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Panic attacks are sudden attacks of intense fear or extreme discomfort that culminate within minutes, and panic disorder is diagnosed – according to the American Psychiatric Association criteria – by repeated panic attacks and persistent worry about the attacks. The future or its consequences.

Epidemiological studies indicate that the lifetime prevalence of panic attacks in the general adult population worldwide ranges from 1.4 to 4.1 percent.

Panic attacks

On average, panic attacks begin in your mid-to-late 20s, although they can occur any time from childhood to late childhood, and panic attacks are thought to decrease with age. As age increases, panic attacks and panic disorder become more difficult to diagnose and treat, perhaps because symptoms differ among older adults and are not accurately captured by standard criteria and instruments designed for younger adults.

Most cases of late-onset panic attacks are associated with psychiatric and medical comorbidities that may prevent correct diagnosis. Age-related changes in brain structures, functions, and peripheral physiology influence susceptibility to autonomic responses, reducing the likelihood of developing disease in the elderly.

Because women are exposed to stressful life events early in their lives, they are prone to common psychological disorders and personality disorders in adulthood, youth, and middle age. Psychological and physical comorbidity is often observed among patients with panic attacks and disorders.

Depression, substance abuse and dependence, agoraphobia, and suicidal behavior have been reported to be associated with an increased incidence of panic attacks. Certain medical conditions, such as heart disease or respiratory disease, are also commonly associated with panic disorder.

Despite the evidence, risk factors may have different effects on the likelihood of experiencing panic attacks across the lifespan. For example: women’s hormonal changes or psychological and social stressors, throughout their lives, may affect their psychological vulnerability differently. Examining the diverse effects of multiple risk factors in adulthood and later life may help identify potential targets for early detection and prevention.

Regarding the epidemiology of the disease, psychologist Dr. Craig N. Sawchuk says many people experience a panic attack only once or twice in their lifetime, and then the problem goes away, perhaps ending in a stressful situation. But if the attacks are repeated and unexpected, leading to persistent fear of another attack over a long period of time, the condition is diagnosed as panic disorder.

Although panic attacks are not life-threatening, they can be frightening and significantly affect quality of life. But the treatment is very effective.

symptoms

Panic attacks usually start suddenly without warning. It can happen anytime, while driving a car, while sleeping, on a business premises or in the middle of a business meeting. You may experience panic attacks from time to time or they may occur more frequently.

Panic attacks take many forms; But symptoms usually peak within minutes. After the panic attack subsides, you may feel tired and fatigued.

Panic attacks usually include some of the following signs or symptoms: A sense of impending doom or danger – Fear of losing control or death – Rapid heartbeat – Sweating – Shaking or shaking – Shortness of breath or throat tightness – Chills – Hot flashes – Nausea – Abdominal cramps – Chest pain – Headache – Dizziness, lightheadedness or fainting – Numbness or tingling – Feeling unreal or disconnected.

One of the worst things about panic attacks is that you are so afraid of another attack that you avoid certain situations where it might occur.

If you are experiencing symptoms of a panic attack, you should seek medical help as soon as possible. Panic attacks are not dangerous, but they can be very annoying; But it can’t be treated alone, and it gets worse without treatment. The symptoms of panic attacks are similar to those of other serious health problems, such as a heart attack; That’s why it’s important to be evaluated by a health care provider.

Causes and risk factors

– Causes: Research indicates that the body’s natural fight-or-flight response to situations exposed to danger contributes to the occurrence of panic attacks. For example, if you are being chased by a bear, your body will instinctively respond by increasing your heart rate and breathing; The body prepares to face a life-threatening situation. Many of the same responses occur in a panic attack. But it is not known why a panic attack occurs when there is no apparent danger. The following factors may play a role in causing seizures:

• Genetic genes.

• Extreme stress.

• Hypersensitivity to stress or a mood prone to negative emotions.

• Some changes in the way parts of the brain work.

Panic attacks can occur suddenly and without warning, but over time, they are usually triggered by certain situations.

– Risk factors: Panic disorder symptoms often begin in late adolescence or early adulthood, and affect women more than men.

Factors that may increase your risk of developing panic attacks or disorders include:

• Family history of panic attacks or disorders.

• Major life stressors such as the death of a loved one or serious illness.

• A traumatic event such as sexual assault or a serious accident.

