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PANIC ATTACK/PANIC DISORDER AND TREATMENT


PANIC ATTACK/PANIC DISORDER AND TREATMENT

A panic attack is a sudden episode of intense fear that triggers severe physical reactions when there is no real danger or apparent cause. Panic attacks can be very frightening. When panic attacks occur, you might think you're losing control, having a heart attack or even dying.

Many people have just one or two panic attacks in their lifetimes, and the problem goes away, perhaps when a stressful situation ends. But if you've had recurrent, unexpected panic attacks and spent long periods in constant fear of another attack, you may have a condition called panic disorder.

Although panic attacks themselves aren't life-threatening, they can be frightening and significantly affect your quality of life. But treatment can be very effective.

SYMPTOMS

Panic attacks typically begin suddenly, without warning. They can strike at any time — when you're driving a car, at the mall, sound asleep or in the middle of a business meeting. You may have occasional panic attacks or they may occur frequently.

Panic attacks have many variations, but symptoms usually peak within minutes. You may feel fatigued and worn out after a panic attack subsides.

Panic attacks typically include some of these symptoms:

*Sense of impending doom or danger

*Fear of loss of control or death

*Rapid, pounding heart rate

*Sweating

*Trembling or shaking

*Shortness of breath or tightness in your throat

*Chills

*Hot flashes

*Nausea

*Abdominal cramping

*Chest pain

*Headache

*Dizziness, lightheadedness or faintness

*Numbness or tingling sensation

*Feeling of unreality or detachment

One of the worst things about panic attacks is the intense fear that you'll have another one. You may fear having a panic attack so much that you avoid situations where they may occur.

When to see a doctor?

If you have panic attack symptoms, seek medical help as soon as possible. Panic attacks, while intensely uncomfortable, are not dangerous. But panic attacks are hard to manage on your own, and they may get worse without treatment.

Because panic attack symptoms can also resemble other serious health problems, such as a heart attack, it's important to get evaluated by your health care provider if you aren't sure what's causing your symptoms.

CAUSES

It's not known what causes panic attacks or panic disorder, but these factors may play a role:

*Genetics

*Major stress

*Temperament that is more sensitive to stress or prone to negative emotions

*Certain changes in the way parts of your brain function

Panic attacks may start off by coming on suddenly and without warning, but over time, they're usually triggered by certain situations.

Some research suggests that your body's natural fight-or-flight response to danger is involved in panic attacks. 

For example, if a Snake came after you, your body would react instinctively. Your heart rate and breathing would speed up as your body prepared itself for a life-threatening situation. Many of the same reactions occur in a panic attack. But it's not known why a panic attack occurs when there's no obvious danger present.

RISK FACTORS

Symptoms of panic disorder often start in the late teens or early adulthood and affect more women than men.

Factors that may increase the risk of developing panic attacks or panic disorder include:

*Family history of panic attacks or panic disorder

*Major life stress, such as the death or serious illness of a loved one

*A traumatic event, such as sexual assault or a serious accident

*Major changes in your life, such as a divorce or the addition of a baby

*Smoking or excessive caffeine intake

*History of childhood physical or sexual abuse

COMPLICATIONS

Left untreated, panic attacks and panic disorder can affect almost every area of your life. You may be so afraid of having more panic attacks that you live in a constant state of fear, ruining your quality of life.

Complications that panic attacks may cause or be linked to include:

*Development of specific phobias, such as fear of driving or leaving your home

*Frequent medical care for health concerns and other medical conditions

*Avoidance of social situations

*Problems at work or school

*Depression, anxiety disorder and other psychiatric disorders

*Increased risk of suicide or suicidal thoughts

*Alcohol or other substance misuse

*Financial problems

For some people, panic disorder may include; agoraphobia — avoiding places or situations that cause you anxiety because you fear not being able to escape or get help if you have a panic attack. Or you may become reliant on others to be with you in order to leave your home.

PREPARING FOR YOUR APPOINTMENT

If you've had signs or symptoms of a panic attack, make an appointment with your primary care provider. After an initial evaluation, your doctor may refer you to a psychiatrist or psychologist for treatment.

TESTS AND DIAGNOSIS

Your doctor or other health care provider must determine if you have panic attacks, panic disorder or another condition, such as heart or thyroid problems, that resembles panic symptoms.

