Panic attack is an attack of severe anxiety, fear, panic, which is accompanied by certain vegetative (bodily) reactions.
The duration of attacks can vary from several minutes to several hours, averaging 15-30 minutes.
For an anxiety attack to be identified as a panic attack, it must have at least four of the following core symptoms:
- Rapid pulse;
- Sweating;
- Feeling short of air, shortness of breath, difficulty breathing;
- Chills, tremors, internal trembling;
- Pain or discomfort in the left side of the chest;
- Nausea;
- Dizziness, lightheadedness;
- Derealization, depersonalization;
- Fear of going crazy or doing something uncontrollable;
- Fear of death;
- Feeling of numbness or tingling in the extremities;
- Insomnia;
- Confusion of thoughts;
Other (additional) symptoms may be present:
- Abdominal pain,
- Elevated temperature
- Stool disorder
- Frequent urination,
- Feeling of a lump in the throat
- Gait disturbance
- Visual or hearing impairment
- Cramps in the arms or legs,
- Motor function disorder
- High blood pressure.
Patients often talk about the spontaneity (unprovoked) of attacks. However, during 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. Such places and situations include:
- Using public transport;
- Staying in a large crowd of people or, conversely, in a confined space;
- And sometimes even, simply, the need to leave your own home.
This list can go on for a long time, but we will stop here.
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Breathe slowly
How to get rid of panic attacks? Slow breathing helps to cope with a rapid heartbeat and shallow breathing, which are both symptoms of a panic attack and its provocateurs. By breathing slowly, you send a signal to your brain to calm down. This is one of the most effective physiological ways to stop a panic attack.
Focus on your breathing. Inhale for one-two-three-four, hold your breath for one second, exhale for one-two-three-four. Look at your stomach (even through clothes): how it inflates as you inhale and retracts as you exhale.
Night PA
A panic attack can strike a person at any moment, even at night. At night, in silence and in the dark, when the patient has nothing to distract himself with, he concentrates on his thoughts of a varied nature, including negative ones.
Another reason is nightmares. But do not confuse the attack itself with a terrifying dream. Paroxysm develops after a nightmare has been seen. And it cannot be forgotten, unlike a dream.
If we are talking about panic attacks of falling asleep, then they most often occur between 00.00–4.00 in the morning. The attack can also awaken its victim in the middle of sleep.
Nighttime PA significantly undermines human health. He suffers from sleep disorders, usually insomnia or problems falling asleep.
Insufficient rest at night provokes headaches and chronic fatigue during the day. The patient's productive activity decreases. He becomes nervous and irritable. The mood becomes depressive.
The symptoms of night attacks repeat the typical manifestations of the condition and also contribute to the development of phobias. So, after the death of her father, the girl began to have panic attacks. She noted that she experienced respiratory spasms at night. Often the thought appeared that he might not wake up. She even asked her friends to call in the morning to check if she was alive.
If a person, during a paroxysm at night, feels disconnected from reality and does not understand what is happening to him, then this feeling persists during the day. An exhausted nervous system that did not have time to recover overnight does not perceive objective reality. The patient does not understand who he is and what is happening to him.
A panic attack of awakening occurs early in the morning. The patient wakes up from a sudden and overwhelming feeling of anxiety. Gradually, other symptoms join in. Naturally, a person can no longer fall asleep, and he feels exhausted and unrested.
Admit you are having a panic attack
How to understand that you are having a panic attack and get rid of it? During a panic attack, a person catastrophizes what is happening: it seems that it is a heart attack, stroke, death, madness, that you are fainting or about to vomit.
Tell yourself mentally several times: “This is not a disaster, this is a panic attack.” The intensity of your symptoms will decrease and you will begin to regain consciousness.
Beck Scale: Test for Anxiety
Signs of the syndrome
A panic attack usually develops suddenly. And he can find the patient anywhere, at any time of the day. Its manifestations vary: from an uncontrollable, painful feeling of fear and anxiety to internal discomfort. A panic attack with mild symptoms is called “panic without panic.” In this case, physiological symptoms dominate.
The duration of the attack may be only a few minutes, in other cases it lasts several hours. But on average its duration is 20–30 minutes. PAs are repeated in one situation 1–2 times a day, in others – several times a month. Having experienced such sensations for the first time, a person retains the memory of them for the rest of his life.
There is an incredible accident when a patient experiences attacks only a couple of times in his entire life. They disappear without a trace, presumably after the stress factor ends.
A panic attack is accompanied by the following symptoms:
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The first case of a panic attack is expressed by an extremely strong fear of dying. Its power is so powerful that it can drive the patient into a state of passion. In subsequent cases, the feeling of imminent death is transformed into a specific phobia. This could be a fear of going crazy, suffocating, etc.
There are situations when the condition is not accompanied by an anxiety-phobic complex. Emotional symptoms come to the fore: apathy, a feeling of uselessness, aggression, nervousness.