• History of physical or sexual abuse in childhood.

• Major changes in your life, such as a divorce or the birth of another child.

• Smoking or drinking too much coffee.

Untreated, panic attacks and panic disorder can affect all aspects of life. A person may have a fear of having more panic attacks. He lives in a constant state of fear, which spoils the quality of life he lives.

Complications: Complications that may be caused by or associated with panic attacks include:

• Specific types of phobias, such as fear of driving or leaving the house.

• Seek medical attention frequently for health concerns and other conditions.

• Avoid social situations.

• Problems at work or school.

• Depression, anxiety disorders and other psychological disorders.

• Increased risk of suicide or suicidal thoughts.

• Addiction to alcohol or other drugs.

• Economic problem.

For some, panic disorder may include agoraphobia, which is the avoidance of places or situations that cause anxiety due to fear of not being able to escape or get help in the event of a panic attack. Or you may depend on others to stay with you until you leave home.

– Prevention: There is no surefire way to prevent panic attacks. However, the following suggestions may help:

• Get treatment as soon as possible to avoid the possibility of panic attacks worsening or recurring.

• Adherence to treatment plan, avoid relapses or exacerbation of symptoms.

• Maintaining physical activity; Because it helps relieve anxiety.

Diagnosis and treatment

Diagnosis: Your primary care provider will rule out a panic attack, panic disorder, or another condition, such as heart or thyroid problems, with symptoms similar to panic attacks. To help determine the diagnosis, the following are done:

• Complete physical examination.

• Blood tests to check for possible conditions, such as thyroid and others, and some tests on the heart, such as an electrocardiogram (ECG or EKG).

• A psychological evaluation to talk about symptoms, fears, stressful situations, sexual relationship problems, situations you avoid and family history. You may need to complete a psychological self-assessment or questionnaire. You may be asked about alcohol or other drug use.

Regarding the criteria for the diagnosis of panic disorder, the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) published by the American Psychiatric Association lists the following criteria for the diagnosis of panic disorder:

• Having frequent and unexpected panic attacks.

• Persistent worry about another attack for at least a month or more following one panic attack or persistent fear of the consequences of the attack. Changes in behavior, such as avoiding situations thought to trigger panic attacks.

• Panic attacks are not caused by drugs or other substance use, medical conditions, or other psychiatric conditions such as social phobia or obsessive-compulsive disorder.

– Therapy: Therapy can help reduce the intensity and frequency of panic attacks that affect a person and improve their performance in everyday life. The primary treatment options are psychotherapy and medications. Depending on preference, medical history, severity of panic disorder, and access to therapists experienced in treating panic disorders, one or more types of therapy may be recommended.

First – Psychotherapy: Psychotherapy is an effective option in treating panic attacks and panic disorder. Psychotherapy can help you understand panic attacks and panic disorders and learn how to deal with them.

Treatment results may take time and effort to appear. You may begin to feel the symptoms of panic attacks diminish within several weeks, and symptoms often diminish significantly or end within several months. You can schedule periodic follow-up visits to make sure your panic attacks are under control or to treat recurrences.

Second – Medications: Medications can help reduce the symptoms associated with panic attacks and depression. A variety of medications have been shown to be effective in relieving the symptoms of panic attacks:

• Selective serotonin reuptake inhibitors (SSRIs): SSRIs are generally safe, have few serious side effects, and are the first prescribed drug choice for treating panic attacks. The US Food and Drug Administration has approved selective serotonin reuptake inhibitors (SSRIs) as drugs to treat panic disorder, including: Fluoxetine Prozac, Paroxetine Paxil, Bexeva, and Sertraline Zoloft.

• Serotonin and norepinephrine reuptake inhibitors (SNRI): These drugs are another type of antidepressant. US Food and Drug Administration venlafaxine (Effexor

• Benzodiazepines: These tranquilizers depress the central nervous system. The US Food and Drug Administration has approved benzodiazepines such as alprazolam, Xanax, and Clonazepam Klonopin as treatments for panic disorder. Benzodiazepines are usually used only for short periods of time; Because it can cause addiction and habituation to it, which can be physically or mentally dependent on it. These medications are not recommended if you have problems with alcohol or drug abuse. It can interact with other medications, causing serious side effects.

* Community Medical Consultant