Panic attacks. Causes and treatment methods.
A panic attack is an attack of severe anxiety, fear, or panic, which is accompanied by certain vegetative (bodily) reactions.
The duration of attacks can vary from a few minutes to several hours, averaging 15-30 minutes.
In order for an anxiety attack to be identified as a panic attack, it must combine at least four of the following main symptoms::
Rapid pulse rate;
Feeling of lack of air, shortness of breath, difficulty breathing;
Chills, tremors, internal tremors;
Pain or discomfort in the left side of the chest;
Dizziness, pre-fainting state;
Fear of going crazy or doing something out of control;
Fear of death;
Sensation of numbness or tingling in the extremities;
Confusion of thoughts;
Other (additional) symptoms may also be present:
Sensation of a lump in the throat,
Visual or hearing impairment,
Cramps in the arms or legs,
Motor function disorder,
Increased blood pressure.
Patients often talk about the spontaneity (unprovoked) of attacks. However, in the course of the conversation, it often turns out that along with spontaneous manifestations of PA, there are also situational attacks that occur in places perceived by a person as potentially dangerous. These places and situations include:
Use of public transport;
Stay in a large crowd of people or vice versa in a confined space;
And sometimes even, just, the need to leave your own home.
This list can go on for a long time, but we will stop there.
Panic attacks are a symptom of what is known as panic disorder.
Panic disorder (episodic paroxysmal anxiety) is a mental disorder that is characterized by the spontaneous occurrence of panic attacks from several manifestations per year to several times a day and an anxious expectation of their occurrence.
“Panic disorder” is internationally recognized as an independent disease. It is included in the International Classification of Diseases of the 10th revision (ICD-10).
Some Russian doctors use outdated terms that are not included in the ICD, but instead emphasize the type of disorder of the autonomic nervous system, depending on the leading symptom:
“VSD (vegetative vascular dystonia) with a crisis course”;
“NCD “(neurocirculatory dystonia)
Causes and development of panic attacks
Panic attacks occur when the level of anxiety is extremely high.
If in phobias the anxiety is increased and looks for ways to rationalize itself, turning into a specific fear, then in panic attacks the level of anxiety is even higher and it is no longer looking for a specific object to implement. The anxiety just comes out and catches the person off guard. This can happen anywhere: in the subway, in a bank, in a store, just on the street, etc..
As a rule, a panic attack occurs when a person’s anxiety is additionally “spurred on”. For example, a person finds himself in a crowded place and it seems to him that today for some reason he somehow looks “wrong” and that everyone is looking at him. This can trigger a fear of judgment and trigger a PA.
An important fact is that people suffering from panic attacks generally always have low self-esteem. They are very critical of themselves. And the triggers that trigger panic attacks are often their thoughts about how they look from the outside and what others think about them. These obsessive thoughts cause internal tension and anxiety. Fear of judgment makes a person afraid to express themselves spontaneously. He is afraid that this behavior may displease someone and cause negative emotions in this dissatisfied person, which he can somehow express.
Comfort zone and alarm control
Very often, the comfort zone of anxious people is very narrow and cramped, and it is very easy to accidentally push them out of it. At the same time, any exit from the comfort zone causes additional anxiety and threatens the appearance of another panic attack.
At the same time, being in the comfort zone of a person with this anxiety-phobic disorder does not feel completely calm. He’s still worried. But being in the usual conditions, he learns not to notice his excitement.
When everything is under control, such a person has the mental resource to push out his anxiety, not to think about what causes it, being in the illusion of comfort. He fills his head with unimportant arguments that do not affect anything.
But as soon as he leaves the usual conditions of existence, as the neuropsychic energy is directed to adapt to a changing environment and there is no resource left to contain anxiety, which leads to its release in the form of panic attacks.
If during psychotherapy we delve into the deeper layers of the psyche and look for the origins of this mental disorder, then we will always come to the childhood and the relationship that this person had with his parents.
The parents of a person with a panic disorder constantly emphasized their inferiority in one way or another:
They might not believe that he would succeed;
They often shamed him, making him feel unworthy of something or guilty about something;
It was always said that someone was better than him;
In general, he was trained in all ways to depend on someone’s assessment, so that he would meet some non-existent standards.
