โรคตื่นตระหนก แพนิค (Panic Disorder) อาการ สาเหตุและวิธีการรักษา

Panic Disorder or Panic Attacks

Panic attacks are more severe than typical anxiety symptoms, where they usually resolve after the stressful situation is over.

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Panic Disorder or Panic Attacks

A panic attack is a rapid occurrence of the body’s physical response to unreasonable fear without apparent cause or danger. This results in the patient losing control, feeling like they're having a heart attack, or, at times, dying. It is usual for people to experience panic attacks once or twice in their lifetime. Panic attacks are more severe than typical anxiety symptoms, and they usually resolve after the stressful situation is over. However, if you have frequent panic attacks and spend time in constant fear of another attack, you may develop a condition called panic disorder. Panic attacks are not life-threatening, but they can be terrifying and significantly impact the quality of life. Therefore, it is worthwhile for you to receive proper diagnosis and treatment.

What are the symptoms of panic attacks?

Panic attacks can occur at times without warning signs, making them unpredictable. Episodes of a panic attack may occur from time to time or, in some cases, often over time as there are so many variations.  Symptoms can last up to half an hour and peak within minutes, resulting in the patient feeling overwhelmed and exhausted after the symptoms have subsided.

These symptoms are usually involved in panic attacks

  • Racing heart rate
  • Shaking or trembling
  • Headache
  • Chest pain
  • Sweating
  • Numbness
  • Stomach pain
  • Intense fear of danger
  • Loss of control
  • Detachment from reality

What kind of panic symptoms should I see a doctor?

Panic disorder is not life-threatening but should be treated as it can become chronic and exacerbate. If you experience symptoms of panic attacks, seek medical help immediately. Generally, panic attack symptoms share similar characteristics to other serious health issues such as a heart attack. Therefore, getting an accurate diagnosis and treatment is recommended.

What are the causes of panic disorder?

It is unsure what causes panic attacks and panic disorder; however, several variables may play a role.

  • Body: Genetic predispositions
  • Mind: Stressful life events
  • Abnormal function in the brain and nervous system
  • Temperament prone to negative emotions

A particular situation often triggers panic attacks. Still, the early stages of panic disorder are often sudden and cause a person to experience attacks out of the blue. Some research suggests that panic attacks usually involve a fight-or-flight response to a life-threatening situation. For example, if a tiger chases you, your body will instinctively react whether to fight or remove yourself from the circumstance to ensure survival. The response is like the reaction during a panic attack; however, it is still unknown why a fight-or-flight mode is activated when no apparent danger is presented.

Risk factors that cause panic attacks

Panic disorder symptoms usually develop in late adolescence or early adulthood. Women are reported to suffer from panic disorder more than men.

Panic attacks or panic disorders are more likely to develop due to the following factors:

  • Family members have a history of panic attacks and panic disorder
  • Traumatic events such as a severe accident to a family member or loved one
  • Major life stress such as going through a divorce
  • History of childhood sexual abuse
  • Alcohol or drug dependence

Complications

Panic disorder is a severe problem that can impact almost every aspect of your life if left untreated. You may be living in a constant state of fear of the next attack, significantly damaging your life quality.

Panic attacks and panic disorder-related complications are:

  • Social anxiety
  • Phobia Development
  • Problems with coworkers or friends at school
  • Depression
  • Financially unstable
  • Increased risk of suicide
  • More likely to abuse alcohol and drugs

How can panic attacks be prevented?

There are no solutions to prevent panic attacks from occurring currently. However, if symptoms seem to appear, the patient should

  • Seek treatment immediately to help prevent the condition from becoming more frequent.
  • Stick to a treatment plan to avoid recurring panic episodes.
  • Regular exercise may help to keep anxiety at bay.

How many methods are there to diagnose panic disorder?

Your healthcare provider will determine if the panic attacks you have resulted from panic disorder or if the patient has other serious physical health problems such as heart disease or thyroid problems.

  • Physical exam to check if you have any other health-related problems
  • Blood test to check for thyroid disorders and heart complications
  • Psychological assessment of the symptoms experienced

Patients must complete a psychological assessment and be asked about alcohol or other substance use. Not everyone who experiences episodes of panic attacks is diagnosed with panic disorder.

