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DSM-5 has defined panic attack as a sudden surge of intense fear or discomfort that reaches its peak within minutes, producing significant physical symptoms.
During this period the person should have four or more of the following symptoms:
• Palpitations, pounding heart, or accelerated heart rate
• Trembling or shaking
• Sensations of shortness of breath or smothering
• Feeling of choking
• Chest pain or discomfort
• Nausea or abdominal distress
• Feeling dizzy, unsteady, lightheaded, or faint
• Derealization (feelings of unreality) or depersonalization (being detached from own)
• Fear of losing control or “going crazy”
• Fear of dying
• Paresthesias (numbness or tingling sensation)
• Chills or heat sensations
Some people may have a panic attack with less than four symptoms which is termed as limited symptom panic attack.
Many people may experience one or two attacks in their lifetime. However, if there are recurrent panic attacks with person having persistent fear of having another attack, for a period of at least one month, it is called as panic disorder.
Panic attacks are different from anxiety attack. However, in popular belief they are considered same and people use them interchangeably.
This occurs because both conditions have some common symptoms which make them appear same. These symptoms are :
• Increased heart rate or heart pounding
• Chest pain
• Shortness of breath
• Sweating, trembling
• Nausea or abdominal discomfort
DSM-5 doesn’t recognize anxiety attack as an entity but, describes anxiety disorders and panic attacks and disorder in details. However, there are some features that may help to differentiate them from each other:
|Time to peak||The symptoms develop suddenly and peak within 10 minutes.||The symptoms develop gradually over a period of time.|
|Types and severity of symptoms||The symptoms are intense and predominantly consist of fear.||The symptoms intensity may vary ranging from mild to severe.|
|When it subsides||The symptoms start subsiding after 10 minutes.|
The exact cause of panic attacks or disorder is not known however, some risk factors have been identified which are as follows:
• Genetic: several studies have shown some genetic predisposition. The people with panic disorders tends to have history of family member suffering from panic disorder or emotional problems like depression.
• Sex: women are twice more likely to develop panic disorder than men.
• Stress events in life: significant stressful incident or big life event can predispose a person for panic disorder. Some researchers have compared life stressors to a thermostat which when lowers the resistance to stress, may make a person predisposed to develop such issues. These stressors could be major life changing experiences such as death or major sickness of a loved one, breakage of marriage, sexual assault or trauma or giving birth to first child.
• Emotional nature: a person who is more sensitive to stress or negative feelings is thought to be more prone to develop panic attacks.
• Physical symptoms: a person with panic disorder if experiences symptoms similar to that of physical symptoms of panic disorder, he may interpret it as onset of panic attack. The fear and anxiety developed from these symptoms may actually lead to triggering of actual panic attack. An episode of increased heart beat on drinking coffee, smoking, taking medicines or exercising could result into such event.
When a person gets panic attack he or she develops intense fear which develops rapidly, reaching its peak in about 10 minutes. During this period, the person has exaggerated sense of fear accompanied with number of physical symptoms, described below:
• Sense of intense fear, threat or impending doom
• Fear of loss of control of the situation or even loss of life
• Palpitations, pounding heart
• Increased heart rate
• Sweating, trembling or shaking
• Feeling of shortness of breath or smothering
• Sensation of choking
• Chest pain or chest discomfort
• Nausea or abdominal discomfort
• Feeling dizzy, lightheaded, unsteady or fainting
• Feeling of unreality (derealization) or feeling of being detached from own (depersonalization)
• Numbness or tingling sensation (paresthesias)
• Sensation of chills or heat sensations
These physical symptoms are a part of sympathetic response of the body to the perceived fear or threat. The body is not able to sustain such exaggerated response, typically for a period over 10 minutes which then comes down to a normal state.
This episode of panic attack in itself, doesn’t cause any harm to the body. However, during this period, the person feels markedly terrified and out of control of the situation, developing fear to develop similar episodes in the future.
When a person develops recurrent attacks with persistent fear of having another attack, for a period of at least one month, he is said to develop panic disorder. This condition is miserable for a person because it is associated with continuous sense of fear and may lead to development of other mental and psychological issues. This may happen especially when a person doesn’t share their problem with anyone and seek medical help.
If repeated panic attacks are left unattended and let it become a part of life it may develop into panic disorder which may cause significant affect in every aspect of life.
• The person may remain in constant state of fear and may start avoiding certain situations which may result in low performance at school and work.
• He or she may start avoiding socialization or may even face awkward moments at social gathering.
• It may also effect his personal life and relationships which may further increase his anxiety or fears.
The person may develop certain psychological conditions which may worsen his quality of life further:
• Phobias: these people may gradually develop phobias (fear) from objects or situations which they link to triggering of panic attack. These specific situations could be leaving from home driving or speaking in front of may people.
Many people who develop panic attack especially for the first time, visits hospital emergency, a general practitioner or a cardiac specialist.
Panic disorder is treated with psychotherapy, medicines, or both depending on the severity of symptoms, availability of the treatment and individual preference. Treatment could help reduce the frequency and severity of the attacks and thus improve quality of life.
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