To help pinpoint a diagnosis, you may have:

*A complete physical exam

*Blood tests to check your thyroid and other possible conditions and tests on your heart, such as an electrocardiogram (ECG or EKG)

*A psychological evaluation to talk about your symptoms, stressful situations, fears or concerns, relationship problems, and other issues affecting your life.

You may fill out a psychological self-assessment or questionnaire. You also may be asked about alcohol or other substance use.

Criteria for diagnosis of panic disorder

Not everyone who has panic attacks has a panic disorder. For a diagnosis of panic disorder, the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), published by the American Psychiatric Association, lists these points:

*You have frequent, unexpected panic attacks. 

*At least one of your attacks has been followed by one month or more of ongoing worry about having another attack; continued fear of the consequences of an attack, such as losing control, having a heart attack or "going crazy"; or significantly changing your behavior, such as avoiding situations that you think may trigger a panic attack.

Your panic attacks aren't caused by drugs or other substance use, a medical condition, or another mental health condition, such as social phobia or obsessive compulsive disorder.

If you have panic attacks but not a diagnosed panic disorder, you can still benefit from treatment. If panic attacks aren't treated, they can get worse and develop into panic disorder or phobias.

TREATMENTS 

Treatment can help reduce the intensity and frequency of your panic attacks and improve your function in daily life. The main treatment options are psychotherapy and medications. 

One or both types of treatment may be recommended, depending on your preference, your history, the severity of your panic disorder and whether you have access to therapists who have special training in panic disorders.

Psychotherapy

Psychotherapy, also called talk therapy, is considered an effective first choice treatment for panic attacks and panic disorder. Psychotherapy can help you understand panic attacks and panic disorder and learn how to cope with them.

A form of psychotherapy called cognitive behavioral therapy can help you learn through your own experience that panic symptoms are not dangerous. During therapy sessions, your therapist will help you gradually re-create the symptoms of a panic attack in a safe, repetitive manner. 

Once the physical sensations of panic no longer feel threatening, the attacks begin to resolve. Successful treatment can also help you overcome fears of situations that you've been avoiding because of panic attacks.

Seeing results from treatment can take time and effort. You may start to see panic attack symptoms reduce within several weeks, and often symptoms decrease significantly or go away within several months. You may schedule occasional maintenance visits to help ensure that your panic attacks remain under control or to treat reoccurrences.

Medications

Medications can help reduce symptoms associated with panic attacks as well as depression if that's an issue for you. Several types of medication have been shown to be effective in managing symptoms of panic attacks, including:

Selective serotonin reuptake inhibitors (SSRIs). Generally safe with a low risk of serious side effects, SSRI antidepressants are typically recommended as the first choice of medications to treat panic attacks. 

*Serotonin and norepinephrine reuptake inhibitors (SNRIs). These medications are another class of antidepressants. The SNRI medicines approved for the treatment of panic disorder.

*Benzodiazepines. These sedatives are central nervous system depressants. Benzodiazepines may be habit-forming, causing mental or physical dependence, especially when taken for a long time or in high doses. 

If you seek care in an emergency room for a panic attack, you may be given a benzodiazepine to help stop the attack. Benzodiazepines are generally used only on a short-term basis. Because they can be habit-forming, these medications aren't a good choice if you've had problems with alcohol or drug abuse. They can also interact with other medications, causing dangerous side effects.

If one medication doesn't work well for you, your doctor may recommend switching to another or combining certain medications to boost effectiveness. Keep in mind that it can take several weeks after first starting a medication to notice an improvement in symptoms.

All medications have a risk of side effects, and some may not be recommended in certain situations, such as pregnancy. Talk with your doctor about possible side effects and risks.

LIFESTYLE AND HOME REMEDIES

There's no sure way to prevent panic attacks or panic disorder. However, these recommendations may help.

*Get treatment for panic attacks as soon as possible to help stop them from getting worse or becoming more frequent.

*Stick with your treatment plan to help prevent relapses or worsening of panic attack symptoms.

*Get regular physical activity, which may play a role in protecting against anxiety.

ALTERNATIVE MEDICINE

Some oral supplements that influence the action of serotonin, possibly may reduce the frequency and severity of panic attacks. However, more research is needed.

Talk with your doctor before trying any supplements. These products can cause side effects and may interact with other medications. Your doctor can help determine if they're safe for you.

______________________________________________


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Mtonga Isaac Pharmacy,

Ng'ombe Township,

#16/24 Off Zambezi road,

Email: mtongaisaacpharmacy@gmail.com,

Tel: +260974272433/+260966399444,

Lusaka, Zambia.

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