Panic attacks
The diagnosis of panic attacks (also called panic attacks or acute anxiety attack) is a diagnosis became fashionable in the 1980s in the U.S. with the DSM classifications. It is the history of this diagnosis in Janet and Peter F. Raymond in 1903 which refer to a definition dating from 1871 and which comes from C. Westphal, a neurologist in Berlin, in an article published in Archive fur Psychiatric und Nervenkrankheiten: "Agoraphobia: a neuropathic event. Sigmund Freud spoke of his anxiety neurosis, one of whose manifestations was the attack of anxiety: The mechanism of anxiety neurosis is to be found in the derivation of sexual arousal somatic and psychic distance from a abnormal use of this excitement is the result.
Today it is described as a period of fear and intense discomfort, typically occur abruptly and in a few minutes to several hours. The symptoms range from chills to the palpitations through sweating, nausea, shortness of breath, hyperventilation, tingling sensations (paresthesia) and felt stifled (more details below on symptoms). A panic attack is a vicious circle, in that the mental symptoms and physical symptoms worsen another.
One patient who experienced a panic attack may be prone to relapse. Is diagnosed in patients suffering from panic attacks regular a "panic disorder".
Introduction
Most patients prone to panic attacks report a fear of dying, fear of "mad" or losing control of their emotions or their behavior. These impressions very difficult in general leading an urgent need to flee the place where the attack began (reaction of "fight or flight") and also escape the gaze of others seeking an isolated area where only shut himself up that feeling of discomfort disappear partially or completely.
To the extent that he often feels pain in the chest or difficulty breathing, the patient feels that his life is in danger, causing frequent recourse to emergency services (EMS).
The panic attack is distinguished from other forms of anxiety by its intensity and its sudden, episodic nature. Individuals often suffer from anxiety disorders others, such as agoraphobia or other psychological disorders related to anxiety - panic attacks are not symptoms of mental illness. Approximately 10% of the general population knows the experience of an isolated panic attack per year, and one in 60 about is prone to panic disorder in their lifetime.
Phobic people can experience panic attacks in response to exposure to the object of their phobia. These seizures are usually brief and resolve when exposure ceases.
Chronic anxiety can lead to situations where a crisis immediately succeeds another, creating a nervous exhaustion in a few days.
Symptoms
It is a discrete period in time, with intense fear or discomfort, in which at least 4 of the following symptoms developed abruptly and reached their peak within 10 minutes:
* Palpitations or rapid heartbeat.
* Sweating.
* Trembling or shaking.
* Dyspnea, sensation of breath, choking, and strangulation.
* Chest pain or discomfort.
* Convulsion in the neck or vomiting
* Nausea, abdominal discomfort (upset stomach).
* Breathing inappropriate, abdomen contracted, inflated impression of lack of air.
* Sensation of dizziness, instability, light-headedness or feeling faint.
* Derealization (feelings of unreality) or depersonalization (being detached from oneself).
* Fear of losing control or going crazy.
* Losing contact with the sound, noise (temporary deafness).
* Do not be able to communicate.
* Paresthesia (numbness or tingling).
* Chills or hot flushes.
* Fear of dying, fear of having a disease.
* Disorder of memory and concentration.
* Headache.
Other names:
* Panic attack;
* Anxiety attack;
* Episode of imminent death
What characterizes a panic attack is the brutality that occurs over a period of time well demarcated from minutes to hours.
A panic attack can be spontaneous, "for nothing", even brutally awaken someone sleeping, or be triggered by the confrontation with the object of a phobia, or be the result of taking certain drugs or certain medications.
Panic disorder is the repetition of these panic attacks or persistent fear of their occurrence, so that often the person enters a circle of fear is therefore increasing.
During a violent crisis, the discomfort makes a sinusoid. This means that the person will feel very badly for a few seconds or minutes, then go a few more minutes later, then the discomfort returned abruptly, etc. ... and that, therefore, a highly variable time.
The patient may associate panic attacks to a specific place or places where they occurred the first time, or when one or times of day, and so, by suggestion, to trigger the unconscious to a time of day or place, which may cause the patient to remain confined at home, or otherwise no longer wish to return.
Treatment
A fundamental step in therapy is to understand the vicious circle and the psychological dimension involved in panic attacks.
Psychotherapy, associated with a number of relaxation methods such as acupuncture, meditation, etc., give very good results. It is of course the patient, assisted or not to adopt those that best match.
The medication may be indicated in recurrent crises. Benzodiazepines such as diazepam, lorazepam, alprazolam or clonazepam are generally prescribed for this purpose. The mere fact that the patient has the medication in his possession may be anxiolytic and prevent the development of a crisis. However, these drugs can cause addiction, and are not always effective, especially during crises that occur abruptly. A nonselective beta blocker, propranolol (Avlocardyl), to block the discharge of adrenaline and stop some annoying symptoms such as palpitations, tremors, and can be taken promptly, with good tolerance and non-addictive. Propranolol works by such well in preventing stage fright artists.
Some doctors prefer prescribing SSRI antidepressants (much better tolerated than tricyclic antidepressants called), which after a certain period are effective in preventing panic attacks. Taking antidepressant or anxiolytic may repel some patients, but it is sometimes necessary.
It is also common for patients feeling better after a short period of treatment, decided to stop all treatment, this is a mistake. Indeed, the abrupt cessation of treatment type antidepressant and anxiolytic withdrawal without more or less long (weeks to months) may resurface if the symptoms worsen.
With the help of treatment, patients with panic disorder are usually able to regain their balance, however, relapse is possible.
Read also Phobia
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