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.

Self-Help Treatment for Panic Attack

Although it is not advisable to diagnose yourself with panic attack, it is really not sensible to wait until your supposed “attack” is over before you do something about it. Here are the things you must know so that when you feel that you are having an attack, you know what to do:

Understand what panic attack is all about. Awareness is the most important weapon to combat panic attacks because when you feel or know that you are under an attack, it is much easier for you to counter the effects of the symptoms that go along with it. Remember this: panic attacks can happen to anyone. It can happen to stressed and depressed person as well as happy and healthy ones. It can happen without warning, without any apparent reason.

Triggers can also cause irrational and exaggerated fear and anxiety. Chemical imbalance in the body (low serotonin and low progesterone levels) can trigger an attack. And while there are so many studies that suggest some causes of panic attacks, the condition is still not fully understood.

Know its symptoms. For most many people, there is no easy telling whether or not they are experiencing a panic attack during the moment of attack since it is difficult for them to rationalize things and to differentiate what is real from the unreal. While this is the case, it is not really an excuse. Here are the symptoms of panic attacks: 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. Take note that people react to triggers differently, thus symptoms may vary from person to person.

Practice deep breathing. Deep breathing during an attack is the most effective way to reduce the symptoms you are experiencing as well as divert your attention from the fearful thought. Breathe in deeply for 3 slow counts, hold your breath for 3 slow counts, and breathe out for another 3 slow counts. Repeat this process until you feel you are calm. You can also breathe into a paper bag. This reason for this is that re-breathing your carbon dioxide helps correct the blood acid level that had been disturbed by excessive breathing.

Stay positive. While it is easier said than done, staying positive during an attack will speed up your recovery. Let the situation flow while keeping in mind that it will going to pass. An attack peaks for 5 to 10 minutes and rarely extends for more than half an hour so do not think that you are going crazy (or going to die) even if it feels that you are going crazy (or going to die).

Avoid unnecessary stress. While you cannot avoid every stressful situation and it is also unhealthy to turn your back on situations that need to be addressed, avoiding unnecessary stress help reduce the chances of you experiencing an attack. Stay away from people who stress you out, from relationship that causes stress, and situations that get you tensed.

Learn to say “no” if you have other much important things to do; do not work for extended hours; do not accept additional work if you know you cannot do it properly, etc.

Implant Placement

Complications commonly arise from any surgical procedure. The possibility and severity of these complications vary depending on all the circumstances of each individual surgery. The same is true for breast augmentation. One factor in determining any potential complications you may encounter is how and where the breast implants are placed. The placement can also affect the final appearance..

There are four commonly used methods of placing breast implants. The placements vary from being underneath, below or against the pectoralis muscle. These methods achieve different results as well as encountering different complications.

The subpectoral technique is the most common method used in North America. It has the lowest rate of capsular contracture. The subglandular method has a higher capsular contracture rate, but is thought to produce results that are more natural in appearance. This method also might show ripples or wrinkles in the implant in women with thin tissue in the placement area.

The benefits of a third method, subfascial, are still being debated. Supporters claim the method helps in sustaining the implant position. The fourth technique is called the submuscular implant. This method is commonly chosen when doing full breast reconstruction.

Your surgeon may have a preferred method, or choose it based on each individual case. He should discuss the method choices available to you before surgery is scheduled. No particular method rules out the chance of complications just as no method assures them either. And the appearance achieved by one technique may differ from person to person.