Could You Be Suffering From Panic Disorder
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During the day if she was out, the attack felt like my head suddenly weighed a thousand pounds and my chest would get really heavy. It literally felt like something was pulling me down. I would usually have to head home immediately. I would then experience foggy vision where itactually looked like there was fog in the air. I also experienced double vision and parts of my bodylike my neck or one arm or one entire side of my facewould go totally numb.
In addition to the emotional turmoil and the physical manifestations that Caroline and Kirstie describe panic attacks can cause palpitations, pounding heart or accelerated heart rate sweating trembling or shaking sensations of shortness of breath or smothering feelings of choking chest pain or discomfort nausea or abdominal distress feeling dizzy, unsteady, light-headed or faint chills or overheating numbness or tingling feelings of unreality or being detached from oneself fear of losing control or going crazy and fear of dying.
Isolated attacks are bad enough. But when the attacks recur in a short period of time or when the fear of another attack is so strong that you begin to avoid situations, places, and people that may trigger an attack, you may be diagnosed with panic disorder.
Are Multiple Medications Needed To Control Both Panic Disorder And Panic Attacks
This is a tough question to answer, as the answer is different for everyone. While the medications discussed above are all effective for treating panic disorder, sometimes, a single medication may not be enough on its own.
For example, your healthcare provider may prescribe an SSRI or venlafaxine ER for you to take every day to help lower the number of panic attacks and a benzodiazepine to take only during an active panic attack. Your healthcare provider will work with you to develop a treatment plan that works best to treat your specific symptoms.
Panic Attacks Quiz: Do I Have Panic Disorder
In order to manage threatening situations, humans have evolved to experience a “fight or flight” response. As part of this response, when humans are confronted with a dangerous situation, their body mobilizes by sending blood away from their extremities and into the major muscles, producing adrenaline, and increasing heart rate so that we are better equipped to fight off danger.
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Use Muscle Relaxation Techniques
Muscle tension is a symptom of anxiety, and muscle relaxation techniques can help reduce tension and promote relaxation during an attack. Progressive muscle relaxation aims to release tension in one group of muscles at a time to relax the whole body.
Much like deep breathing, muscle relaxation techniques can help stop your panic attack in its tracks by controlling your bodys response as much as possible.
If you attend muscle relaxation therapy, your therapist might take you through the following
- First, you may learn how to tense the muscles before releasing the tension.
- Then, you will learn how to relax the muscles without tensing them first.
- You may also learn how to relax specific sets of muscles, for example, in the shoulders, for practical use in everyday situations.
- Finally, you may learn how to practice rapid relaxation, when you can identify any areas of tension and release it as needed.
To start relaxing your muscles at home, consciously relax one muscle at a time, starting with something simple like the fingers in your hand, and move your way up through your body.
Muscle relaxation techniques will be most effective when youve practiced them beforehand.
Relative Efficacy Of Drugs
In a meta-analysis of all available drug studies in anxiety disorders, the pre -post effect sizes of the different drugs were determined. We simply looked at the absolute difference in anxiety scale scores before and after treatment, without regard to the relative efficacy compared with placebo. This approach makes it possible to include hundreds of studies in comparisons of differential efficacy of all available drugs and not only the few direct head-to-head comparisons. From the patients’ point of view, the improvement in anxiety symptoms as measured by the change from baseline to end point is more relevant than the difference from a control group.
The available medications for anxiety disorders showed considerably large differences in pre-post effect sizes. For example, the improvement achieved with the most efficacious drug was almost three times higher than what was accomplished with the drug with the weakest efficacy . Quetiapine, however, is not licensed for the treatment of any anxiety disorder in most countries. Among the drugs showing high effect sizes and that are licensed for anxiety disorders and recommended by guidelines were the SSRIs escitalopram and paroxetine , and the SNRIs venlafaxine and pregabalin . Also, some benzodiazepines, eg, diazepam and lorazepam , showed high effect sizes. However, these drugs are not recommended for routine treatment.
