Panic Disorder
Panic disorder is when you experience unexpected recurring unexpected panic attacks as abrupt surges of intense fear or discomfort that peak within minutes. People with the disorder live in fear of having a panic attack. You may be having a panic attack when you feel sudden, overwhelming terror that has no obvious cause.
Panic disorder is characterised by persistent fear of having another panic attack after you have experienced at least one month or more of persistent concern car worry about additional panic attacks (or their consequences) recurring.
Symptoms –
Symptoms of panic disorder often begin to appear in teens and young adults under the age of 25. If you have had four or more panic attacks, or you live in fear of having another panic attack after experiencing one, you may have a panic disorder.
Panic attacks produce intense fear that begins suddenly, often with no warning. They can strike at anytime – When you are driving a car, at the mall, sound asleep or in the middle of a business meeting. You may have occasional panic attacks or they may occur frequently.
An attack typically lasts for 10-20 minutes, but in extreme cases, symptoms may last for more than an hour. You may feel fatigued and worn out after a panic attack subsides.
Panic attacks typically include some of these signs or symptoms-
• Racing heartbeat or palpitations
• Feeling like you are choking
• Changes in mental state, including a feeling of derealization (feeling of unreality) or depersonalization (being detached from oneself)
• Numbness or tingling in your hands or feet
• Sense of impending doom or danger
• Fear of loss of control or death
• Sweating
• Trembling or shaking
• Hot flashes
• Abdominal cramping
• Nausea
• Headache
• Chills
• Chest pain
• Dizziness, lightheadedness or faintness
One of the worst things about panic attacks is the intense fear that you will have another one. You may fear having panic attacks so much that you avoid certain situations where they may occur.
Causes-
It is not known what causes panic attacks or panic disorder, but these factors may play a role-
• Genetics
• Major stress
• Temperament that is more sensitive to stress or prone to negative emotions
• Certain Changes in the way parts of your brain function
Panic attacks may come on suddenly and without warning at first, but over time, they are usually triggered by certain situations.
How panic attacks feels like?
Here are some of statements that comes from anonymous people suffering from panic attacks –
• It literally feels like my world is falling apart- like whatever thing that has just happened is apocalyptic, even if it is actually a really small thing.
• For me, a panic attack never comes without crying, and with crying comes sobbing, and with uncontrollable sobbing come paralysis. Usually my throat clogs up, I have difficulty breathing, and the sobs rack my whole body.
• They often come as I sleep and feel as if I am suffocating. I wake up gasping for breath with my heart pounding.
• I feel like I am choking,I feel an urgent need to leave the area as soon as possible or something bad will happen.
Risk Factors –
Symptoms of panic disorder often start in the late teensor early adulthood and affect more women than men.
Factors that may increase the risk of developing panic attacks or panic disorder include –
• Family history of panic attacks or panic disorder
• A traumatic event, such as sexual assault or a serious accident
• Major changes in your life, such as a divorce or the addition of a baby
• History of childhood physical or sexual abuse
• Smoking or excessive caffeine intake
• Major life stress, such as the death or serious illness of a loved one
Complications-
Left untreated, panic attacks and panic disorder can affect almost every area of your life. You may be so afraid of having more panic attacks that you live in a constant state of fear, ruining your quality of life.
Complications that panic attacks may cause or be linked to include –
• Development of specific phobias, such as fear of driving or leaving your home.
• Avoidance of social situations
• Alcohol or other substance misuse
• Problems at work or school
• Frequent medical care for health concerns and other medical conditions
• Financial Problems
• Depression, anxiety disorders and other psychiatric disorders
• Increased risk of suicide or suicidal thoughts
For some people, panic disorder may include agoraphobia – avoiding places or situations that cause you anxiety because you fear being unable to escape or get help if you have a panic attack. Or you may become reliant on others to be with you in order to leave your home.
Diagnosis-
If you experience symptoms of a panic attack, you may seek emergency medical care. Most people who experience a panic attack for the first time believe that they are having a heart attack.
Your doctor probably will start by examining you and ruling out other health issues like heart or thyroid problems. If no other condition is causing your symptoms and you have had two or more random panic attacks and live in fear of a repeat episode, you probably have panic disorder.
