It is characterized as repeated sudden intense attacks of anxiety in which physical symptoms dominates and usually reach their peak in less than a minute and are accompanied by fear of serious consequences such as heart attack, losing control etc. These attacks are not restricted to any particular situation or set of circumstances and are hence unpredictable. Individual attacks usually last for minutes only though sometimes longer but the frequency is quite variable.
If the panic attack occurs in a specific situation such as a bus , the patient may subsequently avoid the situation. Frequent an unpredictable panic attack produce fear of being alone or going into public places. Continuous fear of having another attack is what often follows a panic attack.
Symptoms of Panic Disorder
The various symptoms of the panic attack are, shortness of breath and smothering sensations; chocking; palpitation and accelerated heart rate; chest discomfort or pain; sweating; dizziness, unsteady feeling or faintness; nausea or abdominal distress; numbness or tingling sensation; flushes or shaking; fear of dying; and fear of going crazy or doing something uncontrolled. The dominant symptoms vary from person to person.Causes of Panic Disorder
CAUSES OF PANIC DISORDER
Panic attack can also be provoked by the inhalation of Carbon dioxide more readily in panic disorder patients than in controls and it has been proposed that panic disorder patients are usually sensitive to feelings of suffocation and respond with panic anxiety.
Biological Factors: Abnormalities in the presynaptic @-adrenoceptors that normally restrain the activity of presynaptic neurons in brain areas concerned with the control of anxiety and an abnormality of benzodiazepines or 5-HT receptor function may have a causal role in panic disorder. The effects of drugs like Clomipramine, Fluvoxamine and Imipramine, further suggest that 5-HT mechanisms are important in panic disorder.
Psychological factors: The cognitive hypothesis is based on the observation that fears about serious physical or mental illness are more frequent among patients with panic attacks than among anxious patients without panic attacks (Hibbert, 1984). It has also been proposed by Clark (1986) that there is a spiral of anxiety in panic disorder as the physical symptoms of anxiety activate fears of illness and thereby generate more anxiety.
➢ Drugs like benzodiazepines (like Alprazolam, Diazepam etc), Imipramine, Clomipramine and SSRIs (like Fluvoxamine, Paroxetine and Sertraline) are shown to have a therapeutic effect
➢ Cognitive-behavior therapy : Focuses on psycho-educating the patient and his family members about the problem, removing various myths and fears (such as palpitations will surely lead to a heart attack) associated with the physical effects of anxiety, and on teaching patients relaxation exercises and effective stress coping strategies. These individuals are also encouraged to engage in positive self-talk and to avoid focusing too much on their bodily signs of anxiety.
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