Criteria for patients to be diagnosed with panic disorders:

  • You have panic attacks that occur frequently and are usually abrupt
  • You are worried and have a constant fear of having another attack following your last attack; a fear of losing control; therefore, significantly change your behavior to avoid any situations that could trigger it
  • The panic attacks that occurred are not a result of drug or substance usage or another mental health issue.

If left untreated, panic attack symptoms can aggravate phobias and panic disorders. Patients can still benefit from panic attack treatment even if not diagnosed with a condition.

Panic symptoms or panic disorder What is the treatment method?

The severity and frequency of panic attacks can be significantly lowered by receiving appropriate treatment. Psychotherapy, medications, or a combination of both are recommended treatment options. The severity of your panic disorder, past medical history, and preference will determine which option works best for you.

Psychotherapy

Psychotherapy is a highly effective treatment plan. It is often used as the primary treatment in patients with panic disorders where they can recognize and cope with their symptoms.

Cognitive behavioral therapy (CBT) or talk therapy is a form of psychotherapy most used to treat patients with panic disorder. CBT allows you to learn through your own experience and discuss the emotions involved during the attack guided by a mental health professional. Your therapist can help you identify triggers that lead to panic attacks and help you understand the associated physical symptoms. Your reaction, behavior, and thinking will improve accordingly until the severity of the panic attack resolves. Moreover, successful treatment can also help you conquer your fear of situations initially avoided due to panic attacks.

Treatment of panic disorder requires time and effort to get results, and it might take several months for symptoms to decrease or vanish. Therefore, it is recommended that you schedule an occasional visit to your therapist to ensure your treatment progress.

Medications

Medications used to treat panic disorder patients share the same characteristics as medication used in people with depression. These types of medication are used to manage symptoms of a panic attack, including:

  • Selective serotonin reuptake inhibitors (SSRIs)
  • Benzodiazepines

Sedatives are depressants that affect the central nervous system. It is commonly prescribed as a short-term solution due to its vulnerability to dependency usage by patients. Moreover, interacting with other drugs can create serious adverse side effects. All medications risk side effects, and some are not suggested in specific situations, such as pregnancy. Please discuss any potential risks and side effects with your doctor.

How can I take care of myself at home?

Although seeking professional help can be very beneficial, there are things you can do at home to help manage your symptoms:

  • Find a support group: connecting with others facing similar problems can help you feel that you are not alone.
  • Avoid consuming caffeine, alcohol, smoking, and recreational drugs.
  • Practice breathing techniques to manage stress, such as yoga and meditation
  • Get an adequate amount of sleep
  • Stay physically active

Preparing for your appointment

See your doctor if you have panic attacks or suffer from panic disorders. You may be referred to a mental health professional for further treatment.

Before your doctor's appointment, please make a note of the following:
Your symptoms, how often do you feel the panic attack, and when did they first occur

  • Crucial personal history, events that are major life stressors or any traumatic events from childhood that still affects you before the first panic attack has occurred,
  • Medical information, Physical or mental health conditions
  • Medications, The types and dosage of vitamins, supplements intake

Bringing acquaintances along with you to the appointment will be favorable as they can lend support and help you remember the doctor’s advice

Examples of questions to ask your doctor

  • What is causing my panic episodes to continue? What are my stressors?
  • Is it conceivable that particular drugs are causing my symptoms?
  • Do I need a diagnostic test?
  • Do I need to see a therapist?
  • What steps can be taken right now to help control the symptoms?
  • Is this a panic condition or a panic attack?
  • What type of therapy is advised?
  • How frequently should I get treatment?
  • Is group therapy appropriate for my situation?
  • What are the risks of taking medication?
  • How long must I take the medication?
  • How can I assess the efficacy of my treatment?
  • What should be done to limit the possibility of a relapse?
  • What actions should I take to look after myself?

What inquiries should you expect from your doctor?
Preparing for and anticipating inquiries benefits both the patient and the practitioner.

  • How are you feeling? And when was the first panic attack?
  • How frequently do you get panic attacks, and how long do they last?
  • Is there anything specific that appears to be causing your panic attack?
  • How frequently do you worry that the fear may return?
  • Do you avoid any circumstances or experiences that appear to trigger a panic attack?

Panic Disorder Symptoms, Causes, Treatment

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Published: 19 Jul 2022

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