A panic attack is a sudden attack of severe anxiety that lasts a short period of time and is accompanied by vegetative manifestations. A panic attack is a neurotic disorder provoked by psychological trauma. A characteristic feature is the unpredictability of occurrence and the huge difference between the severity of subjective sensations and the objective status of the patient. According to statistics, such conditions develop in 4-5% of the world's population, but there is evidence that every 10th inhabitant of our planet has experienced a panic attack at least once in their life. We will talk about the causes, symptoms and methods of treating panic attacks in this article.

Causes

The first panic attack always develops under the influence of a stressful situation (conflicts in the family, problems at work, information about the illness of a loved one, an exam, public speaking, etc.). Those. The main cause of this condition is overstrain of the body. Subsequent attacks no longer have any direct connection with external influences and often develop without a provoking factor. But we all live in conditions of almost constant stress, but panic attacks do not develop in most people. What is the reason?
The fact is that for the development of a panic attack, a special “background” is required in the nervous system. This “background” could be:

• hereditary predisposition;
• biochemical disorders in metabolism in the nervous system, in particular an imbalance of the mediators serotonin and norepinephrine;
• mental trauma suffered in childhood (physical violence, fear of school, parental alcoholism, quarrels in the presence of children, etc.);
• abuse of coffee and other stimulants (including energy drinks);
• psychological personality characteristics - anxiety, suspiciousness, suggestibility, need for increased attention, excessive fixation on one’s feelings.
• It has been noted that panic attacks occur 2 times more often in women. For both sexes, the risk of development is higher during adolescence and young adulthood.
• Excessive alcohol consumption, lack of sleep, and physical overload can trigger the development of a panic attack.

How does a panic attack develop?

When stressed, the brain gives a command for general “mobilization”. In the body, the adrenal glands secrete hormones that increase breathing and heart rate, increase blood pressure, accelerate metabolism, increase muscle tone, and increase sweating. These physiological measures help the body cope with a stressful situation. This happens normally when there is really a “danger.” During a panic attack, the adrenal glands release hormones without a real threat to the body. Subconsciously, there is a feeling that the body’s reaction in its severity does not correspond to the strength of the causal factor (i.e., the body “goes too far”). The search for the cause of the condition begins, but usually it is not found, resulting in fear and anxiety, and vegetative reactions. Fear contributes to the repeated release of hormones, and this is how a “vicious circle” is formed. All this happens in a matter of seconds. As hormone reserves are depleted, the “vicious circle” is interrupted, and the person calms down.

Symptoms

During a panic attack, severe fear (phobia) arises - fear of losing consciousness, fear of “going crazy,” fear of death. Control over the situation, understanding of the place and time of stay, and sometimes awareness of one’s own personality are lost (derealization and depersonalization). Of course, the severity of such disorders is individual, but there is a tendency to progress as panic attacks persist.
Due to the panic that has arisen, the person seeks to leave the place where the attack occurred - public transport, metro, podium, etc. Since a panic attack suffered leaves an indelible mark on the memory of patients, a secondary fear of a repetition of a similar situation appears. So-called agoraphobia occurs, which worsens the disease. Because of this, patients avoid the places where they had the attack, stop using public transport, and in severe cases do not leave the house at all. Fears grow like a snowball, and so-called restrictive behavior is formed (when the patient himself sharply limits his living space). However, despite these measures, panic attacks recur. There is a risk of developing depression.
Typically, a panic attack develops within a few minutes, lasting on average 10-30 minutes, sometimes several hours. The frequency varies from once a month to several times a day. As the disease progresses, the duration and frequency of attacks increase.
Among autonomic disorders, a panic attack can be accompanied by:

• palpitations or increased pulse rate, interruptions in heart activity, increased blood pressure;
• sweating;
• trembling of the limbs (tremor), feeling of internal trembling;
• dry mouth;
• difficulty breathing (shortness of breath), feeling of suffocation;
• chest pain, breathing discomfort;
• nausea, vomiting, increased peristalsis, flatulence, diarrhea;
• dizziness, headache, lightheadedness, instability when standing and walking;
• feeling hot or cold (chills);
• numbness, tingling sensation, numbness in various parts of the body.

Due to the occurrence of such sensations at a moment of fear, the patient may have the idea that he is developing a terrible disease: stroke, heart attack, cancer, etc. This is why patients with a panic attack are primarily referred to therapists, cardiologists, oncologists, and gastroenterologists, who, of course, do not find such diseases. But since situations are repeated, patients go to other specialists in search of more “competent” ones, in the hope that one of them will still “find the terrible disease.” And this can continue for quite a long time until the correct diagnosis is made.
Sometimes people try to cope with such an “embarrassing” problem on their own by using sedatives or large doses of alcohol. This is the wrong way. Trying to “pull yourself together” or ignoring panic attacks also does not lead to a solution to the problem. A panic attack is a pathological condition that requires treatment from a psychotherapist.

How can I help when a panic attack develops?

If control over oneself is maintained and self-control is not lost, then, sensing an approaching attack, the patient needs to try to “distract himself.” There are many ways to do this:

• counting - you can start counting the number of chairs in the hall or seats on the bus, the number of people without headwear in a subway car, etc.;
• singing or reading poetry - try to remember your favorite song and hum it “to yourself”, carry a verse written on a piece of paper in your pocket and start reading it when an attack begins;
• rituals of prevention - for example, fastening a button or lacing a shoe, changing a ring from one finger to another;
• painful stimulation - a pinch under the knee, a needle prick, etc.;
• “thoughts about something else” - in some cases, it helps to imagine yourself in a pleasant environment on vacation (i.e. you need to try to “transport” to an imaginary place), plan a menu, remember the taste of your favorite food and imagine eating it, etc.;
• changing the type of activity - for example, go draw a bath, start sweeping, do handicrafts. The main thing is that the type of activity is ordinary, familiar and calm;
• The breathing method is a common way to stop an attack that has begun. It involves slow breathing into a bag or with your palms folded together and pressed tightly to your face; you can try to breathe with your stomach or on a count (inhale on 1,2,3, exhale on 4,5,6).

These simple, seemingly ridiculous, at first glance, methods can prevent or alleviate a panic attack. When an attack begins, you should not call your family (this increases panic), try to count your pulse or heartbeat, or measure your temperature. That. it is necessary to avoid “fixation” on the state itself.