After a paroxysm, patients feel exhausted and overwhelmed.
Panic attacks most often occur between the ages of 25 and 50. Approximately 5% of humanity suffers from the pathology. And what’s interesting is that they are mostly residents of large cities. In old age, such paroxysms occur rarely, have an erased character and become remnants of attacks that occurred in youth.
Those who have experienced a similar condition at least once in their lives describe it with horror and excitement.
For example, a girl had an attack while she was driving in a car with her husband and child. There was a feeling of lack of air, an unreal horror ran through from head to toe. In an instant there was a desire to open the door and jump out of the salon. The busy highway held me back.
Another patient was seized with fear when certain sounds appeared. I felt a nasty tingling sensation in my palms. Excitement sets in, causing your thoughts to become confused and your tongue to be taken away.
A woman described her husband experiencing a panic attack while they were walking in the park and talking about a relative who had recently had a heart attack. She noticed that her husband's arms and shoulders suddenly began to shake. He was covered in sweat, it was even dripping. His face turned pale, he practically stopped breathing (he couldn’t take a breath), his gaze was wandering and unconscious. The man was sure he was dying. It took almost 2 hours to get home, whereas it usually took 20 minutes. He constantly stopped, sat down on the ground, and the attack repeated.
Train your mindfulness
Mindfulness is the ability to notice what is happening in and around you.
Panic attacks often lead to a feeling of unreality, out-of-body, detachment from one's own body and from the world. Mindfulness helps cope with a panic attack and the first signs of its approach.
How to deal with panic attacks? Focus on your body, look at it or imagine with your eyes closed: how your feet touch the floor, how your clothes touch your skin, mentally move to the tips of your fingers.
To distract yourself, you can focus your gaze on familiar objects around you - a glass with pens and pencils, a plant on the window, a pattern on the wall or on the floor, and so on.
Panic attacks during sleep
The insidiousness of the attacks is that they are possible not only during the day. Seizures are not horror dreams. They most often occur between 12 noon and 4 am.
During an attack, a person wakes up or is in a borderline state and experiences all the symptoms. After the attack he can continue to fall asleep.
With the onset of the disease there are 1-3 night attacks, in advanced stages - up to 5 in one night. This drives you into a state of depression, a person is afraid to fall asleep, cannot relax, and succumbs even more to stress.
Stop the attack with medication
Drugs from the group of tranquilizers (anxiolytics or anti-anxiety drugs) help stop a panic attack if you take the pill at a time when it is still in its infancy.
Tranquilizers cannot be taken by everyone; they are sold by prescription, so they must be prescribed by a psychiatrist or psychotherapist.
Panic attacks. Why don't pills help?
Diagnostics
If signs characteristic of panic attacks appear, you should contact a neurologist, psychologist or psychiatrist. Diagnosis begins with establishing the number of episodes of panic fear. A person is said to be susceptible to panic attacks if there are several such cases that arise spontaneously without the presence of a real threat to life and health, as well as outside the use of drugs or medications.
To develop the most effective treatment tactics, it is also important to establish the type of panic attacks. There are:
- expected (situationally related and situationally predisposed) – when anxiety attacks are associated with the presence of a specific fear, for example, heights;
- unexpected – when there is no obvious reason for the occurrence of fear and a clearly traceable trigger, so it is impossible to predict in advance the possibility of its occurrence.
In the first case, panic attacks are largely a consequence of the presence of one or another phobia, obsessive-compulsive disorder, post-traumatic disorder, or depression. Therefore, in these cases they are secondary, and therefore treatment will be aimed primarily at eliminating the cause of their occurrence.
Sometimes an additional consultation with a cardiologist, gastroenterologist, endocrinologist or pulmonologist may be required to detect disorders in the cardiovascular, endocrine, respiratory or digestive systems. In such situations, a fairly wide range of studies may be required to exclude underlying diseases, including:
- ECG;
- daily monitoring of ECG and blood pressure;
- Ultrasound of the heart, abdominal organs;
- X-rays of light;
- determination of the level of basic hormones;
- EEG;
- X-ray or MRI of the cervical spine;
- Doppler ultrasound of cerebral vessels.
Therefore, panic disorders, as the main diagnosis, are spoken of only in cases of sudden onset of severe anxiety with the development of physical symptoms to a greater or lesser extent. It is important that there is no anxiety during the period between attacks.
It is also necessary to establish the severity of the patient’s condition at the time of the attack using tests aimed at detecting fears and a special scale. The Spielberg scale is often used for this purpose. To do this, he is asked to fill out a special questionnaire or orally answer the doctor’s questions. In addition, it is important for the doctor to observe the patient over a certain period of time, and also to obtain information about when and what diseases he suffered, how often he is exposed to stress and how much he is exposed to it, what changes have occurred in his life, etc.
