What is Panic Disorder?
Panic disorder (episodic paroxysmal anxiety) is an anxiety disorder in which the main symptom is repeated bouts of severe anxiety (panic), which are not limited to a specific situation or circumstances and therefore unpredictable. Attacks are accompanied by fear and autonomic symptoms. As with other anxiety disorders, the dominant symptoms vary in different patients, but unexpectedly occurring palpitations, chest pains, a feeling of suffocation are common. dizziness and a sense of unreality (depersonalization or derealization). A secondary fear of death, loss of self-control, or insanity is also almost inevitable. Usually attacks last only minutes, although at times and longer; their frequency and course of the disorder are quite variable. In a panic attack, patients often experience sharply increasing fear and vegetative symptoms, which lead to the fact that patients hastily leave the place where they are. If this occurs in a specific situation, for example, in a bus or in a crowd, the patient can subsequently avoid this situation. Similarly, frequent and unpredictable panic attacks cause fear of being alone or appearing in crowded places. A panic attack often leads to a constant fear of another attack.
Causes of Panic Disorder
There are facts confirming the genetic origin of panic disorders (15% of first-degree relatives become ill). Psychoanalysis views the disorder as the result of an unsuccessful unconscious defense against destructive impulses that cause anxiety.
Symptoms of a Panic Disorder
The onset of panic is spontaneous, although it is sometimes provoked by arousal, physical exertion, and sexual activity. The main symptoms are extreme fear and a feeling of impending death, accompanied by tachycardia, shortness of breath, sweating. The patient tries to leave the place where the attack arose and seeks help. Duration up to an hour, between attacks – an alarming expectation of recurrence. There is an increase in seizures with excessive use of caffeine, sometimes the first seizures follow precisely after the use of caffeine.
In 50%, spontaneous recovery is noted, in 20% panic attacks continue, but in 30% they are complicated by depression, the risk of suicide, addiction to alcohol and drugs that temporarily eliminate them, symptoms of obsessive-compulsive disorders, social and family disadaptation may appear. Sometimes qualified by neuropathologists as neurocirculatory dystonia.
Diagnosis of Panic Disorder
Panic disorder should be diagnosed as the main diagnosis only in the absence of any phobia, and a panic attack that occurs in an established phobic situation is considered an expression of the severity of the phobia, which should be taken into account in the diagnosis first.
For a reliable diagnosis, it is necessary that several severe attacks of autonomic anxiety occur over a period of about 1 month:
- in circumstances not related to an objective threat;
- attacks should not be limited to known or predictable situations;
- between attacks, the condition should be relatively free of anxiety symptoms (although anticipation anxiety is common).
Differential diagnosis: Panic disorder must be distinguished from panic attacks that occur as part of established phobic disorders. Panic attacks can be secondary to depressive disorders, especially in men, and if criteria for depressive disorder are also identified, panic disorder should not be established as the primary diagnosis.
Panic Disorder Treatment
Antidepressants, tranquilizers, behavioral therapy, family therapy, psychoanalysis. The patient is asked to breathe in a paper bag to prevent hyperventilation accompanied by alkalosis.