Treatment

The most effective treatment method is considered to be a combination of psychotherapeutic techniques and medication.
Among the methods of psychotherapy, behavioral and cognitive-behavioral psychotherapy, neuro-linguistic programming, suggestion methods, relaxation training, and autogenic training are successfully used.
The following medications are currently used:

• selective serotonin reuptake inhibitors - fluoxetine (Prozac) 10-40 mg per day, paroxetine (Paxil) 5-10-20 mg in the morning, sertraline (Zoloft, Serlift) 50 mg in the morning or evening, fluvoxamine (fevarin) 50-100 mg per day day. You should start taking medications with half the dose (compared to doses for the treatment of depression);
• benzodiazepines - alprazolam 0.25 mg 3 times / day, maintenance dose 1.5-4 mg per day; clonazepam – 0.5 mg 2 times a day, maintenance dose 1-4 mg per day;
• monoamine oxidase inhibitors – moclobemide (Aurorix) initial dose 75 mg 3 times a day, maintenance dose 300-600 mg per day.

The duration of use of most of these drugs is 6-8-12 months.
Drugs such as β-blockers (anaprilin, atenolol, etc.) can be used to stop an already developed panic attack. This is due to their ability to block the effect of adrenaline on the body. But they are not able to prevent the development of subsequent attacks.

A panic attack is a difficult but not life-threatening condition for patients. An attentive approach, comprehensive treatment, patience and understanding on the part of loved ones (including awareness of the problem as a disease) ultimately lead to recovery and a return to a full life for all patients suffering from this illness.

Panic attack

Anxiety, fear, fright - feelings familiar to every person. These are absolutely normal emotional processes that arise as a reaction to some kind of uncertainty or danger (regardless of whether it is real or not).

However, in some cases, people experience sudden bursts of anxiety and fear for no apparent reason. Such states are called panic attacks(abbr. PA). If left untreated, an exacerbation can lead to chronic panic disorder and other mental health problems, which further complicate the person's normal lifestyle.

How are normal fears different from panic attacks?

Fears and anxieties caused by stress are a common experience of humanity. This is how the nervous system reacts to things that make people feel uncomfortable. Moreover, fear is a defense mechanism based on the instinct of self-preservation.

But what is a panic attack? Panic is a wave of fear characterized by an unexpected appearance and debilitating anxiety. Panic attacks can occur even when a person is relaxed or asleep.

An inexplicable, painful attack of severe anxiety for the patient may be a one-time event, but a large part of the population experiences repeated episodes of panic.

Statistics show that anxiety symptoms affect more than half of the world's population. For the most part, panic begins with an irrational fear, after which the person begins to feel fear. In other words, he realizes that something is wrong, perhaps something is happening to his body (for example, his heart is “jumping out” of his chest), and only after this does a feeling of fear for his health or life appear.

Types of panic attacks

Modern medicine classifies panic disorder into several groups:

• Spontaneous panic attacks. They appear for no reason.
• Situational. They are a reaction to a specific situation, for example, a person is afraid of speaking in public or crossing a bridge.
• Conditional situational. They appear in most cases after exposure of the body to stimulants of a biological or chemical nature (drugs, alcohol, hormonal changes).

Causes of panic attacks

The nature of the origin of panic attacks is still not well understood. Some aspects of the manifestation of attacks remain a blind spot in medicine today.

Doctors distinguish three groups of causes of panic attacks:

• somatic;
• mental;
• social.

Somatic (physiological) causes

Somatic attacks are among the most rational. They arise against the background of physiological diseases, when a person fears for his health or life. In most cases, such PAs are characterized by physical symptoms, for example, high blood pressure (),.

The most common conditions during which somatic panic attacks occur are:

• heart disease;
• puberty, pregnancy;
• taking medications.

In some episodes, panic attacks are not. As with phobias, depression can be a consequence of the fear of another episode of PA.

Post-traumatic stress disorder (PTSD)

Panic attacks during a time when a person experiences anxiety are caused by the fear of reliving a situation that led to severe stress (experience). For example, if a person has been seriously injured in a fire, panic attacks may occur from the slightest contact with the fire or news of the fire.

A panic attack is usually called a sudden attack of intense fear that has no objective reasons or grounds. The attack begins with the manifestation of a diverse range of physiological ailments, lasts on average about thirty minutes (but can last more than two hours) and subsides on its own, leaving behind a feeling of anxiety and fear of repetition.

The most common cause of a panic attack is considered to be psychological pathologies: depressive states, schizotypal disorders, phobias, obsessive-compulsive disorders. However, it can arise as a result of exposure to three groups of provoking factors:

Psychogenic

This includes any situations that keep a person in tension for a long time: acute conflicts - divorce, dismissal, showdowns. These can also be events that can cause mental trauma - a serious illness or death of someone close, a disaster, an accident. In addition to the above, abstract factors of a psychogenic nature - books, movies, television shows or information received via the Internet - can also provoke a panic attack.

Biological

This group includes various changes in hormonal levels in the body: pregnancy, its interruption, childbirth, the beginning of sexual life, taking hormonal drugs, features of the menstrual cycle (algomenorrhea and dysmenorrhea). This also includes various physical diseases that can trigger panic attacks: myocardial infarction, coronary heart disease, mitral valve prolapse, adrenal tumor, endocrine system hyperactivity, low blood sugar.

Physiogenic

This group of factors includes the use of certain medications (anti-asthma drugs, anabolic steroids), drug use, alcohol abuse, withdrawal symptoms, and even excessive caffeine consumption. In some cases, sudden meteorological changes, climate change, and physical stress can provoke an anxiety attack.

It is known that people with certain character traits are more likely to suffer from panic attacks: a tendency to dramatize, exaggerate problems, and publicity - in women; and excessive anxiety, increased fear for one’s health - in men.

Interesting fact! People who tend to care more about others than about themselves practically never experience panic attacks and other neurotic disorders. Therefore, a common feature of people prone to this disorder is egocentrism.

