Panic attacks strike like lightning with no warning. terrifying the victim. Fear floods the mind and body, threatening disability or death. When it diminishes after ten or twenty minutes, the secondary fear is that it will happen again.
The American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders (DSM 1V) identifies a panic attack as a discrete period of intense fear or discomfort in which four or more symptoms develop abruptly and reach a peak within ten minutes. There is often a sense of impending doom and an urge to escape. Episodes of fewer than four symptoms are referred to as limited-symptom attacks.
Symptoms
The following are typical symptoms:
People understandably think the problem is physical. A panic attack causes the fastest and most complex reaction within the human body, and alerts the functioning of the eyes, glands, the brain, heart, lungs, stomach, pancreas, kidney, bladder and most muscle groups. During an attack, the heart increases its rate of contractions and pain is felt in the chest. Decreased blood flow to the brain causes light-headedness or a feeling of depersonalization, and an inability to concentrate. Blood vessels in the legs and arms constrict, causing muscle tension. Pupils dilate to improve distance vision, and may cause the vision to flicker. Digestive activity diminishes, causing stomach distress. Increased perspiration may cause hot or cold flashes and the mouth may feel dry .
Related conditions
It is important to rule out cardiovascular, respiratory, endocrine/hormonal, neurological/muscular, ear, or kidney disorders, and drug related conditions or medication side effects. The intensity of a panic attack and lack of an obvious precipitating specific stressor help differentiate it from other anxiety disorders such as generalized anxiety, agoraphobia, specific phobias, post traumatic stress disorders, and obsessive compulsive disorders. Some complicating issues include premenstrual syndrome, hypoglycemia, depression and alcoholism. Medication, such as tranquilizers or anti-depressants, can help with symptoms but does not resolve the underlying causes.
Causes
Because panic attacks seem to come out of the blue, the real causes are misunderstood. In general, accumulated stress over time creates the conditions in which panic attacks arise. Recent stressful events may trigger an attack. Behaviorists believe people become conditioned to panic when they are in a situation similar to the one that triggered the first attack. Cognitive theorists believe incorrect thinking (misinterpretation of symptoms) can trigger attacks. Others believe that disturbances in neurotransmitters cause attacks. Psychoanalytic theory posits that unresolved conflicts cause attacks. There is some evidence that there is a genetic basis for the disorder. While panic attacks are not yet completely understood, many forms of treatment can be helpful.
Treatment
Treatment of panic attacks includes treating the symptoms with
behavioral and cognitive strategies, such as breathing techniques and
relaxation exercises. Patients learn to develop positive self talk to
counter negative thoughts. The patient is helped to re- evaluate
personal circumstances by completing a life stress inventory, which
helps the patient develop a broader perspective of the problem instead
of focusing on symptoms. Psychotherapy helps to resolve
long standing inner conflicts, and to develop the self esteem and
assertiveness
needed to deal effectively with the dilemmas of life. The true solution
to
panic attacks is accurate information, therapy, and a supportive
environment
in which to grow in self confidence.
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