Tag: Panic Disorder

Panic Attacks: Between Panic Disorder and Agoraphobia

For most people, dealing with life stressors job changes, moving, pregnancy, birth of a child, death of a loved one etc. do not result to anxiety and panic attacks. However, to those who are vulnerable to emotional stress, such situations may lead to panic attacks even if these events happened way back in their life. The reason for this is still not fully understood but it is believed that one major cause of panic attacks is extended period of stress (not by a few days of tension but by several months of constant worrying and unprocessed emotions).

The chances of having an attack are even greater when a panic-prone person receives unnecessary stress such as additional tasks at work or additional responsibility at home. Instead of performing normally under regular circumstance, the additional load can put more pressure that can lead to more stress which can be a catalyst for an attack.

What is panic disorder?

It is commonly believed that panic attacks happen out of the blue, without any reason. It can happen to anyone at any point in their life. Many people experience one episode of panic attack. However, others go on to suffer from panic disorder. Panic disorder is characterized by several episodes of panic attacks related to past traumatic experiences, existing stress (mentioned above) or something else.

Many attacks last for not more than 30 minutes but the effects of panic disorder can leave lasting effects. People suffering from panic disorder experience emotional stress and excessive fear due to the memory of past attacks. This negative memory has a negative impact to self-confidence and self-esteem, which can lead to the disruption of everyday activities and normal living. While the causes of panic disorder vary from person to person, all conditions lead to these symptoms:

Anticipatory anxiety or the fear of having future attacks. This can have a detrimental effect to the sufferer since they cannot relax and they always feel anxious and tensed in between attacks.

Phobic avoidance is characterized by avoiding situations or events in the belief that the situation may cause panic attack. Phobic avoidance can also be avoiding places where help is unavailable during emergency situation.

What is agoraphobia?

Agoraphobia is traditionally believed to involve fear of open spaces or public places. Literally means “fear of the marketplace,” agoraphobia is now believed to be a result of panic attacks.

People diagnosed with agoraphobia show different symptoms. But common to all agoraphobics is avoidance either being in public places or being alone. This is actually a character of phobic avoidance (one distinct symptom of panic disorder). The difference, however, is that the effects of agoraphobia can significantly limit the person’s normal activities. Thus, what sets agoraphobia apart from panic disorder is the amount of activities that the person avoids.

People with panic disorder stay generally active, although there are specific situations that they tend to avoid. On the other hand, agoraphobics limit their activities because of fearful thoughts. These fearful thoughts can be very damaging the person’s life as well as his relationship to others.

Either way, both conditions are the result of panic attacks. Hence, it is always best to know the things you can do in order to prevent panic attacks from recurring and worsening. On the first sign of attack, seek for professional help.

Various Treatments for Panic Attacks

The cause of panic attacks is still not fully understood. What is known is that it can happen to anyone, without any reason, regardless of age. Meaning, a happy and healthy person has an equal chance of experiencing a panic attack with those who are depressed and unhealthy. An episode of panic attack chooses no time. It can happen while you are at home, sitting on your couch, watching television, while driving, shopping or walking, at the office, etc. It can even happen while you are asleep.

Given such circumstances, methods of treatment may vary from person to person, depending on his conditions, symptoms, lifestyle, and frequency of attacks. Typically however, treatment involves psychotherapy, cognitive behavioral therapy (CBT) and/or medication. Other treatments that can be employed are meditation, breathing exercises, relaxation techniques and herbal treatment.

Anti-anxiety medications such as Ativan, Xanax and Klonopin provide quick relief from the symptoms panic attack. Benzodiazepines have immediate effects, usually within 30 minutes to an hour. Benzodiazepines, however, are highly addictive and have some serious withdrawal symptoms. Anti-depressant drugs (Paxil, Prozac, Zoloft, Lexapro, and Celexa) should be taken continuously before you can begin to notice the effects, usually up to 6 months to a year. You cannot take anti-depressant drugs just during an attack.

In addition, since you cannot anticipate when you will have such attack, only those who are diagnosed with panic disorder (or recurring panic attacks) can acquire these types of drug.

Panic attacks, as well as panic disorder, agoraphobia and other phobias and related conditions can be treated effectively by psychotherapy. Cognitive-behavioral therapy is proven as an effective way to reduce the symptoms of panic attacks or completely eliminate the condition. CBT focuses on changing the thinking pattern of the person from negative to positive thoughts as well as changing the way a person reacts or behaves when he encounters emergency or situations that can trigger an attack.

Another treatment similar to CTB that is worth mentioning is exposure therapy. This helps the person overcome his fear by letting him face those fearful situations in a controlled and safe manner. The result of this technique is that the person learns how to react positively on what he thinks are fearful situations. Moreover, through this experience, the patient learns that the situations he fears are not harmful and dangerous.

In many cases, medication alone or therapy alone is enough to completely treat the condition, but other cases require both treatment methods to effectively treat panic disorder.

Meditation, breathing exercises, and relaxation techniques have been found effective in reducing the chances of experiencing another attack. They help calm the mind and relax the muscles. Regularly practicing these exercises and techniques strengthen the body’s relaxation response.

Natural herbs such as bacopin, ginkgo biloba, passion flower, St. John Wort, hyperforin, 5HTP (5-hydroxytryptophan), chamomile, rhodiola, are equally effective since they have natural anti-stress properties. In some cases, using these herbs is sufficient enough to combat panic attacks. Many people also react positively using this kind of treatment.

Fresh leaves can be made as tea. Some are also available over-the-counter in oil, tincture, capsule, powder and tea. The best thing about these natural herbs is that they do not carry any side effects as compared to mainstream anti-anxiety and anti depressant prescription medications.

