Panic Attacks


Each year more people come to talk about panic attacks and what they can do to relieve stress, though most panic attacks from fear. In many cases the symptoms have always been present, but with better mental health care and more awareness of behavioral disorders, people seek help and solutions to their emotional problems.

Panic disorder is a diagnosed psychiatric mental condition that causes the sufferer to experience sporadic, intense, and often reoccurring panic attacks. A panic attack is a period of incredibly intense, often temporarily debilitating, sense of extreme fear or psychological distress, typically of abrupt onset. The feeling of fear in the body can be so intense it may even be borderline painful. If one has never suffered from an attack, it is very hard to describe in words. A panic attack is different from a normal 'fear' because the panic attack very often paralyzes the person in complete paranoia and worry. Though it is often a purely terrifying feeling to the sufferer, panic attacks are actually an evolutionary body response often known as the fight-or-flight response occurring out of context.

The most common symptoms may include a strange 'skin crawling' sensation throughout the body (fear), trembling, shortness of breath, heart palpitations, chest pain (or chest tightness), sweating, nausea, dizziness (or slight vertigo), light-headedness, hyperventilation, paresthesias (tingling sensations), and sensations of choking, smothering and dreamlike and disconnected sensations. During a panic attack, the body typically releases large amounts of adrenaline into the bloodstream.

First time panic attacks are usually one of the worst experiences of a person's life. Usually first time sufferers of a panic attack truly believe they are dying, going insane or having a heart attack. Repeated and seemingly unprovoked panic attacks may be a sign of panic disorder, but panic attacks are associated with other anxiety disorders as well. For example, people who suffer from phobias may experience panic attacks upon exposure to certain triggers.

Also, it is a known fact that people with 'overly active' minds, such as those suffering from bipolar disorder or some form of ADHD are much more prone to have an attack. People with panic disorder often can be successfully treated with therapy and/or anti-anxiety medication or antidepressants, however it is usually a task that is accomplished over a period of time. It usually involves a process of 'relearning' how to cope, and very few people are treated successfully instantly.




Description

Almost all sufferers of panic attacks report a fear of dying, "going crazy", having a heart attack, fainting, vomiting, or losing control of emotions or behavior. These feelings generally provoke a strong urge to escape or flee the place where the attack began ("fight or flight" reaction) and, when associated with chest pain or shortness of breath frequently result in the sufferer seeking medical attention, often in an emergency room. Panic attacks have been linked to high quantities of acetylcholinesterase in the blood. Also the release of adrenocortisols aid in catalyzing the panic attacks.

Panic attacks create a feedback loop, because as the feeling of the anxiety increases, the sufferer feels they are dying, and in turn, worry more, etc. The feeling of panic manifests itself and amplifies itself and typically the person is so worked up by it they cannot continue with normal activity for a while. Some may literally collapse, pass out, or as stated before, call emergency medical services.

The panic attack is distinguished from other forms of anxiety by its intensity and its sudden, episodic nature. Panic attacks are often experienced by sufferers of anxiety disorders and other psychological conditions involving anxiety, though panic attacks are not always indicative of a mental disorder, nor are they uncommon. In fact, some sufferers are not under any "fear" or any psychological illness but are under extreme amounts of stress and anxiety resulting in a panic attack or an anxiety attack. Up to 10 percent of otherwise healthy people experience an isolated panic attack about once per year, and 1 in 60 people in the U.S. will suffer from a panic disorder at some point in their lifetime. When the sufferer experiences more than four bodily symptoms at once it is said that they have had a full-blown panic attack, while experiencing four or fewer symptoms constitutes a limited symptom attack.




Duration

A panic attack typically lasts ten minutes according to the American Psychological Association. However, panic attacks can be short lived (1-20 minutes) as well. More severe panic attacks may form a series of episodes waxing and waning every few minutes, lasting for a period of up to two hours, only to be ended by physical exhaustion and sleep. In conditions of chronic anxiety, one panic attack can roll into another, leading to nervous exhaustion over a period of hours or even days.




Trigger

People with phobias will often experience panic attacks as a direct result of exposure to their trigger. Other triggers include physical activity, pain, feeling of having no control, stress, disagreements, and fear of failure. Hyperventilation alone can bring about some of the symptoms of a panic attack. However, the person experiencing the panic attack often does not realize this and sees these symptoms as further evidence of how serious their condition is. An ensuing positive feedback loop of adrenaline release fuels worsening physical symptoms and psychological distress. Panic disorder has been found to run in families, and this may mean that inheritance genes plays a strong role in determining who will get it. However, many people who have no family history of the disorder develop it. Often the first attacks are triggered by physical illnesses, a major life stress, or certain medications.

