When you are in real danger, like facing a bear or a gun, your body prepares for an autonomous mechanism called “fight-or-flight”: your heart rate will increase, blood will pump faster to your muscles causing numbness or tingling, and you may sweat and become flushed, and you will sense fear and aroused.
A person who suffers panic attacks experiences repeated, sudden episodes of fight-or-flight mechanism without a real danger or cause. These repeated attacks can be debilitating.
Everyone may experience a self –resolving panic attack once or twice in their lifetime, perhaps while they are under unusually stressful events, and with no need to seek treatment. However, when a person experiences several panic attacks, and fears that they will happen again, s/he may have a condition called panic disorder, which requires professional attention.
What does panic disorder feel like?
- Sudden and repeated attacks of fear that last for minutes
- Sense of loss of control
- An intense worry about future panic attacks
- Avoidance of places or situations of previous panic attacks
- Physical symptoms during panic attacks include pounding and fast heart rate, sweating, rapid and/or shortness of breath, weakness or dizziness, numbness, feeling too hot or too cold, chest pain, and stomach pain. Sometimes feelings of being unreal may be experienced.
What puts a person at risk of developing panic disorder?
The cause of panic disorder has not been fully understood , yet the following are the most common risk factors.
- Genetics; panic disorder runs in families
- Tendency to negative emotions
- Changes in brain chemistry; in panic attacks, there is over-activity in the danger-sensing zone of the brain, called locus ceruleus, which stimulates the amygdala, the region of the brain that is responsible for controlling thinking and emotions. As a result, the physical symptoms are initiated.
- Traumatic experiences, during childhood or adulthood
- Major life events, such as divorce, having a baby, losing a job, stressful health issues and sudden and unexpected surgeries, etc.
- Excessive caffeine intake or smoking
The use and withdrawal of drugs, alcohol, or nicotine may worsen the symptoms of anxiety
What are the treatment modalities at LWHCC for panic disorder?
- Psychotherapy plays an important role in the treatment of panic disorder. Psychotherapy will help you understand panic disorder and guide you into coping with the symptoms. It aims at modifying your thinking process and provides techniques that help you control your behaviors and emotional responses. One “side effect” of psychotherapy is temporary discomfort during behavior modification sessions. The psychotherapist will help you through this process to keep discomfort to a minimum level, and will provide you with a safe environment.
- Antidepressants, which are usually prescribed when patients have been suffering with panic disorder and requires a long term solution and when symptoms interfere with daily activities.
- You may start sleep better and feel less anxious after a few days of starting antidepressants, but your overall improvement will probably take 2-4 weeks.
- Benzodiazepines, which are used with extreme caution, since they may develop dependency. These medications are strictly for short term use and acute anxiety relief. They are usually very helpful if taken judiciously and exercise caution s as advised by your doctor.
Which treatment modality is better for me?
At LWHCC, we will provide you with free triage service with a professional nurse who will carry on a brief mental health assessment, either over the phone or during a face-to-face interview, and guide you to the appropriate service based on your mental health status and individual needs.
What can you do to help yourself?
- Talk to someone you trust
- Keep a journal of your thoughts and emotions. It will help you identify triggers and plan future responses to them
- Try to reassure yourself that those symptoms will go away
- Try shifting your focus. It might be helpful to look at a certain object and focus on details; this can shift your attention away from the anxiety you are feeling.
- Stay physically active, even a short walk can help relieve your anxiety symptoms
- Try to maintain a sleeping routine; try lying down in bed and listening to soft music if you can’t sleep
- Avoid alcohol and other sedatives as they may worsen anxiety, especially during withdrawal
- Quit smoking
- Reduce caffeine intake
- Eat healthy meals
- Use relaxation techniques, such as yoga and meditation
- Follow your treatment plan
- Socialize; social isolation can worsen your anxiety
- Join a support group, if available
What can you do to help a close one who has panic disorder?
Panic disorder poses many challenges in the life of the patient and spouse/ family/ caregivers. Some of these challenges include disrupted plans and routines, finances, social life, and emotional wellbeing. You may feel burned out on several occasions. The following tips might be helpful.
- Learn about panic disorder. You may want to discuss your concerns with the patient’s mental health team. Please do not hesitate to contact us any time you have a question.
- Empathize with your spouse/ relative
- Do not criticize irrational fears; rather show positive reinforcement of positive behaviors
- Encourage treatment
- Listen to their fears and worries. Do not assume that you know their thoughts or needs
- Ask how you help
- Acknowledge that you do not know the experience of panic attacks
- Measure your close one’s progress based on their own improvement rather than absolute standards.
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