There are also a number of factors that are not direct causes of panic attacks, but are at risk:

• Lack of physical activity. A sedentary lifestyle leads to the accumulation of tension, which is recommended to be relieved through regular exercise.
• Bad habits. Excessive coffee consumption no longer stimulates the nervous system, but can lead to the development of anxiety, and cigarettes themselves are a depressant.
• Suppressed conflicts. Unresolved disputes lead to the accumulation of negative emotions that develop into constant nervous tension. Emotions that have not found a way out can manifest themselves in a number of physical symptoms, including a panic attack.
• Lack of sleep. It has been scientifically proven that regular lack of sleep has a bad effect on the functioning of the brain and body, and sleep deprivation leads to an increase in stress hormones in the blood, which play a major role in the development of a panic attack.

The above factors can significantly reduce the body’s resistance to stress, which makes the occurrence of an anxiety attack in a person more likely. If you are experiencing severe stress due to these factors, which significantly reduce your quality of life, immediately contact a specialist, for example, a hypnologist. Baturin Nikita Valerievich.

The basis of the vegetative crisis

There are several versions that explain the processes occurring in the human body during periods of panic attacks. They are considered to be the cause of the symptoms characteristic of a panic attack.

Cognitive version

According to this hypothesis, it is believed that a panic attack is provoked by a person’s misinterpretation of the sensations experienced. For example, he may perceive an increase in heart rate provoked by fear or increased stress as a threat to his own life. In the future, such people (usually they are characterized by increased sensitivity and a tendency to exaggerate) record this feeling as a harbinger of death and panic. Here, the most pronounced may not be the panic attack itself, but the constant anticipation of its occurrence.

Genetic version

This theory is based on the opinion that there is a genetic basis for the development of panic attacks. It is believed that the disease is encoded in genes and will develop under favorable conditions. Thus, approximately twenty percent of those suffering from vegetative crisis have a close relative with a similar disorder. In cases of identical twins, if one is ill, the chance that the other will develop panic attack syndrome is 1:1.

Catecholamine version

The hypothesis is based on the relationship between anxiety states and increased levels of catecholamines in the blood. Catecholamines are hormones produced by the adrenal cortex. During the normal functioning of organs, they are produced only in situations of tension and danger, stimulating the body to fight: increasing the heart rate for better blood supply, increasing blood pressure, increasing breathing, stimulating brain activity. If, in normal times, the production of these substances in a person’s body is increased, then he has a greater tendency to develop panic attacks.

This theory is confirmed by experiments with intravenous administration of adrenaline, as a result of which the test subject exhibited both physical and emotional triggers of a panic attack.

Psychoanalytic version

According to Sigmund Freud's theory, the basis for the development of anxiety is suppressed conflict within the individual. In the absence of emotional release (in particular, the release of sexual energy), tension in the body accumulates, transforming into anxiety at the mental level.

Later, Freud's students were of the opinion that the cause of a panic attack is not the sexual desires themselves, but their danger due to some social prohibitions.

Behavioral version

The basis of the hypothesis is considered to be a person’s fears that appear in certain situations, that is, the symptoms of a panic attack are provoked from the outside. For example, a person may perceive traveling in a car as a threat to life due to the likelihood of a car accident, and therefore he may develop a panic attack even without the development of a dangerous situation. A similar thing can be observed with heart diseases.

It makes sense to look for the causes of panic attacks, starting from the underlying disease, if present. For the most part, panic attacks appear only as a symptom of a specific illness, often a mental pathology.

Mechanisms of attack development

Panic attacks tend to begin suddenly and end quickly; within the body, this period is characterized by a whole cascade of reactions.

The step-by-step mechanism of a panic attack is as follows:

1. Under the influence of stress, adrenaline and other catecholamines are released.
2. Adrenaline stimulates all systems: circulatory, respiratory and others to work in danger mode (constricts blood vessels, increases the speed of heart rate and breathing).
3. Due to vasoconstriction, blood pressure increases.
4. An increase in heart rate leads to tachycardia, which causes shortness of breath and a panicky feeling of lack of air.
5. Due to an increase in breathing rate, the percentage of carbon dioxide in the blood plasma falls, leading to increased feelings of anxiety.
6. Decreased carbon dioxide levels lead to changes in the acid balance of the blood, which causes panic attack symptoms such as dizziness and a feeling of numbness in the arms and legs.
7. Since vascular spasms occur only in tissues on the periphery (muscle tissue, skin, fat cells), weakening their blood supply, lactic acid accumulates here. Absorbed into the blood and increasing its own concentration, it intensifies the signs of a panic attack.

As a result, the mechanism of development of a vegetative crisis is a vicious circle: the stronger the feeling of anxiety, the more actively the symptoms manifest themselves, which, in fact, increases anxiety even more.

Symptoms

The central symptom of a panic attack is an increase in feelings, nervous tension, anxiety, developing into panic.

Other symptoms of panic attacks may occur selectively in the form of:

• increased heart rate;
• a sharp increase in blood pressure;
• lack of air, asthma attack;
• nausea;
• pain in the left side of the chest;
• increased sweating or chills;
• numbness or tingling in the limbs;
• dizziness, near fainting;
• the emergence of fear of loss of control, madness, death;
• a feeling of unreality of events, partial memory loss.

When trying to sleep at such a moment, terrifying images may appear in the head, a phantom feeling of falling, and high-frequency sounds.

Also, during a panic attack, a person may experience a wide variety of phobias: from fear of swallowing food to claustrophobia or, conversely, fear of being in open areas.

In addition to the above signs, as a result of a panic attack, the patient may exhibit atypical symptoms that indicate the development of an atypical panic attack:

• impaired hearing and vision;
• the occurrence of muscle cramps;
• uncertainty in movements, walking;
• the occurrence of vomiting;
• presence of throat constriction;
• loss of consciousness;
• excessive urination.

One of the main problems with recurrence of panic attacks is the patient’s constant state of tension. A person cannot stop worrying and thinking about the situation that frightens him, as a result of which the body can fail again. Thus, the patient is his main assistant in getting rid of panic attacks: if you do not focus on the attacks and perceive them as a temporary disturbance, then they will occur less and less often and will not manifest themselves as clearly as at the beginning.

