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Panic disorder

What is Panic disorder

Everyone experiences feelings of anxiety and panic during their lifetime. It is a perfectly natural response, particularly when one is in a dangerous or stressful situation.

Feelings of anxiety, stress and panic can occur at any time and for no obvious reason.

What is a ‘panic attack’?

A panic attack is when one’s body experiences a sudden rush of intense psychological and physical symptoms. One may feel an overwhelming sense of fear, apprehension, and anxiety. As well as these feelings, one may also experience physical symptoms, such as nausea, sweating, trembling, and a sensation that one’s heart is beating irregularly and fast .

A panic attack can be very frightening and intense, but it is not dangerous. It will not cause any physical harm.

How common are panic attacks?

At least 1 in 10 people experience occasional panic attacks, which are usually triggered by a stressful event or situation.

Panic attacks are quite common, and not a sign of serious physical or mental illness.

It might be reassuring to know that the symptoms usually peak within 10 minutes and most panic attacks last between 5 and 20 minutes.  Lot of people have panic attacks; some have only one in their lifetime, others have them occasionally, and there are individuals who experience them on a regular basis for many years.

Symptoms

When faced with a perceived threat, the body normally prepares itself to cope with it by producing a special type of chemical. Unfortunately in people suffering from Panic attacks  this coping system is faulty and triggers the reaction with minimal or without any source of danger. Thus, a panic attack is an exaggeration of the body’s normal response to fear, stress or excitement.  . 

 

Symptoms of a panic attack may include:

  • Heart ‘pounding’, beating fast or ‘skipping’ a beat
  • Sweating, trembling or hot flushes
  • Changes in breathing, either gulping air, breathing fast or feeling short of breath
  • Numbness or tingling in fingers or toes
  • Feeling one is unable to swallow, dry mouth, feeling sick or choking sensations
  • Chest pain
  • Feeling as though one may faint, ‘wobbly’ legs or nausea and dizziness
  • A need to go to the toilet
  • Feelings of utter terror or frightening thoughts
  • A feeling of dread, or a fear of dying.

The symptoms of a panic attack can be so sudden and intense that it can make one feel like one is having a heart attack. The fear of having a heart attack can then add to one’s sense of panic.

Although frightening, a panic attack will not cause one any physical harm.

Causes

The exact cause is unknown. It is seen that panic disorder is common in family members.

Some people have panic attacks in response to specific situations. For example, they may have a fear of enclosed spaces , and therefore experience panic attacks when faced with an enclosed space. Others may find it difficult to identify a trigger factor.

Treatment

Self help:

  1. Breathe as slowly and deeply as one can. Concentrating on breathing will help give one something to focus on, and will also help to control one’s physical symptoms. Breathe as slowly and deeply as possible.  Concentrate on breathing, aiming to breathe 10-12 times a minute.  Breathe through the nose, pause between breaths and try to exhale for as long as one can.
  2. Cup one’s hands over mouth and nose while one breathe. This again helps to stabilize one’s breathing. Try breathing into a paper bag – by doing this, one will re-breathe one’s own carbon dioxide.  This helps to correct the blood acid level which has become upset due to one over-breathing. 
  3. Try and focus on something else in one’s surroundings. This will help to distract one from one’s panic attack.
  4. Try not to fight a panic attack: Fighting a panic attack can often make the experience worse. Trying to fight it and then finding that one is unable to stop it can increase one’s sense of anxiety and panic.During a panic attack, try to reassure one by accepting that although it may seem embarrassing and symptoms may be difficult to deal with, the panic attack is not life-threatening. Focus on the fact that attack will have an end, and try best to let it pass.

Remember, panic attacks are not harmful

  1. Relaxation: Learning to relax can help to relieve some of the stress and tension, and may also help one to deal more effectively with one’s panic attacks when they happen.

Some people find complementary therapies, such as massage help them to relax. Others find activities such as yoga helpful.

  1. Exercise: It has been seen that regular exercise helps in panic attacks.

Talking Therapy (Cognitive behavioural therapy)

Cognitive behavioural therapy (CBT) is thought to be one of the most effective forms of treatment for panic disorder. CBT is a psychological form of treatment, involving a therapist ( Psychiatrist or a psychologist).

For example, the therapist may talk to one about the way one reacts and thinks about when one is experiencing an attack.

Once the patient and the therapist have identified negative thoughts and beliefs, one can work on replacing them with more realistic and balanced ones. The therapist can also teach ways to change undesirable behaviour, which in turn would make it easier to deal with future panic attacks. For example, learning favourable breathing techniques which are used to help keep one calm during the stress of a panic attack.

Medication

There are effective medications available which help patients with panic attacks by increasing some chemicals (such as Serotonin) in the brain. These medicines can significantly decrease the intensity and frequency of panic attacks.

The medicines however talk a while to start acting and one needs to wait patiently even if in the first few weeks there appears to be no effect of starting medications.

~ courtesy: AAR 

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