Panic Attacks: Symptoms, Treatment, and Prevention.

What Are Panic Attacks?

Panic attacks occur as short incidents of anxiety that result in extreme fear. Panic attacks are usually triggered by many factors and can happen in response to a harmless situation. The main symptoms of panic attacks include:

• Discomfort in the chest causes difficulty in breathing.
• Stiffness in the extremities (legs and hands).
• Shivering and excessive sweating.
• Tachycardia (increased heart rate) leads to pain in the thoracic region.
• Nausea, fainting, and weakness can be felt.
• Patients may lose control and end up in hallucinations (unreality situations).

Panic attacks are troublesome, causing distress and irritation in people. Usually, panic attacks can stay over a period of 10 minutes, but in some patients, they remain for up to 1 hour.

What Is the Difference Between Panic Attack and Panic Disorder?

Everyone faces panic attacks once in their lifetime because of stressful circumstances. But the symptoms vanish once the situation subsides. But when these panic attacks occur repeatedly and regularly, it leads to a condition known as panic disorder. In panic disorders, people stay in a state of fear or anxiety for a long stretch, and simple panic attacks, when left untreated, lead to panic disorders. But not everyone who is suffering from panic attacks develops panic disorders.

What Causes Panic Attacks?

The exact etiology of panic attacks is unknown, but certain risks factors act as predisposing conditions for panic attacks; they include:

• Genetical Inheritance: Panic attacks are inherited conditions. In a family, when first-degree relatives are facing panic disorders, it is likely for the individual to develop these attacks.

• Underlying Mental Health Conditions: People with anxiety and stress are likely to develop panic attacks.

• Lifetime Experiences: Negative childhood experiences below the age of 16 can negatively impact children, and later they develop panic attacks.

How to Diagnose Panic Attacks?

Diagnosis of panic attacks needs:

• Step 1: Physical examination.

• Step 2: Laboratory examinations such as blood tests, which include thyroid profile. Patients with panic attacks are also advised to have cardiac examinations. This includes measuring blood pressure and ECG (electrocardiogram).

• Step 3: In this step, the psychiatrist does the evaluation of the patient to know about the mental health status. During this process, the psychiatrist poses many questions to the patients regarding the triggering factors, horror incidents, family history, pressure or tension situations, and bonding with loved ones. The doctor also questions the habits and lifestyle.

After the physical examination, the patient is asked to fill up the questionnaire. This questionnaire contains questions regarding the mental health of the patient. The score of the tests helps to determine the patient's mental status. The American Psychiatric Association has developed a Diagnostic and Statistical Manual of Mental Disorders (DSM-5). This is written and published by qualified and experienced psychiatrists in America, where different mental illnesses are clearly classified and well explained.

How to Treat Panic Attacks?

Panic attacks are treated by a psychiatrist (a person who is an expert in dealing with mental disorders). Treatment is mainly indicated to reduce the severity and occurrence of the attacks. This helps in leading a good quality of life. Depending on the intensity, underlying health conditions, and age, the following treatments are recommended for the patient:

Therapies: Psychotherapy, also called talk therapy, is the first line of treatment. This is considered successful, but the patients need time and physical effort (as the patient needs to visit the clinic for therapy). Different forms of psychotherapy include:

• Cognitive Behavioral Modification Therapy: In this method, the patient is made to talk and share feelings during panic attacks with a psychiatrist (also called a psychologist). During this communication, the doctor notifies the triggering factors of panic attacks. Then the patient is counseled regarding the modifications in the behavior, thinking ability, and response to the panic attacks. This helps in coping with panic attacks, and the response to attacks slowly decreases and stops.

• Exposure Therapy: During this therapy, the patient is continuously exposed to triggering factors. Over a period of time, resistance develops, and the patient will learn how to deal with and be restful with the panic situation. Breathing exercises, such as meditation, mainly help in dealing with anxiety during these attacks.

• Medications: Medications help in relieving anxiety and depression, which are considered as main symptoms of panic attacks. And the medications include:

• Antianxiety Drugs: These are also called Benzodiazepines, a group of drugs that decreases the hyperactivity of the brain and nerves. This shows sedative (calming) effects on the patient. Major disadvantages include addiction and side effects of these drugs.

• Antidepressants: They are also called Selective Serotonin Reuptake Inhibitors (SSRIs). These are the first line of choice in treating panic disorders. These are FDA-approved and commonly used drugs Venlafaxine, Fluoxetine, Paroxetine, and Duloxetine.

Single medication does not suit all patients. Changing the drugs or using combination drugs helps in better treatment outcomes. The results of the treatment are not momentary; it takes several days to months to improve the condition of the patient. One must take into account the age and underlying health conditions such as hypertension, diabetes, and health status like pregnancy of the patient before prescribing the medication.

Can Lifestyle Modifications Prevent Panic Attacks?

Panic attacks are treated by medications and therapies, but practicing home remedies can manage the symptoms and decrease the threat caused by panic attacks. Some of the tips include:

• Following Strict Treatment Protocol: The treatment plan should be followed with care and accuracy. Timely appointments, regular follow-ups, and discussing the side effects must be made compulsorily. Skipping medications and missed counseling therapies must be avoided. This helps in the better outlook of treatment.

• Maintaining a Healthy Weight: Walking, exercising, and indulging in physical activity helps in the weight control of the patient.

• Dietary Changes: A balanced diet (containing fruits, vegetables, minerals, vitamins, and carbohydrates) is very important for the proper body functioning. Patients must opt for healthy foods.

• Avoiding Caffeine: Caffeine increases the brain and nervous activity and makes the patient sleepless. Hence this should be strictly avoided. One must avoid narcotic drugs, alcohol, and smoking as they worsen panic attacks.

• Anxiety Management Techniques: Anxiety is the main cause of stress. This can be handled by learning stress management techniques such as breathing exercises, yoga, massages, and muscle relaxation techniques. Getting the right amount of sleep is often indicated in anxious people.

Conclusion:

Panic attacks are not uncommon, they exist for about a few minutes, but the symptoms of the panic attacks will last for a few hours. If left untreated, patients with panic attacks may develop suicidal tendencies, depression, and decreased or no social interaction. This can lead to compromised quality of life, and life expectancy decreases. But avoiding triggering situations, making certain lifestyle modifications, and following home remedies can prevent panic attacks.