Diagnosis of the disease

Before diagnosing a panic attack, it is necessary to conduct research to exclude diseases with similar symptoms:

• cardiac arrhythmia - taking an electrocardiogram, recording heart rhythm for up to 48 hours;
• coronary heart disease - conducting an ECG both at rest and during physical activity, ultrasound diagnostics of the heart;
• stroke, tumor formations of the brain - taking a computer or magnetic resonance imaging scan;
• bronchial asthma - conducting breath tests and taking allergy skin tests;
• internal bleeding - ultrasound diagnostics of the pelvic and abdominal organs;
• mental illness - examination by a psychiatrist.

To diagnose panic attack syndrome, certain conditions must be met:

• repetition of the attack - with a one-time development of the panic attack state, this is not considered evidence of the disease;
• spontaneity - without an objective absence of threat, one cannot talk about the unreasonableness of a panic attack;
• absence of an obvious state of anxiety in the periods between outbreaks of panic;
• presence of one or more known symptoms of panic attacks.

In cases where the therapist does not detect diseases that can provoke panic attacks, the person is referred to a psychologist or psychiatrist, who, as a result of a conversation, will prescribe the necessary treatment regimen.

Treatment

When treating panic attacks, work with the patient is carried out in two directions:

• taking medications;
• psychological help.

In accordance with the individual characteristics of the disease, only one direction can be used, if necessary - both.

Drug treatment

Includes the use of medications that help treat the underlying disease (if any), drugs to eliminate and alleviate the symptoms of panic attacks. Antidepressants are considered the main means of drug treatment. Since they have a cumulative effect, you should not expect an instant result, just as you should not stop taking it if it does not appear.

Important! Starting to take certain medications may be accompanied by increased feelings of anxiety. This is usually a temporary phenomenon. However, if there is no improvement after several days after starting treatment, you should immediately inform your doctor.

Based on the test results, the doctor may prescribe anticonvulsant or antiepileptic drugs. Also during therapy, it is recommended to conduct repeated examinations at certain time intervals in order to determine the effectiveness of therapy for panic attacks.

Psychotherapy

The most effective psychotherapeutic technique is cognitive behavioral therapy. In addition, at the discretion of the psychotherapist, he can treat panic attacks with the help of:

• psychoanalytic techniques;
• body-oriented psychotherapy;
• methods of classical and Ericksonian hypnotization;
• Gestalt therapy;
• neurolinguistic programming;
• desensitization and reprocessing by eye movements.

The fundamental goal of psychotherapy is to convince the patient that panic attacks are not a serious illness, they do not pose a mortal threat and are subject to their own control. A change in the client's perspective on many current situations may also be important for healing.

Specialists also teach the patient breathing techniques to help him survive a panic attack and ease its course.

How to cope with an attack on your own

Knowing how panic attacks manifest themselves, a person can minimize their course and impact. To do this you need:

• Remember that panic attacks do not pose a mortal danger, they are just an incorrect reaction of the body.
• Focus on breathing as much as possible - inhale deeply, holding your breath, then exhale smoothly, relaxing your muscles. You can relieve panic by exhaling into a paper bag or cupped palms.
• Use a shower, replacing warm water with cold water every twenty to thirty seconds.
• Do an independent massage of the ears, little fingers, thumbs, focusing on your own sensations. Rubbing lavender cream or oil into your hands will also help.
• Try to distract yourself by counting objects on the street or visualizing a panic attack and engaging in mental struggle with it.
• Dissolve ten drops of infusion of medicinal herbs, if any, in a glass of water: valerian, motherwort, peony, valocordin.

Other medications in the event of a panic attack should be taken only with the permission of a specialist and strictly in the indicated dosage.

Helping a person have a seizure

Due to the prevalence of the disease in the modern world, knowing what a panic attack is and what signs of a panic attack can occur in an adult is useful for everyone. In this case, you can provide effective assistance to a person present if he or she is experiencing a panic attack.

Methods of support that alleviate the attack and contribute to its rapid relief:

Emotional encouragement

It is important not to panic around the patient, demonstrating calm with your appearance and tone of voice. You can take a person by the hands and let him know that what is happening to him is not dangerous, and you will help him survive this moment. However, you should be wary of template phrases, since they have a nasty effect - the person thinks that they cannot understand him and this increases the symptoms of a panic attack.

Physiotherapeutic technique

You can help normalize breathing - breathe correctly with the patient; reduce muscle tension by massaging the neck, shoulders, ears, fingers; help achieve relaxation using a special technique - relaxation through tension - if you are familiar with it; help the patient take a contrast shower.

Distraction

To reduce the severity of a panic attack, it is worth trying to shift the patient’s focus from the sensations he is experiencing to ordinary factors: mathematical examples, pinching, household chores, singing songs, games and visualization of the attack.

Herbal infusions

Mix and offer to drink an infusion of appropriate medicinal herbs.

Helping a loved one suffering from panic attacks comes down to preparation, which should, if not prevent another attack, then at least cope with it as quickly as possible. This can be done by studying relaxation and breathing techniques, as well as preparing things that can help the patient survive an acute condition if he finds himself alone at the time of an attack.

You can study techniques through specialized literature, as well as in thematic groups, on the pages

These conditions are pronounced phobias, fears and anxieties in combination with somatic (bodily) symptoms(excessive sweating, rapid heartbeat, digestive disorders, etc.).

In psychiatry, panic attacks are classified as neurotic disorders that have a wave-like course.

Violations occur in the form of unexpected attacks ( attacks), between them the patients feel well, nothing bothers them and they lead their usual lifestyle. The prevalence of this phenomenon today reaches 10% of the population.

Symptoms and treatment of panic neurosis have their own characteristics, which are within the competence of psychiatrists, psychologists and psychotherapists. After a comprehensive examination, specialists develop treatment tactics and effective methods for relieving an attack. Of great importance is the explanatory work of doctors with patients, with the obligatory identification of the root cause of their poor health, which is hidden in the depths of the psyche, and not in physical ailment (it is a consequence of psycho-emotional problems). It is the work with the experiences of patients, their inner mood, worldview and stereotypes that shapes therapeutic measures and helps determine ways to get rid of panic attacks on your own, forget about neurosis forever and maintain harmony in the soul.

Video of a panic attack (mild form):

The very concept of “psychic attack” appeared in the early 80s in America and quickly took root in world medicine; it is now used in the International Classification of Diseases (ICD-10).

