishing relationships with people, his orientation,
perception and all cognitive abilities are in place. However, during a panic attack
the person appears extremely anxious and agitated, cannot speak comfortably, his voice trembles.
There is excessive fear and arousal. During a panic attack, from time to time, a situation may occur as if the person does not know his/her environment and has a perception disorder
. The person may be in a state of mental confusion and bewilderment. An alienation can be seen as if he/she is watching him/her from the outside. or the fear of going crazy, of losing control
(fear of losing control, of falling and fainting, or of shouting frantically,
of doing something crazy) is evident. The most important complaint of the person after the panic attack subsides is the fear of experiencing the panic attack again. The fear of the repetition of the panic attack
is called "anticipatory anxiety"
. Individuals are constantly thinking about what they can do
to prevent the development of attacks and how they can stop the attack when it develops
The onset of the disease is usually spontaneous (ie, in the absence of a stimulus
) and abruptly. Although it has been reported, most of the
individuals with this disorder have been exposed to a
life stressor (an important life event such as death, separation, humiliation) that can be associated with an attack in the last year
. Yet these It cannot be said that it is a specific stressor
.
Considering the physical and physiological symptoms experienced by the person, palpitations,
feeling the heartbeats or increased heart rate; sweating, shivering,
shaking, chills, chills, or hot-cold flushes; unable to breathe,
as if suffocating, increased breathing; chest pain or tightness in the chest; nausea or abdominal pain; dizziness, inability to stand,
lightheadedness or fainting; numbness or tingling
sensations, frequent urination; Elevated blood pressure is the most common
symptoms.
Panic attacks start suddenly, reach a peak in 10 minutes, then decrease in
severity. Attacks last about 15-20 minutes (sometimes a few minutes,
rarely several hours). In the beginning, the person is surprised at what has happened.
Because of the fear of death or going crazy, he waits for help from those around him and
usually applies to the emergency room fearing a heart attack. The initial panic attack
occurs spontaneously and unexpectedly, but over time, it can become associated with certain situations or cues, such as
entering a crowded shopping mall or getting on a plane or train
.
The frequency and severity of panic attacks vary greatly between individuals or in the same person over time
. For example, from having attacks
a few times during the day to having panic attacks only a few times a year... Attacks
mostly occur during the day. However, some individuals wake up with panic attacks in the first few hours after falling asleep at night. This is called “nocturnal panic
attack”. Some individuals may find that physical exercise can trigger
attacks. These individuals may avoid exercise or
sexual intercourse. Many substances (eg, caffeine) can
cause panic attacks.
Some people with panic attacks are afraid to go out alone. Most
the fear of death, loss of self, doing something out of control, or falling and fainting will subside most of the time when there is someone he trusts with him. The person enters the environment where he/she has a panic attack, or the environment where he/she thinks that the attacks may occur and that he/she cannot get support. may begin to avoid. As a result,
panic disorder can cause agoraphobia. People often describe panic attacks as
the worst experience of their lives. Recurrent panic
attacks can become so difficult to cope with that the person may become suicidal
.
Diagnostic Criteria
Panic disorder In order for the diagnosis to be made, panic attacks that start unexpectedly
-not triggered by any object or situation- should be seen repeatedly. It is unclear where
these attacks came from. On the other hand, about an hour
before the unexpected attack, some mild/subtle physical symptoms may occur, and the person may not be aware of these
symptoms.
Diagnosis of the person according to DSM-5 criteria For this, the person must show signs of panic attack
. Also 1. Persistent worry or worry about
other panic attacks or their possible consequences (eg, losing control, having a heart attack, “going crazy”). 2. Concerning the attacks,
behavioral changes associated with adjustment disorder (eg, behaviors designed to avoid
panic attacks, such as playing sports or
avoiding familiar, unfamiliar situations) at least one of the items
must live for at least 1 month.
Panic attacks can occur in the context of anxiety disorders as well as in other
mental disorders (eg depression disorders, substance use disorders
disorders). and certain health conditions (eg cardiac, respiratory
). When the presence of a panic attack is diagnosed, it should be specified as a
determinant (eg “post-traumatic
stress disorder with panic attacks). In panic disorder, the presence of panic attack is included in the diagnostic criteria for this disorder
and panic attack is not used as a predictor
. If panic attacks occur only in response to certain triggers
, then the diagnosis of panic disorder is not made, but the related anxiety disorder
.
Panic disorder can be combined with many diseases. Among these, the most common
disease Major depressive disorder, other
anxiety disorders, alcohol and substance use disorders, bipolar disorder, some
medical diseases (dizziness, cardiac arrhythmias, hyperthyroidism, etc.) can be counted among the symptoms.
Onset and Course of Panic Disorder
Panic disorder usually begins in late adolescence to mid-30s.
Panic attacks are rare before 14 years of age. Although the first panic attack
may seem to occur "out of the blue", it often occurs after some high-stress
life events such as the loss of a loved one,
loss of an important relationship, or job loss. The normal course is chronic, but increases and decreases.
Some individuals show persistent severe symptoms, while others may have
periods of remission.
Differences in clinical features of panic disorder between men and women does not appear. Alcohol
use may increase as a coping method in men. A history of panic attacks may increase the risk of suicide, independent of comorbid disorders
.
The lifetime prevalence of panic disorder is 4.7%. It is 2 times more common in women than men. In addition, poor people
are 50% more likely to have panic disorder than rich people.
Treatment
In the treatment of a person diagnosed with panic disorder it is aimed to no longer experience panic attacks
, to minimize the agoraphobic avoidance and anticipatory anxiety
and to restore functionality. For treatment
pharmacological treatment and psychotherapy treatment can be found. Because of the biological basis of panic
attacks, it is tried to minimize the biological
problems of the person with pharmacological treatment. For this reason, antidepressants and benzodiazepines
can be prescribed by specialists to people who have
a diagnosis of panic disorder. Resolving the factors
can be targeted. With Cognitive Behavioral Therapy, cognitive misinterpretations can be corrected
and emphasis is placed on breathing regulation exercises, relaxation exercises, exposure
.
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