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Prevalence Of Panic Disorder
Panic disorder affects 2-3% of people every year in the United States and Europe, with varying rates depending on race and ethnicity. On average, Native American Indian populations experience panic disorder at higher rates than non-Latino white Americans. In contrast, African Americans, Latinos, Caribbean Blacks, and Asian Americans all experience the disorder at lower rates than non-Latino white Americans. In addition, it has been well established than females are twice as likely to be diagnosed with panic disorder than males . A number of factors have been identified as possibly influencing sex differences in rates of panic disorder . However, no one theory has been determined so the underlying reason for sex differences in rates of panic disorder remains unknown.
The typical course of panic disorder begins in adolescence and peaks in early to mid-twenties, with symptoms rarely present in children under the age of 14 or in older adults over the age of 64 . Caregivers can look for symptoms of panic attacks in adolescents, followed by notable changes in their behavior , to help potentially identify the onset of panic disorder. Panic disorder is most likely to develop between the ages of 20-24 years and although females are more likely to have panic disorder, there are no significant sex differences in how the disorder presents .
Get Involved In Your Community
Find a way to volunteer or be active in your community.
Science shows that helping others may influence levels of oxytocin in the brains of volunteers, according to a study in Hormones and Behavior by Michael J. Poulin and E. Alison Holman. Oxytocin helps the body manage stress.
Helping others also allows people to focus on something other than their anxiety.
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Strike Up A Conversation
This probably seems like the last thing youd want to do when suffering from a panic attack or severe anxiety, but Greta Hirsch, PhD, clinical director of the Ross Center for Anxiety & Related Disorders told Health.com that striking up a conversation, even if its with a stranger is better than nothing because it will force you to breathe.
This harmless conversation will also distract you from internalizing any fears of will I pass out? Allowing yourself to be consumed with those thoughts will only make your symptoms worse, so its best to find a distraction, no matter what it is! If you cant muster up the courage to talk to a stranger, call someone you know. It gets you in the moment, it gets you breathing, it gets you, maybe, out of the triggering environment for a few minutes, says Hirsch.
What Does A Panic Attack Feel Like
The first step in managing a panic attack is being able to recognize when it’s happening.
Panic attacks can impact the entire body and mind and, along with physical symptoms, bring about feelings of doom, dread, and intense fear. They usually come on without warning, and their cause may be unknown.
Panic attacks can be so distressing that they can cause the person to feel as though they are dying, and the experience of having a panic attack can bring about additional fear or anxiety of future panic attacks.
When panic attacks continue to occur over time, it could be a sign of a panic disorder.
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Ssris And Venlafaxine Er
SSRIs and venlafaxine ER can take longer to start working than benzodiazepines. These medications must be taken every day and can take 4 to 6 weeks or more to kick in. SSRIs and venlafaxine ER are also known to cause bothersome side effects such as sweating and sexual dysfunction that are not typical with benzodiazepines.
SSRIs and venlafaxine ER also both carry a risk of a rare but serious complication called serotonin syndrome. This potentially life-threatening side effect is caused by the presence of too much serotonin in the body. Serotonin syndrome can become an emergency situation and requires medical attention.
Seek immediate help if you experience the following after starting an SSRI or venlafaxine ER:
Unexplained agitation, confusion, or restlessness
Treatment Of Anxiety And Panic
There is plenty that can be done for people who have problems with anxiety and panic.
Treatment can include:
- psychological therapies, such as cognitive behavioural therapy
Getting professional support is always a good idea. Its important to find the right health professional for you. And there are plenty of online self-help programs, support and ways to get therapy, too.
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Treatment Options For Panic And Anxiety Attacks
Whether youre dealing with panic, anxiety, or both, its important to know that help is available. The most common treatment options include therapy, medication, and self-help strategies.
