By Dr.Stephen Antony , MD (Psychiatry)
Panic attack is an anxiety disorder that is illustrated by unforeseen and continual incidents of strong terror along with physical indications that may include chest ache, shortness of breath or abdominal distress.
Panic attacks affect 1 to 3 percent of the general population at some point in their lives. Panic attacks can be described as a discrete period of intense fear or discomfort.
The following are the panic attack symptoms developed abruptly and reached a peak within 10 minutes:
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There is marked individual variation in the length of attacks. To be classified as panic disorder, the attacks should cause subsequent anxiety about their recurring or their effects, or bring about significant behavioral change in the patient.
A heightened sensitivity to bright lights, temperatures, sudden or harsh sounds and other sources of physical stimulation is common for people who have panic attacks. Panic attack sufferers may start fearing a subsequent panic attack so much so that they will start to alter their daily routine or the places that they go to and the things that they will do.
From time to time this terror of the next panic attack becomes stronger than having the actual panic attack itself.
Frequent situations that may trigger the panic attack include waiting at the doctor’s office, attending an interview, worrying about future, being stuck in heavy traffic and a standing in a long line in the marketplace
There are three major factors that can contribute to panic attacks:
- Emotional: The emotional well-being of a person can greatly influence the onset of panic attacks. For example a person who has weak emotional support and stays alone has a higher chance of panic attack than a person who has healthy emotional support and relationships. Frequently the person is in a miserable condition due to life events. Depression may co-exist and can contribute to the development of anxiety disorders.
- Genetics: A strong link has been found between anxiety and family history of psychiatric disorders. These individuals are found to have easily excitable brain areas and which causes renders the individual susceptible to panic even under normal conditions.
- Psychological: People with panic disorders are known to exaggerate the importance of negative events and they are known to have negative expectations from life. Such patients benefit greatly from cognitive behavior therapy as it helps them identify their negative patterns of thinking and take control over their thoughts.
Other factors causing panic attacks:
Medications:
Researchers have found that large amounts of sodium lactate in the bloodstream can cause panic attacks in people. Sodium lactate is the basic solution in intravenous fluids given in the hospital. In one study, panic disorder patients were given sodium lactate and a dramatic increase of blood flow to the temporal lobes of the brain was found. Therefore a thorough review of all medications is recommended in patients who suffer from panic attacks.
Overactive adrenal system:
It has been studied that people with panic disorders, including agoraphobia, have adrenal glands that are overactive and are therefore more likely to experience and adrenaline rush (which produces the ”fight or flight” response) when faced with a perceived psychological threat, this makes them more susceptible to panic attacks.
Under stressful situations, the adrenal glands of people with panic disorders tend to become overactive and produces more adrenaline and stress hormones such as cortisol. This overproduction of adrenaline and cortisol can interrupt the production of serotonin and dopamine in the brain. Seretonin and dopamine stabilize the mood and also produce a sense of calm and well-being , the lack of these chemicals in the brain makes the patient more distressed.
The medications for panic disorders restore the seretonin balance and promote a sense of well-being and emotional stability. Patients with low serotonin and dopamine levels lose the ability to cope with stress because their mood becomes unstable.
The underlying reason behind panic attacks is an imbalance in neurochemicals , this can make the patient more easily fatigued, the immune system is compromised and consequently the risk of experiencing anxiety and panic attacks increases and hence necessary treatment methods are required for you to get relieved from panic disorders.
Underlying medical condition:
If you are suffering from a panic attack, you need to visit a physician and rule out any underlying medical disorder. Medical disorders that mimic panic attacks include:
- Hyperthyroidism.
- Hypoglycaemic episodes
- Paroxysmal cardiac dysrhythmia.
- Mitral valve prolapse.
- Myocardial infarction.
- Recurrent small pulmonary emboli.
- Epileptiform disorders, particularly temporal lobe epilepsy.
- Withdrawal from alcohol/sedatives/opiates.
- Paroxysmal vestibular disorders, e.g. Ménière’s disease
The exact cause of panic attacks is unknown. If you are prone to these attacks, it is important for you to learn to recognize the triggers. In this way you can control the intensity and occurrence of attacks. When you recognize what it is that sets off your feelings of panic, you can also take action to prevent the occurrences.
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References:
(1) Kumar S, Oakley Browne M. Panic disorder. Clin Evid. 2003;9:1084–90.
