Panic Attacks, Panic Disorder and drug treatment

A panic attack is a sudden and strong feeling of overwhelming fear and apprehension often including one or more of the following:

  • dizziness
  • shortness of breath
  • temporary vertigo or dizziness
  • feeling of not being able to swallow
  • palpitation (noticeable or increased heartbeat)
  • sweating
  • trembling
  • feeling very hot or cold
  • being convinced that death or insanity is imminent
  • chest pains

Many people rush to the emergency room or casualty department after their first panic attack convinced they have had a heart attack or a stroke. If you think you have had, or are having a panic attack you should be given a thorough check-up by a medical professional to rule out a physical cause for your symptoms.

Common Misconceptions

Panic attacks themselves are completely harmless but there are two common misconceptions that are regularly repeated.
1) You might have a heart attack. Actually, a normal adult heart could sustain palpitations for much much longer than a panic attack can last. There is no evidence that a panic attack does any short or long term damage to the heart.

2) You might faint. While you may feel faint and slightly dizzy during a panic attack, it is highly unlikely that you will faint. The reason for this is simple. Fainting is caused generally by a loss of blood pressure, where as in a panic attack blood pressure tends to rise a bit.

Remember, panic attacks were designed by god(s)/nature to protect you. They feel so bad because they are trying to make you escape a perceived threat.

What disorders are associated with panic attacks?

In modern medical and psychiatric terms, people who suffer from panic attacks are usually put into one of two categories.

1) “Panic Disorder” is the term used for people who have panic attacks seemingly without cause, coming as it were out of the blue. People are diagnosed with panic disorder if they have had two or more panic attacks or if they have had more than a month of severe worry about suffering from another panic attack.

2) Phobia or Agoraphobia. If a panic attack is related to a specific situation then a simple phobia will be diagnosed. Often sufferers of Panic Disorder become afraid of having panic attacks away from home, and begin to avoid going out, going out alone, or going to some places. In these cases agoraphobia is diagnosed.

Remember: A good therapist will ignore labels and treat your personal symptoms as unique.

How common are they?

Very common, possibly as many as 10% of people have some of the above at sometime.

What is the prognosis, what are my chances of recovery?

Very good. Drug treatments and therapies have high success rates. And some alternative remedies can also be very helpful

Panic Disorder is a label given to a person who either frequently has panic attacks or who lives their life in fear of having panic attacks and is thus in some way disabled in their social or professional life. The fear of having a panic attack is important, because it is this fear, rather than the attacks themselves, that causes the major impact on life.

Panic attacks have evolved/were designed by god specifically to feel exceedingly nasty. The idea is that they give you the impetus to fight or flee. Panic Attacks are of course completely harmless despite being unpleasant. Panic Disorder is highly treatable. Clare Weekes seminal work Pass Through Panic is a good place to start. Also Cognitive Behavioural Therapy (CBT) and Medication for panic attacks may be helpful.

DSM IV describes panic disorder as: Recurrent unexpected Panic Attacks At least one of the attacks has been followed by 1 month (or more) of one (or more) of the following: Persistent concern about having additional attacks, worry about the implications of the attack or its consequences (e.g., losing control, having a heart attack, “going crazy”), and a significant change in behaviour related to the attacks.

So what’s the prognosis for a sufferer with Panic Disorder? What’s the chance of recovery? The news is good, 70-90% of people make a full recovery with mainstream treatments such as a combination of drugs and CBT. Some people see Panic Disorder as chronic and relapsing, in that you never get over it. This is not the case, if you deal with the cause and inoculate yourself against panic using Claire Weekes’ method it definitely can be conquered for ever!

More information here on Panic Disorder from another website.

Drug treatment for Panic Attacks

Drugs often prescribed for panic attacks include Benzodiazepines and Selective Serotonin Re-uptake Inhibitors. (Commonly called SSRI’s).

Benzodiazepines are tranquilisers which work by increasing the efficiency of GABA (Gamma Amino Butyric Acid), a neurotransmitter which calms down excitory responses causing inhibition and calmness. They can have side effects and can be addictive or habit forming. That said, if they are used correctly (as prescribed by your doctor) they are usually very safe. One major problem is that panic attack sufferers can build up a tolerance to them, so they are less effective. The major advantage of benzodiazepines for panic attacks is that they work fairly fast, and can therefore be taken on an as needed basis.

SSRI’s work by inhibiting the re-uptake of the neurotransmitter Serotonin. Increasing the levels of Serotonin leads to an improvement of mood and a lessening or even cessation of panic attacks. There are many kinds of SSRI’s and they don’t all work for everyone. Some people find the side effects are too much, others find they are not effective. Some other people find them very effective. The major drawbacks are that they take at least two weeks to become effective and must be taken every day. Also they should be withdrawn slowly at the end of treatment.

Remember that drugs treat symptoms and not causes, and while under drug therapy it is a good idea to try and treat the cause.

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