Panic attack is in the section with mental disorders and behavioral disorders (V, F00-F99). Subsection: neurotic, stress-related and somatoform disorders (F40-F48): Other anxiety disorders (F41): Panic disorder [episodic paroxysmal anxiety] (F41.0).

Causes

Anxiety and panic can arise in people suddenly and completely unexpectedly.

Often provoking factors are:

- stress, mental trauma;
- severe chronic diseases or emergency surgical interventions;
— change in the usual way of life or place of residence;
— high responsibility in personal life or professional activity;
- drug and alcohol abuse;
— characteristics of temperament and character;
- sensitivity to a certain drug or overdose of a pharmacological drug;
- rejection of criticism from other people;
- heredity;
- hormonal status;
— low adaptive abilities and difficulties in settling into a new place (How to fall asleep? Establish the usual rhythm of life? Calm anxiety?);
- physical or mental fatigue, excessive stress on the body;
- lack of proper rest (sleep disturbances, work without vacations, etc.).

Symptoms and signs

The state of anxiety and fear during panic attacks has a wave-like character. Its distinctive features are:

- a growing increase in negative perception of reality, painful fear and panic, reaching a certain threshold, after which there is a decline in emotions and unpleasant sensations;
- a combination of emotional intensity with physical ill health, painful symptoms in many organs and systems;
- a feeling of “emptiness”, “brokenness” and confusion after the end of the attack.

Panic attacks, symptoms (signs) of which include autonomic complaints, similar to manifestations of vascular dysfunctions (VSD, arterial hypertension) and mental illnesses. However, these states have a clear time limit; they take from 5 minutes to 1 hour. After the end of the attack, the health of the patients is completely restored. In addition, no organic or pronounced functional disorders are detected during objective examination (X-ray, ultrasound, hormonal tests, laboratory tests).

Types of Panic Attacks

1. An attack similar to a cardiovascular crisis. In these cases, patients complain of rapid heartbeat, cardiac arrhythmias, a feeling of increased blood pressure (a feeling of constriction in the head, mild nausea, heaviness in the sternum, inability to take a breath).

2. Seizure as a mental disorder. Here we observe: loss of orientation in space, poor coordination, internal trembling, confused speech, a feeling of a “lump in the throat” or fainting, various fears or phobias.

3. Attack resembling dyspeptic disorder. Occurs with increased or decreased gastric peristalsis, decreased appetite, bloating, obsessive belching or hiccups.

In any form of these disorders, at the peak of panic and fear, people lose their usual concentration, do not know what to do during an attack, rush around the room or, on the contrary, freeze in one position, waiting for the end of the disorder.

Most often, a panic attack has a combination of various somatic symptoms: neurotic, vascular, respiratory and digestive in nature.

Most common symptoms panic states are:

- severe sweating, feeling of cold or heat in the body;
- intense anxiety or total fear (of death, illness, loss of identity);
- tremor and trembling in any part of the body;
- nausea, urge to vomit (defecation, urination), pain and heaviness in the stomach or intestines;
- a feeling of dryness in the throat, nasal passages, on the surface of the skin;
- paresthesia.

Test

Diagnosis of panic attacks is carried out with a study of the physical and mental health of patients.

Due to the fact that somatic signs of this condition are also observed in cardiac, respiratory, gastric or intestinal pathologies, and also occur in thoracic and cervical osteochondrosis, differential diagnosis is carried out with them (ultrasound, MRI, ECG, gastroscopy, blood and urine tests, and etc.).

Questioning patients using psychodiagnostic questionnaires and tests allows one to assume the presence of neurosis and identify its characteristic signs. They examine the presence of patient complaints of sudden attacks of fear, excitement, horror, their frequency and intensity, as well as the presence of sensations of increased breathing and heartbeat, digestive disorders, changes in clarity of perception, impaired concentration, decreased mood, physical and mental discomfort.

Tests for panic attacks help to identify the degree of control people have over the situation during attacks, the level of awareness of the problem, methods that help patients cope with with sudden fears and anxiety.

As a result of analyzing individual patient data, psychotherapists and psychiatrists make recommendations for correcting these conditions, give advice on how to calm down during an unexpected attack and restore mental balance after it.

How to fight?

Many methods have been created in psychiatry to quickly relieve an attack:

1. Normalization of breathing. For people suffering from sudden panic attacks, special exercises have been developed to slow down breathing (smooth exhalations and inhalations, breathing in a square, etc.). Such complexes allow you to focus on normalizing breathing and distract from internal pressure, fear and anxiety.
2. Auto-training, with an emphasis on relaxing the whole body and concentrating pleasant sensations in it.

3. Kinesio taping for panic attacks is based on the use (gluing) of special tapes (tapes), which help to evenly distribute the load on the skin, relaxing it and reducing excess tension in the body.
4. Training sessions (art therapy, symbol drama, dolphin therapy and other types of psychotherapy) help normalize the emotional background of the mood, ease mental pressure, and reduce the consequences of stress and trauma.
5. Antidepressants and anxiolytics, these tablets have the ability to normalize the activity of the nervous system and improve mental processes. These include drugs such as: Sonopax, Afobozol, etc.

The use of modern methods of treating panic attacks makes it possible to effectively combat them using psychotherapeutic techniques, innovative techniques and pharmacological agents.

Their timely identification and contact with a psychiatrist helps many people get rid of the scourge and return to an active and fulfilling life.

Video:

Urbanization, technological progress, and huge flows of information impose a rhythm and lifestyle that causes diseases such as panic attack or anxiety disorder.

A person is not always able to independently recognize the symptoms and begin treatment on time. One of the features of this disease is an unexpected feeling of panic fear, which cannot be explained by objective reasons.

The processes that occur in the body during a panic attack are identical to those that occur during a real threat to life. The brain receives a signal of danger and a large amount of adrenaline, the hormone responsible for stress, is released. Under its influence, the body is mobilized to survive in extreme conditions.

During a panic attack, a person finds himself in a conflict: he experiences a feeling of fear and physical symptoms, but there is no danger or threat.

Disoriented by such a discrepancy, the patient concentrates all his attention on internal sensations, increasing the level of anxiety. In this case, a cyclical pattern is observed: the higher the level of emotional stress, the more active the physiological processes that provoke this state. The attack ends as suddenly as it begins.

