PANIC ATTACKS

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Panic attacks are the sudden onset of intense anxiety with heart-palpitations, chest-pain, and the fear of "going crazy" or loosing control.

Criteria for Panic Attacks: ·

1. Palpitations, pounding heart or accelerated heart rate
2. Sweating, trembling or shaking
3. Shortness of breath or hyperventilation
4. Choking sensations and chest pain
5. Nausea, abdominal distress
6. Feeling dizzy, light-headedness or fainting
7. Derealizations (feeling of unreality)
8. Depersonalization (feeling split or out-of-body experiences)
9. Fear of going crazy or loosing control
10. Fear of dying such as the fear of sudden death from a heart attack
11. Numbness and tingling sensations over mouth, fingers
12. Chills or hot-flashes

Agoraphobia: Agoraphobia is the fear of going to places such as the supermarket, driving on highways, avoiding bridges and the fear of leaving the house or driving in general. Transportation gets constricted and one might completely stop driving and looking for employment. Panic attacks may result in many emergency room visits with the fear of dying resulting in costly workups such as cardiology tests, endoscopic examinations for gastroenterology, neurological exams such as CT scans, EEG tests that yield negative results. Patients get frustrated when no causes have been found.

Causes: In fact, panic attack is a physical condition that we don't have a routine clinical test for. Panic attacks are due to an abnormal sympathetic nervous system with the sudden release of adrenaline due to malfunctions of part of the brain stem called locus cereuleus. Panic attacks can occur in sleep also. Experimental tests such as IV lactose infusion (similar to glucose) can induce panic attacks. Voluntary heavy breathing can increase dizziness and numbness. The opposite is also true; breathing slowly with relaxation can reduce tingling and dizziness.

Treatment: Panic attack is a physical condition that needs to be treated with SSRI medications such as Zoloft, Prozac, Paxil, Celexor, etc. Agoraphobia is a psychological condition which needs psychological treatment which may include:

• Medications
• Behavioral - relaxation, paperbags, etc.
• Self-help groups, aims
• Suggested reading
• Associations

 

The following are sources for additional information on panic attacks:

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