A psychological evaluation to talk about your symptoms, fear or concerns, stressful situations, relationship problems, situations you may be avoiding and family history. You may fill out a psychological self assessment or questionnaire.
Criteria for diagnosis of panic disorder –
Not everyone who has panic attacks has panic disorder. For a diagnosis of panic disorder, the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), lists these points-
• You have frequent, unexpected panic attacks.
• At least one of your attacks has been followed by one month or more of ongoing worry about having another attack, continued fear of the consequences of an attack,such as losing control, having a heart attack or “going crazy”, or significant changes in your behaviour, such as avoiding situations that you think may trigger a panic attack.
• Your panic attacks are not caused by drugs or other substance use, a medical condition, such as social phobia or obsessive-compulsive disorder.
Treatment –
Your doctor may refer you to a specialist called a psychotherapist. They might recommend-
• A type of talk therapy called cognitive behavioral therapy that keeps you learn how to change unhealthy thoughts and behaviors that bring on panic attacks.
• Antidepressants, like selective serotonin reuptake inhibitors ( SSRIs) such as fluoxetine, paroxetine and sertraline or serotonin and norepinephrine reuptake in hibitors( SNRIs) such as venlafaxine
• Benzodiazepines such as alprazolam and clonezepem, which are sedatives that affect your central nervous system. There are generally used only on a short-term basis because they can be habit-forming, causing mental or physical dependence.
• Anti-anxiety medications
• Cutting back once caffeine
• Regular exercise
• Limiting alcohol
• Deep breathing exercises
Life style Changes-
• Stick to your treatment plan
• Join a support group
• Avoid caffeine, alcohol, smoking and recreational drugs
• Practice stress management and relaxation techniques
• Get physically active
• Get sufficient sleep
Ayurvedic Perspective-
Panic disorder is a Vata disorder with the primary subdoshas involved being prana and Vyana.
During a panic attack, vata derangement results in an intense stress response and agitated state of mind.
Prana vata is what moves prana into the air we breathe, and the food and water we consume. This prana is the gluethat binds body, mind and spirit together. In acute anxiety, the impairment of the Prana Vata is what makes the individual feel disconnectedas the mind and senses do not function at optimum levels.
Vyana vata ,finds its origin in the heart and is present throughout the body, causing energies ,such as the nervous energies to circulate within our being. When the vyana vata in aggravated, . the person might seem like they have boundless creative energy. But a closer look might reveal that it is a disorganized overabundance of energy, common in the case of inefficient Vatadosha.
line of treatment–
• External therapies –
¤ Shiroabhyanga
¤ Shirodhara
• Beneficial Herbs –
¤ Brahmi – It acts as a brain tonic capable of improving mental ability, anxiety and memory. It induces a sense of peace and calm.
¤ Ashwagandha-It stimulates the immune system and is one ofthe top herbs for anxiety and stress.
¤ Vacha – It acts as an all natural sedative and is used to enhance coordination, memory and speaking abilities.
¤ Shankapushpi – It is the single greatest herb for enhancing all threeaspects of mind power- learning (Dhi), memory (Dhriti) and recall (Smriti).
¤ Tulsi – It basically reduces the levels of corticostrone. The lower the levels of Corticosterone, the more mental clarity and memory one will have.
• Effective medications-
¤ Saraswat Churna
¤ Brahmi Vati
¤ Ashwagandharhishta
¤ Shankhpushpi Sharbat
¤ Manasmitra Vati
¤ Saraswatarhishta
• Yoga and meditation –
Ujjayi Pranayam is the king in treating panic attacks.It is highly effective is balancing the autonomic nervous system through an enhanced activation of the parasympathetic system i.e. the rest and recovery or relaxation responses. As a result-
• Your heartbeat decreases to resting level
• Blood vessels and muscles relax, allowing blood to bring nutrients tt and cany waste away from your cells
• Blood is diverted back to the gastrointestinal tract
• Breathing slows down
…..and you will feel your panic attack dissipate…….
Along with that Bhramri, Anulom vilom , Bhastrika, Omkar uccharan also give peace and strength to body and mind.
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