Panic attacks have a destructive impact on a person’s quality of life and personality, as they are a source of causeless, uncontrollable, severe stress.

There are several theories and hypotheses that explain the nature of panic attacks. Moreover, every assumption is correct. But, taking into account the individual characteristics of the physiology and psyche of any person, genetic and personality differences, the conclusion arises that attacks of irrational fear are based on the influence of a combination of reasons.

Catecholamine hypothesis

The catecholamine hypothesis is based on the idea of ​​a hormonal imbalance in the patient’s body. It has been experimentally proven that when the level of adrenaline, a hormone of the catecholamine group, increases in the blood, the vegetative-vascular system mobilizes the body to adapt to extreme external conditions.

This explains the physiological sensations during attacks and causes emotional stress, increasing anxiety levels.

Improper functioning of the adrenal glands, which produce adrenaline, provokes unmotivated and unpredictable attacks of physical ailments, and, as a result, panic attacks.

Genetic hypothesis

Scientific observations have revealed a pattern in the genetic inheritance of the disease. The likelihood of panic attacks increases to 50% in cases of close relationship with a person suffering from this disorder. The disease encoded in genes is activated under favorable conditions.

Psychoanalytic theory

Psychoanalysts suggest that the basis of panic attacks is hidden tension accumulated by suppressing one’s own desires. The inability to realize desires due to danger or unacceptability in society leads to internal conflict.

And unspent sexual energy has a depressing effect on the emotional state. As a result of psychological overload, a feeling of anxiety appears. At the highest point of tension, anxiety is transformed into a feeling of fear, provoking panic attacks.

Behavioral theory

Behavioral theory explains the nature of panic attacks from the point of view of the acquisition and consolidation of a conditioned reflex. After severe stress, associative connections arise in the memory between the feeling of fear and an external circumstance, which can be very conditional.

Subsequently, the reflex is consolidated: a person encounters a stimulus in everyday life, an association is triggered, and an attack of irrational fear occurs.

For particularly impressionable people, the fact of experiencing stress may be absent. To form an attack, only slight deviations from the usual state of health in a new environment or situations that cause uncertainty.

Physical ailment caused by natural causes (hidden disease, poorly ventilated room), but at the moment of experiences caused by the current situation (flying on an airplane or a large crowd of people around), is associated with external conditions and far-fetched fears.

The first attack has nothing to do with a panic attack, and only creates the conditions for it. In the future, under similar circumstances, an attack of fear will arise reflexively, reliably cementing such a reaction in behavior.

Cognitive theory

According to cognitive theory, panic attacks occur under the pressure of one’s own negative thoughts and attitudes. Any ailment is considered by the patient as one of the symptoms of a serious, incurable disease. By developing these depressing thoughts, a person makes the situation loop.

A premature and unreasonably far-fetched diagnosis stimulates the imagination.

Mentally imagining prospects creates anxiety and fear. As a result, the level of adrenaline in the blood increases, triggering a panic attack mechanism. With each attack, it seems to the person that his (fictitious) disease is progressing or killing him.

These sensations are reinforced by the fact that physical symptoms directly depend on the psychological state and intensify along with the feeling of fear.

Stages of development of a panic attack

The duration of the attack ranges from 10 to 30 minutes. In rare cases, a panic attack lasts more than an hour. Often, the occurrence of an attack is unpredictable: when faced with an irritant (or conditions that provoke an attack), the body’s reaction is instantaneous.

Stages of development:

1. Associative memory is triggered and the brain receives a signal of danger. A feeling of anxiety appears.
2. At the same time, the adrenal glands secrete large amounts of adrenaline.
3. Under its influence, the blood vessels of the skin and mucous membranes narrow and the blood vessels of the brain dilate. These changes lead to sudden surges in pressure. The skin turns pale.
4. Symptoms of tachycardia appear. There is a feeling of suffocation and breathing quickens.
5. Due to an excess of oxygen in the blood and a deficiency of carbon dioxide, dizziness and numbness of the limbs begin.
6. There is an urge to go to the toilet, nausea, and vomiting.
7. Adrenaline stimulates the nervous system. Absent-mindedness, a feeling of disorientation and derealization appear.
8. Mental tension and anxiety arise, fear prevails over all emotions.
9. Negative emotions provoke an increase in the level of adrenaline in the blood, which intensifies symptoms.

In rare cases, during a panic attack, a person loses consciousness. There are also cases when an attack is accompanied by convulsions resembling epilepsy. Panic attacks, its symptoms and treatment in each individual case are very individual and depend on the characteristics of the person.

In some cases, the patient is not able to independently recognize the disorder. And symptomatic treatment, as a rule, does not produce results. It is important to understand that solving the problem requires an integrated approach consisting of medications and psychotherapy. If left untreated, panic attacks become a generalized anxiety disorder.

Causes of panic attacks

The causes of panic attacks depend on the lifestyle, physical and mental characteristics of a person. Favorable conditions for an attack are stress, chronic diseases, phobias and other similar conditions that have a depressing effect.

All causes that provoke panic attacks can be divided into three categories: somatic, mental and social.

Somatic (bodily) diseases

Acute or chronic forms of diseases, as well as changes in hormonal levels lead to psychological discomfort. The slightest deterioration in well-being provokes anxiety and fear. In combination with the characteristics of the underlying disease or condition, emotional experiences take the form of panic attacks. Increased sweating, shortness of breath, and tachycardia are observed.

At the same time, the physical symptoms of attacks are felt stronger than the emotional ones, which fade into the background and seem natural with such ailments. Among somatic diseases, heart disease and thyroid disease are especially prominent. As well as hormone-dependent physiological conditions: pregnancy, premenstrual syndrome, menopause.

Symptoms of panic attacks in the treatment of alcoholism and drug addiction are more common due to the use of medications that stimulate the nervous system. Steroid medications used for asthma should be used with caution.

Mental illness

Prolonged depression, phobias, and stress are the most favorable conditions for the appearance of panic attacks. Irrational fear may be based on claustrophobia or neurasthenia, on memories of a disaster or obsessive suspicion.