- Psychotherapy helps people gain a better understanding of their symptoms, develop constructive ways to manage them, work through past pain and trauma, and build a strong support network.
- Medications can help reduce your symptoms. Sometimes medications are needed only for a short time, but other people may benefit from long-term medication use.
- Self-help techniques, including breathing exercises and positive self-talk, can teach you ways to manage symptoms yourself in a healthy way.
Ways To Prevent Panic Attacks
“You need to try to work out what particular stress you might be under that could make your symptoms worse,” says Professor Salkovskis. “It’s important not to restrict your movements and daily activities.”
- Doing breathing exercises every day will help to prevent panic attacks and relieve them when they are happening
- Regular exercise, especially aerobic exercise, will help you to manage stress levels, release tension, improve your mood and boost confidence
- Eat regular meals to stabilise your blood sugar levels
- Avoid caffeine, alcohol and smoking these can make panic attacks worse. Panic support groups have useful advice about how you can effectively manage your attacks. Knowing that other people are experiencing the same feelings can be reassuring. Your GP can put you in touch with groups in your area
- Cognitive behavioural therapy can identify and change the negative thought patterns that are feeding your panic attacks
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How To Deal With Anxiety
Treatments for anxiety include prescription drugs, counseling, meditation and exercise. Experts recommend a combination of these modalities. Experiencing some anxiety when facing difficult decisions or life changes is normal, but when that anxiety interferes with daily life it becomes a disorder.
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About 40 million American adults have an anxiety disorder, according to the National Alliance on Mental Illness. This makes anxiety disorders the most common mental illness in America.
Anxiety disorders are characterized by feelings of anxiety that go beyond worrying about everyday things like problems at work or school or dealing with life changes. People with anxiety disorders may have constant, uncontrollable fear that interferes with their lives.
Breathing and meditation techniques can manage anxiety and panic attacks when practiced regularly.
Deep breathing increases the supply of oxygen to your brain and stimulates the parasympathetic nervous system, which promotes a state of calmness, according to The American Institute of Stress.
Do I Have An Anxiety Disorder
If you identify with any of the following seven signs and symptoms, and they just wont go away, you may be suffering from an anxiety disorder:
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Unresponsiveness To Standard Treatments
Before considering a patient to be treatment unresponsive, it should be ascertained that the diagnosis was correct, adherence to the treatment plan was sufficient, the dose prescribed had covered the full range, and there had been a trial period of adequate duration. When patients report previous treatment failures, it often turns out that a drug was only prescribed in the lowest dose or was stopped within the first 2 weeks due to side effects that occurred in the initial phase before the patient could experience improvement.
Elderly patients may take longer to show a response. Table III contains options in case of drug inefficacy or intolerance. In patients who are unresponsive to psychotropic drugs, the addition of CBT is generally recommended.
A combination of antidepressants and benzodiazepines is sometimes used in treatment-refractory cases.
When all standard treatments have failed, the off-label use of drugs may be considered, for example, drugs licensed for another anxiety disorder or that are not licensed but have shown efficacy in clinical studies. Such drugs include quetiapine and agomelatine.
Differential Diagnosis And Comorbidity
When evaluating a patient for a suspected anxiety disorder, it is important to exclude medical conditions with similar presentations . Other psychiatric disorders use of substances such as caffeine, albuterol, levothyroxine, or decongestants or substance withdrawal may also present with similar symptoms and should be ruled out.5
Complicating the diagnosis of GAD and PD is that many conditions in the differential diagnosis are also common comorbidities. Additionally, many patients with GAD or PD meet criteria for other psychiatric disorders, including major depressive disorder and social phobia. Evidence suggests that GAD and PD usually occur with at least one other psychiatric disorder, such as mood, anxiety, or substance use disorders.10 When anxiety disorders occur with other conditions, historic, physical, and laboratory findings may be helpful in distinguishing each diagnosis and developing appropriate treatment plans.
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