12 August

Panic Attack : Symptoms, Treatment , dif.diagnosis , causes, what to do , how to cope


  • statistics
  • What underlies panic attacks
  • What happens during an attack
  • Causes Panic Attacks
  • How does
  • attack symptoms between crises
  • Algorithmaction in the development of panic attack
  • diagnosis of panic attacks
  • Treatment of attacks and preventing their occurrence
  • panic attacks in children

panic attack is called the attack a strong (deep, "animal") fear that comes on suddenly, sometimes- at night, a few minutes reaches maximum intensity.He is accompanied by palpitations, shortness of breath or difficulty breathing, chest pain, nausea, a feeling of "lump" in the throat, a sense of fuzziness, unreality.Status appears for no apparent reason, lasting from 10 minutes to 2 hours (usually - up to 30 minutes), held itself within the first hour of moderate accompanied by anxiety, fear leaves a repetition of such a paroxysm (attack).

Panic attack (also called vegetative, or a crisis of sympathadrenalic cardioneurosis) rarely solitary.Most often, the person who has experie

nced it once, passes through it again and again.In this case, he appeared phobia, his personality changes occur.Such a state, with a duration of one year or more, known as panic disorder or panic attack syndrome.Evolve it can not only in adults: children since the advent of consciousness (3 years) may also experience a panic attack.

themselves bouts of panic attacks for life are not dangerous.Not a single case of death from them, and this is due to their mechanism: it is aimed at mobilizing the body with the threat (such as develops in real danger or when severe unusual exertion).The same symptoms may be a harbinger of other diseases - such as the heavy bleeding, stroke, asthma, or temporal lobe epilepsy, and not life-threatening such as migraine or thyrotoxicosis.Like symptoms may occur and side effects of certain drugs.How to distinguish a panic attack from other pathologies, what to do when it occurs, and how to pay off a wave reaching each other autonomic seizures, consider further.Let us also panic attacks in children.


Panic attacks - a common condition.At least once in your life it bore every fifth, frequent the same disorders, repeated more than a year, subject to not more than 1% of people.At 5 times more common in women and the peak incidence between the ages of 25-35 years.But the attack may appear in a child older than 3 years old and a teenager, and in people over 60 years.

In 70% of cases of panic attacks are the causes of depression and suicide attempts.And one in five suffering from "fighting" with the panic of alcohol or drugs, acquiring them dependency.

Get rid of panic disorder may completely if to make this harder than remember taking pills.

What underlies panic attacks

There are several hypotheses, each of which in its own right describes the processes occurring in the body during the development of panic attacks.It is they who are to blame for all the signs ( "autonomic storm"), which are characteristic of a panic attack.

catecholamine hypothesis

Here are placed at the heart of catecholamines - the hormones of the adrenal medulla: epinephrine, norepinephrine, dopamine.The main of them - the adrenaline.He mobilizes the nervous system under stress: quickens the heartbeat, to each organ was enough blood for the same purpose increases the pressure, respiratory rate changes to all the organs of enough oxygen, stimulates the brain.This response is turned on, if you need to fight or flee.

When vegetative crises catecholamine levels increase not only in the blood and urine, but also directly into the nervous tissue.And if you enter the adrenaline intravenously (this confirms the hypothesis), then develop a typical panic attack.That is, correlators catecholamines may be called the condition, and one of the body more prone to the development of more crises.

genetic hypothesis

If panic attacks suffers from one identical twin, there is a 50% probability that the same condition will develop, and the second.Relatives say the same disease in 15-20% of cases.On this basis, we believe that the disease is encoded by certain sections of genes, and originally destined.Manifest as it is in a favorable situation, against a background of stress, hormonal changes, a serious illness, and so on.


psychoanalysts Sigmund Freud and his followers believe that panic attacks occur in people with intrapersonal conflict that constantly suppress it, not having the emotional release.

behavioral hypothesis

The occurrence of panic attacks provoke human fears (sink, break, get in a car accident), resulting in a certain situation.

cognitive hypothesis

Proponents of this theory lay the basis for the syndrome erroneous interpretation of its human sensations.For example, arose in response to fear or physical stress palpitations they interpreted as a harbinger of illness or death, and that provokes a state of panic.