In this case, it is very difficult to establish the boundary between a panic attack and its cause. Due to similar symptoms, there are very often cases where a panic attack becomes the cause of a nervous disorder (depression, schizophrenia).

Social reasons

The rhythm of life in large cities and large volumes of information create conditions for chronic stress. Children and adolescents are especially susceptible to borderline emotional states.

Lack of proper rest and constant emotional stress, responsibility and high demands lead to the fact that the child’s immature nervous system cannot stand it, and ordinary experiences become fears.

An attack can be triggered by problems in relationships with peers, upcoming exams, or fear of punishment.

Systematic panic attacks in children can cause the development of neuralgic disorders and diseases such as asthma or enuresis, complicating the treatment of attacks and depressing the emotional state even more.

Risk factors

Risk factors include conditions that reduce stress resistance:

1. Bad and destructive habits. Alcohol, smoking, and drugs are strong depressants and cause irreparable damage to health and immunity. A significant portion of primary panic attacks are triggered by withdrawal symptoms.
2. Passive lifestyle. Lack of physical activity leads to the accumulation of emotional stress. Weak muscles become one of the causes of health problems and the appearance of chronic hidden diseases.
3. Weak socialization. Conflicts, obvious or suppressed, lead to dissatisfaction with the outside world and become a cause of nervous tension.
4. Lack of proper rest. Short, superficial and irregular sleep is not able to relieve the nervous system after a hard, busy day. Fatigue and irritability from lack of sleep use up the body's reserves faster than any obvious stress, leading to nervous exhaustion.

In addition to external risk factors, one should remember the individuality of each person. The more labile a person is, the higher the likelihood of a panic attack. While a stable, mentally flexible person may never encounter an attack of irrational fear due to the body’s high stress resistance and defense mechanisms.

How the attack manifests itself

Panic attacks, the symptoms and treatment of which are very individual, depend on the mental and physical characteristics of the person. People who are strong-willed and disciplined can suppress anxiety attacks during the day and face them at night. The reasons that provoked the attack directly affect the manifestation of the attack.

In the presence of serious somatic diseases, physical symptoms are felt more strongly: dizziness, lack of oxygen, nausea and other conditions. Mental symptoms are more acutely experienced during panic attacks provoked by social causes or mental illness.
Mental symptoms

The most common symptoms related to the nervous system are:

Physical symptoms of attack

The physical symptoms of panic attacks are caused by the effect of adrenaline on the body. In addition to individual sensations, there are a number of signs that accompany almost any attack, regardless of the cause and physiology.

The symptoms are as follows:

• Increased sweating.
• Pale skin.
• Rapid breathing.
• Sharp acceleration of heart rate.
• Dilated pupils
• Trembling in limbs.
• Urge to go to the toilet.

Atypical attacks

In rare cases, a person experiences an atypical panic attack.

Its symptoms make the patient even more helpless than during a normal attack:

• Temporary dysfunction of the sensory organs. Loss of vision or hearing.
• Loss of voice control.
• Feeling of stiffness in movement.
• Nausea, vomiting, involuntary urination.
• Convulsions reminiscent of epileptic attacks.
• Loss of consciousness.

Instead of fear and panic, the patient experiences emotions corresponding to depression: irritability, melancholy, a feeling of hopelessness. Atypical panic attacks, due to the characteristics of the symptoms, are much more difficult to diagnose.

How can an attack begin?

An attack can be triggered by negative thoughts about the stress experienced, associative memory, and one’s own imagination. Even memories of a previous attack can cause a new one. The body responds very sensitively to thoughts and mood, especially in cases where at least one panic attack has already been experienced.

An uncontrolled thought process about an exciting event awakens negative emotions, anxiety and worries. This tension is often enough to trigger the physical symptoms of an attack.

When the attack is worse tolerated

There is a relationship between a person’s psychological profile and how severe panic attacks are. People who are characterized by high emotionality, pessimism, and a tendency to be dramatic feel the symptoms of attacks more vividly.

If, after the first attack, a person independently and incorrectly analyzes what happened, convinces himself that the cause is a serious (incurable) illness or the inevitability of an accident, then there is a high probability of recurrence of panic attacks. Through his own suspiciousness and imagination, the patient develops and perpetuates the disease.

When a person tolerates an attack more easily

Panic attacks and symptoms, the treatment of which may not require treatment, are more easily tolerated by strong-willed, self-sufficient people, socially adapted and independent of the opinions of others.

In these cases, when faced with an attack, a person does not focus his attention on sensations or think about the reasons. This reaction does not allow the symptoms to close in a circle; the disease does not receive nourishment and fades away on its own.

Night crises

Night attacks are more difficult to tolerate and have a strong negative impact on a person’s life between crises. Instead of proper rest after a busy day, the patient faces even more stress. First, an attack interrupts sleep - a depressed, depressed state occurs, and fatigue accumulates. The person begins to be afraid to fall asleep.

Insomnia leads to nervous exhaustion, which causes borderline states, depression, and other more serious mental disorders. With night crises, there is a high probability of rapid development of generalized anxiety disorder.

Menopause and panic attacks

Age-related hormone-dependent changes in a woman’s body very often cause panic attacks. Due to the decreasing amount of estrogen, a woman’s mental state becomes unstable. Menopausal syndrome, the symptoms of which are very similar to the symptoms of panic attacks, can also complicate the situation.

Distinctive features are the following:

1. irritability;
2. nervous breakdowns;
3. so-called “hot flashes”, a condition in which a feeling of stuffiness and heat is replaced by chills;
4. fear and anxiety.

Panic attacks most often occur during pathologically early or late menopause, as well as in cases of artificially induced menopause for medical reasons. Panic attacks, the symptoms and treatment of which are determined by the joint efforts of a gynecologist and a psychologist, are the most common and natural reaction of the female body to the decline of reproductive function.

Vegetative-vascular dystonia

Vegetative-vascular dystonia is responsible for pain in the heart area, neuralgic disorders, headaches during panic attacks. As such, there is no disease - this is a generalized name for body dysfunction, in which poor health is due to a combination of reasons, and not to one specific disease.

The vessels are the first to suffer. In this regard, pressure surges, arrhythmia, weakness and other symptoms accompanying panic attacks are observed. Considering the characteristics of vegetative-vascular dystonia, it can be both a symptom and a cause of anxiety.