The fact is that a person with PA does not allow himself to criticize the upbringing that his parents gave him and idealizes them, forgetting that they are ordinary people who, like everyone else, tend to make mistakes. Such an approach to one’s own personality and the personality of one’s parents becomes one of the reasons for the emergence of PA.
Agoraphobia. Panic anchors.
On the basis of panic attacks, a special type of phobia can also form.
If you need some event logic for the usual phobia formation, then you don’t need it for the formation of phobias under the influence of panic attacks. Since a panic attack can happen anywhere and anytime, then a phobia can form on anything. And such a phobia will not be one, but there will be many of them, since each place and circumstances under which a panic attack occurred will become an anchor reminding a person of the incident in which he panicked. And there will be more and more such anchors during the course of the disease, due to the fact that a panic attack happens, each time in new places and in new conditions. Thus, panic attacks expand their possessions and over time a person begins to be afraid to leave the house, since the phobic state occurs almost everywhere.
The result is agoraphobia – a fear of crowded places.
Improving your self-esteem
One of the areas of treatment for panic attacks is to work on improving self-esteem and self-confidence. And also on the ability to be critical of the personality of their parents. The ability to criticize the upbringing that was given to him by his parents will allow a person to move on, working on their personal characteristics and developing their own personality, and not freeze in place, afraid to change what adults who are important to them have created.
In the process of psychotherapy, a person goes through the following stages::
Understanding that parents are not perfect because they are ordinary people;
Protest against parenting methods used by parents and against the parents themselves;
Separation – mental separation from parents;
The beginning of the formation of your own personality;
Acceptance and gratitude to parents for doing everything they could and how they could to raise their child.
Accepting yourself as you are and starting to build your life according to your own preferences.
It is worth noting that all the procedures described in this section should be carried out under the supervision of a psychotherapist or psychologist. Or at least periodically visit it and talk about the work done in order to get the necessary recommendations and make adjustments to your wellness activities.
At the same time as working on self-assessment, it is necessary to conduct procedures that help reduce anxiety.
Help reduce anxiety:
Also, if a psychiatrist or neurologist prescribes medications, then they should also not be neglected, just as you should not get carried away.
Medications should be treated as an auxiliary tool that facilitates psychotherapy and, the dosage of which should be constantly reduced as progress is made in psychotherapeutic treatment.
Psychotherapeutic treatment can be carried out in various directions:
Cognitive behavioral therapy. It will help you develop the habit of not being afraid of panic attacks.
Body-oriented therapy. It will teach you how to understand the body signals that precede panic attacks, and how to manage your body’s responses to ease symptoms.
Hypnotherapy. It will help to create new internal attitudes that promote mental immunity, which helps to predict and prevent panic attacks.
Also, in addition to all of the above, a psychotherapist will help you understand the causes of PA. During psychotherapy sessions, you will find out what is at the root of this disorder and what events or series of events led to it.
In order for the treatment of panic attacks to be successful, a certain number of vectors must converge:
The doctor prescribing medications should respect psychotherapeutic methods of treatment and understand that medications do not treat a mental disorder to the full, but only relieve certain physical symptoms and adjust the chemical and hormonal background of the body. As soon as a person stops taking them, his body ceases to produce the necessary chemical elements for maintaining health. Therefore, in the long run, medications lead to addiction.
The psychotherapist should also not sabotage medical treatment, but should cooperate with the doctor to discuss the results of medical and psychotherapeutic treatment, as well as determine and adjust the dose of medications.
The third condition is the cooperation of the patient himself with the specialists treating him. He should try to be honest with them and follow all their instructions. In other words, the patient should feel responsible for what is happening to them and not pass it on to the people treating them.
If the client-therapist collaboration is established, there will gradually be a decrease in the number of panic attacks, as a result of which they will stop completely.
As treatment progresses, the dosage of medications should be reduced until they are completely discontinued. All this should happen against the background of psychotherapy treatment.
As the general anxiety decreases, both phobias and panic attacks will go away, that is, a complete physical and mental recovery will come.