What happens during an attack

Though the symptoms of panic attacks and appear almost simultaneously, reactions occur causing them to cascade:

  1. stress activates the release of adrenaline;
  2. epinephrine constricts blood vessels, increases the rate of heartbeat and breathing becomes more frequent;
  3. vasoconstriction leads to increased blood pressure;
  4. rapid breathing leads to the removal of carbon dioxide, which is why anxiety is amplified even more;
  5. removing excess carbon dioxide changes the blood pH, which leads to dizziness and a feeling of numbness in the extremities;
  6. vasospasm occurs only in the peripheral tissues (skin, fat, muscles), which impairs the local blood circulation and nourishment (whole blood is mobilized to the center: the brain, the heart, in order to survive, according to the body).As a result, malnourished tissues of lactic acid accumulates, it is absorbed into the bloodstream and increases the concentration of ownership in the blood.That lactic acid, according to latest figures, the amplifier is a panic attack symptoms.

Causes Panic Attacks

The condition can be caused by any disease, pain, or surgery, because of which the person is experiencing.Most often, the attack develops on the background of mental pathologies, but also it can be caused by:

  • myocardial infarction;
  • coronary heart disease;
  • mitral valve prolapse;
  • childbirth;
  • pregnancy;
  • onset of sexual activity;
  • menopause;
  • pheochromocytoma (tumor of the adrenal gland, which is produced when too much adrenaline);
  • thyrotoxic crisis;
  • cholecystokinin taking drugs, glucocorticoids, hormones, anabolic steroids.

Panic attacks may be symptoms of mental illness:

  • phobias;
  • depression;
  • schizophrenia and schizotypal disorder;
  • posttraumatic disorder (after the accident, burns, natural disasters)
  • obsessive-compulsive disorder - conditions that are constantly present some fear (get sick, burn), leading to the emergence of compulsive actions (checking appliances, frequent hand washing, and so on).

Panic attacks can be caused by the accelerated pace of life, the constant stress of the work in an unpleasant team or unloved work.Children on the background of panic attacks may develop enuresis and encopresis.

panic attacks Risk Factors

big risk to "earn" a panic attack people who have one or more of the following factors:

  • sedentary lifestyle with no physical exertion, especially during adolescence.Sports and fiznagruzki facilitate discharge of negative emotions, bringing the imbalance in the emotional background of the procedure.Without this, there are restlessness, impulsiveness, unbalance.Behind them there and panic attacks.
  • abuse caffeine .It leads to the depletion of the nervous system.
  • Smoking , changing the structure of human blood vessels, reduces stress resistance of the organism.
  • Holding emotions "in itself» .
  • lack of full sleep .In this case, additional blood ejected amount of adrenaline and other hormones, leading to the development of panic disorder.

How does

attack Consider, what are the symptoms of a panic attack.Conventionally, they are divided into physical and mental.The former include the sensation of the body, the second place "in the head".

Mental symptoms

These symptoms predominate over the others because of its severity.It:

  • sense of impending danger;
  • fear of death: it is usually present only during the first 2-3 crises, when transformed into a fear of ill fear of heart attack or stroke, and so on;
  • fear of going crazy;
  • sensation of a lump in the throat;
  • derealization: the world fades into the background, can be distorted sounds and objects may seem that there is a slow motion;
  • depersonalization may occur: own actions are considered as "outsiders", it seems that one can not control them;
  • can be felt "lightheadedness" or "dizziness in the head."

This person may attempt to hide and escape, but he can and seems to paralyze.

Mental symptoms are not necessarily the same each time.Sometimes the same person may develop panic attacks both expressed (to affect) phobias and crises completely without emotional coloring.Only rare people always develop only with crises unfolded symptoms.Typically, its frequency ranges from several times a week to once in a few months the appearance.The development of the poor attack symptoms can occur up to several times per day.