Diagnosis

To make a diagnosis, the psychotherapist must make sure that the repeated attack occurred unpredictably, without external provocation. A depressed, depressed state between attacks is also excluded.

A single attack is not considered a disorder. For diagnosis, the frequency of attacks should vary from once every six months to 3-4 times a week.

When the diagnosis is confirmed, the medical history is supplemented with information about the patient’s lability, stress experienced and other important information that will help in identifying the causes and prescribing treatment.

Treatment of panic attacks

There are two directions in the treatment of panic attacks: psychotherapeutic and medication. The most effective treatment is a mixed treatment that simultaneously addresses both physical and mental symptoms.

In addition to professional medical assistance, a person suffering from panic attacks can independently learn ways and techniques that will help ease and more calmly endure the next attack. Knowledge of how to help a person during an unexpected attack of irrational fear will be useful to people who are surrounded by such patients.

Actions during a panic attack: proper breathing techniques

Regulating your breathing is one of the first ways to restore calm and break the cyclical nature of the attack. To do this, you need to take a deep breath through your nose. Hold the breath. Exhale through your mouth. It is recommended to carry out all actions slowly and repeat at least 15 times until breathing is completely normalized.

Accompanying breathing with hand exercises will help to distract attention from unpleasant health and quickly regain composure.

To do this, while inhaling, you need to slowly raise your outstretched arms above your head. And as you exhale, also slowly and without bending, lower them along the body. This exercise will help synchronize breathing with movements, and also help relieve the feeling of numbness in the limbs.

How to help a person during a panic attack?

In cases where a person is unable to cope with an attack on his own, it is very important that there are people nearby who can provide all possible assistance. First of all, it is necessary to capture the patient's attention. In moments of fear, a person needs emotional support and the confidence that he will not be left to cope with the situation alone.

You should reassure in a confident, calm and even voice using affirmative phrases that reflect reality: “You are not alone, I will be there, together we will cope, there is no threat.” In this case, you can first adjust your breathing to the patient’s breathing rhythm, and then gradually normalize the frequency of inhalations.

The patient will repeat these actions unnoticed, which will speed up the end of the attack and make him feel better.

In addition to emotional support, physical contact plays a very important role. Massage will help relax tense muscles and relieve spasticity, which is a common symptom of panic attacks. The more and longer a person fixates on his feelings, the more intense the attack.

Distraction can completely stop a panic attack. Any activity that involves mental work is suitable for these purposes: complex counting of objects, composing or retelling a story. It is important to captivate the patient and direct his thoughts away from the sensations he is experiencing.

Drug treatment for panic attack

Panic attacks, the symptoms and treatment of which are determined by a psychotherapist, are amenable to medication correction. Treatment is carried out in two directions: stopping a panic attack at the first symptoms and preventing recurrent attacks in the future.

To stop an attack, quick-response medications are used that have a sedative and anti-anxiety effect: diazepam, midazolam, temazepam. The disadvantage of these drugs is the development of dependence in the person taking them.

Control of repeated attacks is carried out with the help of long-term use of antidepressants, tranquilizers and hormonal drugs in courses. These drugs are selected in accordance with the patient’s physical health and the causes of nervous disorders.

The dosage is gradually increased to that required to maintain the effect. When the drug is discontinued, the dosage is gradually reduced.

All medications are prescribed by a psychotherapist. In the presence of acute or chronic diseases, the use of medications is agreed with the therapist.

Psychotherapy in the treatment of panic attacks

Panic attacks are more effectively treated with an integrated approach. Psychotherapy in these cases is aimed at identifying and eliminating the causes of anxiety disorders.

In each case, an individual technique and treatment program are selected:

1. Cognitive behavioral psychotherapy. The basis of therapy is the patient's change in attitude towards attacks.
2. Psychoanalysis is popular in severe cases accompanied by negative living conditions. Treatment is aimed at finding out the true reasons for what is happening to the patient and resolving internal conflicts.
3. Hypnosis. Suitable for patients susceptible to such influence, suggestible. The therapy consists of psychological instructions that the patient receives during a trance.
4. Neurolinguistic programming corrects the patient's response to potential stimuli, increasing stress resistance.
5. Gestalt therapy helps to identify suppressed needs and find a way to satisfy them. This approach helps calm subconscious anxiety and makes a person more confident.

The use of herbal preparations

For mild attacks and to eliminate mild anxiety, collections of medicinal plants that have a calming effect will help. The infusions should be taken in a course, but not more than 1 month. Then a break is needed.

Plants that have a relaxing effect:

1. linden flowers;
2. Melissa;
3. St. John's wort;
4. chamomile;
5. motherwort
6. valerian.

It is important to understand that systematic attacks cannot be cured with herbal medicine. It is aimed at alleviating symptoms of anxiety, normalizing sleep, and reducing tension.

Preventing recurrences of panic attacks

Preventive measures will help reduce the risk of a repeat panic attack:

1. Meditation will help stabilize your emotional state and organize your thoughts.
2. Playing sports will relieve tension, relieve accumulated fatigue, and strengthen physical health.
3. Herbal medicine will have a calming effect and improve sleep.
4. A good rest that will charge you with positive emotions and restore the strength of the body.

It is very important to change your usual life for the better, to work on yourself.

What should you do to avoid panic attacks?

By reviewing your habits, lifestyle, and improving yourself as a person, you can avoid panic attacks:

A positive attitude towards life, sociability, and the ability to express oneself can significantly improve the quality of life and reduce anxiety attacks to zero.

What can trigger a recurrence of panic?

The irritant for the formation of a repeated anxiety state can be conditions in which attacks have previously occurred. Unexpected sounds, claps, and gunshots can also provoke panic. The situation is aggravated by the refusal of qualified assistance and medication treatment.

Patients who have chosen an isolated lifestyle are especially sensitive to provocations. Every exit from their comfort zone becomes a severe stress that they are unable to cope with on their own.

A diagnosis of a panic attack is not a sentence to a painful existence in fear. Its symptoms are treatable and correctable. But it is important to understand that the result, first of all, depends on the person himself, his desire to overcome the disease and determination to work on himself and his worldview.

Article format: Lozinsky Oleg

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