Understanding Panic Attacks

What is a panic attack?

A panic attack is a sudden attack of exaggerated anxiety and fear. Often, attacks happen without warning and without any apparent reason. Some people may experience just one episode of panic attack, while others can have recurring episodes. Recurring episodes usually happen after a person is exposed to various events or situations that may “trigger” panic. While it is generally harmless, panic attacks can severely disable a person physically, emotionally and psychologically. In extreme cases, panic attacks can lead to panic disorder.

Who gets panic attacks?

The condition affects many people. It is believed that 10% of the total population is suffering from panic attacks, yet many are still undiagnosed or under-diagnosed. They tend to occur more on young adults. Female are twice as prone to have an attack as male. It is also said that the condition is genetically inherited so panic attacks may run in the family.

How do I know if I am having an attack?

A panic attack can be identified with different signs and symptoms. They include increased heartbeat or palpitation, chest pain, hyperventilation or shortness of breath, stomach churning, upset stomach, trembling and shaking, muscle tension, sweating, dizziness and light-headedness, hot or cold flashes, tingling sensation or numbness, fear of dying, going crazy or losing control and feeling detached from the surroundings.

The signs and symptoms of panic attacks are similar to a heart attack. The former is not dangerous, the latter can be deadly. It is best therefore to seek for emergency medical help, especially if the patient experiences it for the first time.

What cause an attack?

Many panic attacks happen without any apparent reason; they just come out of the blue. However, attacks may be caused by past traumatic experiences such as death of a loved one, family conflicts, bad relationships, divorce of parents, car accident, public humiliation, etc. An attack may occur when a person is exposed to various events or situations almost similar to the past that may “trigger” panic.

Stress is closely linked to panic attacks. Triggers include stressful life event as well as stressful working and living environment. Genetics is also believed to cause an attack.

What should I do during an attack?

Panic attacks peak from 5 to 10 minutes; it rarely lasts for more than half an hour. But during this time, you can experience discomfort such as those signs and symptoms mentioned above. Since the increased in heart rate is the main reason for experiencing other symptoms, it is important to take control of your breathing during an attack. Breathe slowly and deeply as you can. Breathe in slowly for 3 counts then hold your breath for the next 3 slow counts. Then, exhale for 3 slow counts.

Do this until you are calm. If you are able to stand, get up slowly and walk around. It is also helpful to breathe into a plastic or a paper bag. This allows you to re-breathe your carbon dioxide. Carbon dioxide helps correct the blood acid level that had been disturbed by excessive breathing.

While practicing deep breathing, try to focus your attention away from the cause of panic. Replace your anxious thoughts with happy ones. If available, do something that will occupy your mind such as solving puzzles and playing word games.

Triggers and Causes of Panic Attacks

Here are the common triggers and causes of panic attacks:

Phobia People who are exposed to certain situation or objects they are afraid of will often experience a panic attack.

Passiveness Many think that excessive politeness, shyness, and respectfulness are a positive thing and it is normal for someone to possess these characteristics. Be that as it may, a growing number of evidence supports the idea that passiveness as a result of fear (sometimes unexplained), low self-esteem and self-confidence is consistent with a person experiencing episodes of panic attack.

Hyperventilation syndrome Mouth breathing and over-breathing or exhaling more carbon dioxide with respect to the amount of oxygen in the bloodstream can result to symptoms including dizziness, lightheadedness, and rapid heartbeat. These symptoms, in turn trigger panic attacks.

Benzodiazepines Drugs such as benzodiazepines are prescribed to treat the symptoms of panic attacks. These drugs have a very quick to take effect. Usually, the patient finds relief within 30 minutes. However, benzodiazepines are highly addictive and rebound effect is common (a panic attack triggered by withdrawing from the drug).

Medications There are certain drugs such as fluoroquinolone type antibiotics and Ritalin (methylphenidate) with panic attacks listed as a side effect. Attacks may be temporary, usually occurring when a patient begins medication but may continue occurring even if the patient is already accustomed to the drug. When this happens, change of dosage or type of drug is usually warranted. Selective Serotonin Reuptake Inhibitors or SSRIs boost the level of serotonin in the brain which regulates and normalizes emotions. However, intake of SSRIs can increase anxiety at the beginning of use. Panic attacks may even be more frequent to patients who wean on and off the medications

Biological causes post traumatic stress disorder, obsessive compulsive disorder, Wilson’s disease, pheochromocytoma, hypoglycemia, mitral valve prolapse and labyrinthitis (inner ear disturbances) can manifest through panic attack. Vitamin B deficiency from periodic depletion because of parasitic infection from tapeworm or due to inadequate diet can trigger panic attacks.

Heredity Children, whose parents have been found to suffer from panic disorder, are likely to experience or have panic attacks as well. In other words, inheritance plays an important role in determining who gets it. However, people with no family history can still develop panic disorder.

Environment factors and upbringing People who grew up overly cautious about their life and actions, and those who live in a very stressful environment, plus different traumatic experiences from the past are likely to have panic attacks.

Short-term triggering causes Significant life changes, emotional trauma from a failed relationship, life transition, stimulants such as nicotine and caffeine, psilocybin, marijuana, and drugs can trigger panic attacks.

Take note that these triggers and causes may have different effects to different people. One may only need one trigger to have an episode of panic attacks. Others may require several triggers in order to break down. Also, by simply being exposed to any of these triggers do not automatically result to panic attacks because some are emotionally stronger than others.

It is also important to note that some symptoms of panic attacks may also be a sign of other medical condition. Hence, it is important to precisely pinpoint the cause of the symptoms in order know what type of treatment is necessary.