Sometimes panic attacks may be a listed side effect of medications such as Ritalin (methylphenidate). It may be a temporary side effect only occurring when a patient first starts a medication, or could continue occurring even after the patient is accustomed to the drug, which likely would warrant a medication change in either dosage, or type of drug.




Physiological Explanation

The various symptoms of a panic attack can be understood as follows. First, there is frequently (but not always) the sudden onset of fear with little provoking stimulus. This leads to a release of adrenaline (epinephrine) which brings about the so-called fight-or-flight response wherein the person's body prepares for strenuous physical activity. This leads to an increased heart rate (tachycardia), rapid breathing (hyperventilation), and sweating (which increases grip and aids heat loss). Because strenuous activity rarely ensues, the hyperventilation leads to a drop in carbon dioxide levels in the lungs and then in the blood. This leads to shifts in blood pH which in turn can lead to many other symptoms, such as tingling or numbness, dizziness, burning and lightheadedness. It is also possible for the person experiencing such an attack to feel as though they are unable to catch their breath, and they begin to take deeper breaths, which also acts to decrease carbon dioxide levels in the blood.




Symptoms

Physical

Mental

Emotional

Perceptual

People who have had a panic attack in certain situations, for example, while driving, shopping in a crowded store, or riding in an elevator, may develop irrational fears, called phobias, of these situations and begin to avoid them. Eventually, the pattern of avoidance and level of anxiety about another attack may reach the point where individuals with panic disorder are unable to drive or even step out of the house. At this stage, the person is said to have panic disorder with agoraphobia. This can be one of the most harmful side-effects of panic disorder as it can prevent sufferers from seeking treatment in the first place. Agoraphobia of this degree is extremely rare. It should be noted that upwards of 90% of agoraphobics achieve a full recovery. Agoraphobia is actually not a fear of certain places but a fear of having panic attacks in certain places, where escape would be difficult and/or embarrassing.

The thinking behind agoraphobia usually follows the line that were a panic attack to occur, who would look after the person, how would he or she get the assistance and reassurance they needed? The vulnerability grows from the feeling that once victims of agoraphobia are caught in the anxiety, they are suddenly unable to look after themselves and are therefore at the mercy of the place they find themselves in and the strangers around them. In its extreme form, agoraphobia and panic attacks can lead to a situation where people become housebound for numerous years. AgoraphobiaIt is important to note that agoraphobia is by no means a hopeless situation. Successful treatment is possible with the right combination of therapy and medication.




Panic Disorder

Panic disorder sufferers usually have a series of intense episodes of extreme anxiety, known as panic attacks. These attacks may last from several minutes to hours, and may vary in intensity and specific symptoms of panic over the duration (i.e. rapid heartbeat, perspiration, dizziness, dyspnea,trembling, psychological experience of uncontrollable fear, etc.). Some individuals deal with these events on a regular basis, sometimes daily or weekly. The outward symptoms of a panic attack often cause negative social experiences (i.e. embarrassment, social stigma, ostracization, etc.). As a result, as many as 36% of all individuals with panic disorder also have agoraphobia.

Panic disorder is a serious health problem but can be successfully treated. It is estimated that 1.7 percent of the adult American population alone has panic disorder. It typically strikes in young adulthood; roughly half of all people who have panic disorder develop the condition before age 24, though some sources say that the majority of young people affected for the first time are between the ages of 25 and 30. Women are twice as likely as men to develop panic disorder.

Panic disorder can continue for months or even years, depending on how and when treatment is sought. If left untreated, it may worsen to the point where the person's life is seriously affected by panic attacks and by attempts to avoid or conceal the condition. In fact, many people have had problems with friends and family or lost jobs while struggling to cope with panic disorder. In some individuals symptoms may occur frequently for a period of months or years, then many years may pass symptom free. In others, the symptoms persist at the same level indefinitely. There is also some evidence that many individuals (especially those who develop symptoms at an early age) may experience a cessation of symptoms naturally later in life (i.e. past age 50). It is advised however, not to alter any current treatment or medications without the advice of a physician.