Physical symptoms attack

They are as follows:

  • palpitations with a sense of "the heart out of his chest jumps" (the latter is due to the increase in strength of heart muscle contractions).This is due to the release of adrenaline in the blood of dopamine and its predecessor.Same way they mobilize the body to protect or escape from danger, which does not exist.
  • Feeling hot flushes or cold.By this change of tone causes vessels in the skin and subcutaneous tissue with a tendency to their narrowing (to internal organs no shortage of blood and oxygen), despite the fact that the muscles of the body is trying to supplying the most "normal".
  • rapid breathing: so the adrenaline and other catecholamines ensure the maintenance of the level of oxygen in the tissues, where the narrowed vessels.
  • Increased sweating: thus the body via the autonomic system is cooled in order to save energy that would be spent on the body warm.
  • Dry mouth.The cause of this symptom - stimulation of the autonomic nervous system.
  • diarrhea or, conversely, constipation "owe" their appearance deterioration of the intestinal blood supply (it is not the most important for the survival of the body, blood vessels are narrowed).
  • Pain in the left side of the chest.
  • Coldness of the feet and hands.
  • Symptoms of the gastrointestinal tract: nausea, belching, discomfort in the upper abdomen, vomiting, diarrhea.
  • Chills with severe tremor.
  • weakness.
  • Vertigo.
  • Feeling "blur", "unreality" of what is happening.

last three signs are due to changes in pH of blood and cerebrospinal fluid, which leads to a lack of carbon dioxide (it's all "out of steam" with frequent breathing).

This state lasts 10-30 minutes.Ends attack copious urination, or vomiting (often this reaction is observed in children), which is also provided by the autonomic nervous system.After him, there is a feeling of depression, weakness, a bad feeling.

Such symptoms are marked and in some diseases, such as stroke, bleeding, prolonged attack of asthma.But they differ from panic attack is that in diseases of these symptoms last longer than half an hour, accompanied by other symptoms, some of which remain after the seizure (eg, asymmetry of the face or difficulty breathing).A more detailed distinction of panic attacks and other disorders will be discussed further.

Atypical attack

Sometimes the symptoms of a panic attack does not like the fact that a person has had a panic attack.Ghastly animal fear there may be a slight emotional stress.Physical symptoms described above are largely absent.Instead, there is a temporary dysfunction of one of the senses, which then passes.So maybe:

  • lack of voice;
  • lost sight;
  • inability to utter a word;
  • gait disturbance;
  • sensation of twisting arms.

Such attacks often develop in a crowded room, but do not appear when a person is alone.They are also called hysterical neurosis.

How can begin an attack

Debut panic attack can be in the form of one of the three options.

  1. Attack begins against the backdrop of overall health, but - after stress, small operations, physical overexertion or excess alcohol.In this case, a person can not understand the reason for the state, but it can clearly indicate the date of the attack.
  2. Against the background of existing asthenic-depressive or anxiety disorders occur crises with physical symptoms, but without much emotional coloring.If at this moment a person suffers stress, surgery or serious illness, there is a panic attack unfolded.
  3. Against depressive or anxiety disorders suddenly develops a bright panic attack.

When the attack is less well tolerated

more pronounced attack people feel with such personality traits:

  • fearfulness;
  • anxiety;
  • drama;
  • artistry;
  • unstable mind.

be important, as the man explained himself first panic attack.If he thought his heart attack, or mini-strokes beginning of some disease, the probability that attacks will be repeated and will be the beginning of formation of phobias, much higher.There

relationship between emotional and mental symptoms of crisis and the further formation of the interictal period: than an expression of the fear, the more chances of anxious expectation of new attacks in the future.

When a person suffers an attack easier

To do this, he must possess such qualities:

  • independence;
  • inner richness;
  • diligence;
  • diligence did not go to the selected path;
  • not lose his head in anxiety and conflict situations.

Night crises

Night panic attacks are concerned, more than half of people.It is noted that such attacks often occur in people of strong-willed and demanding that day completely "keep themselves in his hands."

Precedes night attack usually prolonged inability to calm down and fall asleep.Man is long, it overcomes anxiety, but against which develops a panic attack.It may happen, and so that the attack wakes man, then he wakes up in a wild state of fear, trying to find a rescue or escape, not yet realizing where.

most often develops during an attack from midnight until morning, with the advent of natural light, he goes alone.Some people say that it becomes easier, if all households awaken and turn on the light (or just the last step).Moreover, this tendency is maintained during all attacks, and not just the first one.

symptoms of nocturnal seizures are the same: fear, shivering, nausea, heart palpitations.Often they are more intense than their daytime option.