What is panic disorder?
Panic disorder or panic attack is a feeling of sudden intense and recurring anxiety and restlessness. The most intensified sensations last from 2 to 10 minutes and then gradually disappear. However, the impression of affected person is quite the opposite, it seems to a person that the attack lasts a very long time and will never end. The incidence of panic attacks usually ranges from a few in a month to several dozen a day.
A panic attack is accompanied by very unpleasant sensations related to the physiology of the body, such as: rapid heartbeat, dizziness, a feeling of shallow breathing, very fast breathing (called hyperventilation), choking, nausea, chest pain, trembling of arms and legs, hot flashes numbness or tingling in your fingers and toes and a sense of unreality in yourself and the environment; “As if I were not myself” (called depersonalization). During panic disorder a person loses the ability to critically judge a situation, control his behavior and communicate with others. There are thoughts that in a moment something bad or terrible will happen. The most common cognitive symptoms are: I will die, I will get a heart attack or stroke, I will faint, suffocate, fall, go crazy (I wil lose control over myself), vomit, stop breathing, make a fool of myself.
Panic attacks usually lead to the formation of a secondary anticipatory fear called the fear of waiting or the fear of unexpected attacks. A person begins to associate panic disorder with situations or places where he or she stayed and where help was unavailable. Then comes the fear of leaving the house, loneliness, finding oneself in a crowd of people, using public transport, and entering the store. Patients also often carry sedative medications “just in case”, paper bags, if they vomit, hold on to something to avoid falling, walk in places that they know well, even with a loved one, rest or avoid movement. These behaviors are called security behaviors that are designed to protect against panic attacks and feel safe.
Causes of panic attacks
There are many psychological causes that cause panic disorder. However, based on cognitive and behavioral theories, the following should be mentioned: conditional learning to respond to stress or frustration, and erroneous cognitive patterns, i.e. imitating the behavior of parents.
It is also assumed that the factors predisposing to panic attacks are early critical childhood experiences, such as: separation from parents or their loss (this applies to the mother), problems in building relationships with parents, experience of sexual and physical violence, especially in case of women, lack of support and help from parents or guardians. Other factors are: temperament as a component of behavior in the face of danger and somatic diseases, which are a source of anxiety and fear.
Cognitive-behavioral therapy
Cognitive therapy for panic disorder involves lowering your sensitivity to anxiety by modifying beliefs about your excitation symptoms. To this end, the patient becomes familiar with the cognitive model, i.e. the mechanism of maintaining panic anxiety (psychoeducation). The next step in therapy is to encourage a more rational look at the problems (here a helpful technique is to identify negative automatic thoughts), and as a result to develop new, alternative thoughts that will be supportive.
Behavioral therapy focuses on symptom control strategies, helping to reduce the likelihood of panic attacks and, importantly, suppressing the tension and anxiety that causes panic. The most known methods are: relaxation training (diaphragm breathing, deep muscle relaxation), distraction strategy, i.e. distraction from negative thoughts, exposure to anxiety stimuli, or experiments with causing panic disorder.
The last method of treating panic attacks is drug therapy. It is used when the panic disorder is very strong and at first there is no other way to help the patient solve his problems. Drug treatment uses antidepressants, benzodiazepines or anxiety-reducing drugs with a sedative effect.
Read more: How to get rid of fear or feeling depressed?
Author: Karina Pizoń
Bibliography:
Pużyński, S.; Wciórka, J. (red.). (1998). Klasyfikacja zaburzeń psychicznych i zaburzeń zachowania w ICD-10. Badawcze kryteria diagnostyczne. Kraków: Uniwersyteckie Wydawnictwo Medyczne „Vesalius”.
Wells, A. (2010). Terapia zaburzeń lękowych, rozdział 5 Zaburzenie lękowe za napadami paniki. Kraków: Wydawnictwo Uniwersytetu Jagielońskiego
Westbrook, D.; Khadija, R. przedkł. Pytrek-Smith, M.; Pytrek, S. konsultacja meryt. Gulcz, M. (2012). Zrozumieć napady paniki. Katowice: Wydawnictwo Prospect.