For people who seek active treatment early in development, the majority of symptoms can disappear within a few weeks, with no permanent negative effects once treatment is completed. Although this does by no means apply to all people




Treatment

Panic disorder is real and potentially disabling, but it can be controlled. Because of the disturbing symptoms that accompany panic disorder, it may be mistaken for a life-threatening physical illness. This misconception often aggravates or triggers future attacks. People frequently go to hospital emergency rooms when they are having panic attacks, and extensive medical tests may be performed to rule out these other conditions, thus creating further anxiety.

Treatment for panic disorder includes medications and a type of psychotherapy known as cognitive-behavioral therapy. The mental health professionals that typically can assist an individual in treatment of panic disorder are psychiatrists, psychologists, mental health counselors, and social workers. To pursue a medical treatment for panic disorder, one should visit a medical doctor, typically a psychiatrist. Psychotherapy is typically provided by a clinical or counseling psychologist, a Licensed Professional Counselor (LPC), or a Licensed Clinical Social Worker (LCSW). In remote areas, or when a psychiatrist is unavailable, a general practice physician ("family doctor") may be competent to manage the pharmacological ("medications") treatment in coordination with a psychologist or LCSW. A psychiatrist is, by training, better prepared than a general practice physician in the pharmacological treatment and should be sought out if available.

Medications can be used to break the psychological connection between a specific phobia and panic attacks. Medications can include:

Exposure to the phobia trigger multiple times without a resulting panic attack (due to medication) can often break the phobia-panic pattern, allowing people to function around their phobia without the help of medications. However, minor phobias that develop as a result of the panic attack can often be eliminated without medication through monitored cognitive-behavioral therapy or simply by exposure.

Usually, a combination of psychotherapy and medications produces good results. Some improvement may be noticed in a fairly short period of time -- about 6 to 8 weeks. Often, it may take longer to find the right pair of medications and mental health professional. Thus appropriate treatment by an experienced professional can prevent panic attacks or at least substantially reduce their severity and frequency -- bringing significant relief to 70 to 90 percent of people with panic disorder. Relapses may occur, but they can often be effectively treated just like the initial episode.

In addition, people with panic disorder may need treatment for other emotional problems. Clinical depression has often been associated with panic disorder, as have alcoholism and drug addiction. Research has also suggested that suicide attempts are more frequent in people with panic disorder, although this research remains controversial.

About 30% of people with panic disorder use alcohol and 17% use other psychoactive drugs. This is in comparison with 61% (alcohol) and 7.9% (other psychoactive drugs) of the general population who use alcohol and psychoactive drugs, respectively. It often varies between individual cases whether any observed drug use worsens the condition, or is initiated by the sufferer to alleviate the condition ("self medication").

Most stimulant drugs (caffeine, nicotine, cocaine) would be expected to worsen the condition, since they directly increase the symptoms of panic, such as heart rate. The medically established psychoactive properties of marijuana present a special case - at low doses there may be some anti-anxiety psychological effects comparable to those of benzodiazepines, whereas at some undefined threshold (as dose is increased), marijuana has been shown to produce extreme anxiety on its own, with an intensity potentially comparable to that of the panic disorder symptoms themselves.

As with many disorders, having a support structure of family and friends who understand the condition can help increase the rate of recovery. During an attack, it is not uncommon for the sufferer to develop irrational, immediate fear, which can often be dispelled by a supporter who is familiar with the condition. For more serious or active treatment, there are support groups for anxiety sufferers which can help people understand and deal with the disorder.

Other forms of treatment include journalling, in which a patient records their day-to-day activities and emotions in a log to find and deal with their personal stresses. Breathing exercises, such as diaphragmatic breathing, can also be found helpful. In some cases, a therapist may use a procedure called interoceptive exposure, in which the symptoms of a panic attack are induced in order to promote coping skills and show the patient that no harm can come from a panic attack. Stress-relieving activities such as tai-chi, yoga, and physical exercise can also help ameliorate the causes of panic disorder. Many physicians will recommend stress management, time management, and emotion-balancing classes and seminars to help patients avoid anxiety in the future. Research has also shown that the herbal supplement 5-HTP can be used to treat panic disorders by its ability to boost serotonin levels. This works by providing the body with the raw material to make serotonin, as opposed to SSRIs which work by recycling serotonin.




Causes

Panic disorder has been found to run in families, and this may mean that inheritance plays a strong role in determining who will get it. It has also been found to exist as a co-morbid condition with many hereditary disorders, such as bipolar disorder, and alcoholism. However, many people who have no family history of the disorder develop it.

Other biological factors, stressful life events, environment, and thinking in a way that exaggerates relatively normal bodily reactions are also believed to play a role in the onset of panic disorder. Often the first attacks are triggered by physical illnesses, major stress, or certain medications. People who tend to take on excessive responsibilities may develop a tendency to suffer panic attacks. Post-traumatic stress disorder (PTSD) patients also show a much higher rate of panic disorder than the general population. The exact causes of panic disorder are unknown at this point. Studies in animals and humans have focused on pinpointing the specific brain areas involved in anxiety disorders such as panic disorder.

Fear, an emotion that evolved to deal with danger, causes an automatic, rapid protective response that occurs without the need for conscious thought. It has been found that the body's fear response is coordinated by a small but complicated structure deep inside the brain called the amygdala. Eating disorders have also been linked to have caused panic attacks in several people. Some mood disorders can cause panic disorder. In addition to clinical depression, bipolar disorder can cause panic disorder in some people. Due to the nature of the fight or flight response many cases of panic disorder may be linked with the limbic system and be initiated by those biological factors that could be biological, reinterpreted emotionally as a threat to survival, such as hypoxia (lack of oxygen). If panic disorder is experienced more severely during sleep, it would be recommended to have the sufferer evaluated for conditions such as sleep apnea or hypopnea. A sleep-related panic disorder could be most easily distinguished from a night terror by the ability (usually instantaneous) of the panic disorder sufferer to regain full consciousness, unlike the night terror sufferer.

Stimulants are a rather common cause for panic attacks. An excess of common stimulants such as caffeine and nicotine often can induce panic attacks in less experienced users. Chemicals, including carbon monoxide, in tobacco smoke can also trigger panic attacks in certain people. Some people's response to small amounts of carbon monoxide is to panic. Not surprisingly, the attacks stop or get much less severe after they quit the cause, such as smoking.

Psychological explanations of panic disorder have also been put forward. Clark (1986) suggests that panic disorder is often caused by "catastrophic misinterpretations", whereby normal bodily sensations, often normal responses to anxiety such as palpitations and sweating, are interpreted as indicating something seriously wrong such as a heart-attack, and this interpretation can be done either consciously or subconsciously. Quite a bit of evidence exists for this theory. For example, activating catastrophic misinterpretations increases anxiety and panic; panic attacks can be reduced as a result of cognitively challenging these misinterpretations; with ambiguous events questionnaires, panic-disorder patients interpret ambiguous sensations more catastrophically than controls. Further, a study by Ehler which provided false heart-rate feedback to participants found that those with panic disorder react with far greater anxiety.




In the News ...


Understanding the brain's 'suffocation alarm'   PhysOrg - December 1, 2014

Panic disorder is a severe form of anxiety in which the affected individual feels an abrupt onset of fear, often accompanied by profound physical symptoms of discomfort. Scientists have known from studying twins that genes contribute to the risk of panic disorder, but very little is known about which specific genes are involved. Two of the most common and terrifying symptoms of this severe anxiety are a sense of shortness of breath and feelings of suffocation. Studies have shown that breathing air that has increased levels of carbon dioxide can trigger panic attacks in most people with panic disorder as opposed to people without the disorder.




Metaphysical Connections

Many people develop physical conditions related to the heart and chest areas, the heart chakra, which is linked with lack of love. Fear and one's inability to affect needed change, are generally the cause of heart attacks, breast cancer, bronchial problems, all things related to the emotional heart and its inability to feel loved.

Most likely the emotional body (the inner child who is easily wounded), has searched for love, compassion, and understanding all of its life, and never found it, or found it briefly in one form or another and lost it, forever mourning the pain and suffering. But that is the story of our reality.

In all age groups and walks of life, millions of people suffer from anxiety and panic disorder as never before. As with a migraine headache, as all is consciousness, a panic attack can strike at any time, generally caused by fear and stress. It forces those afflicted to recognize that there is an emotional problem and seek professional help. Souls seek balance and freedom, not a sense of helplessness and confusion in the physical body.

During a panic attack the Subtle Bodies try to realign with the grid. Fear causes their 'hologram/projection' in this reality to disconnect from the grid. The disconnection will cause one or more of these symptoms simultaneously.





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