Panic understandably explained (panic attacks, panic disorders, panic attacks)

Understand fear

Panic understandably explained
(Panic attacks, panic attacks, panic disorders)

As an ordinary part of the human psyche is panic a intensely experienced fear, which causes a strong stress response of the organism. The triggering threat can be real, fictitious, conscious or unconscious. A panic attack however, it is considered one sudden attack of panic, on the one hand from a well-being and on the other hand has no specific reason. As a panic for no reason, it can be a symptom of a mental illness or disorder. Especially when such a panic attack happens out of nowhere, it can be both an expression of panic disorder (also panic syndrome) according to ICD-10 (F41.0), as well as a symptom of numerous other mental and organic diseases.

From one diagnosed panic disorder is spoken when the person concerned repeatedly suffering from panic attacks and if an organic cause can be excluded. In addition, the panic symptoms may not occur in situations in which they could be expected because, for. B. a particular situation or an object is a known trigger. However, psychotherapists diagnose the Panic disorders are often related to further anxiety disorders.

YOUTUBE: “panic disorder” // interview of patient, doctor and presenter on panic attacks / panic attacks (

Conceptual delimitation:
Panic, fear, phobia

panic means an intense fear. In addition, the panic disorder is a subset in the category of anxiety disorders and thus the mental disorders.

anxiety is a basic human feeling and panic is an extreme form of it. Both can be appropriate in some situations.

A anxiety disorder occurs when the anxiety is disturbed. However, the criteria for when this is the case are relatively blurred. Mainly it is about the Inadequacy of fear in relation to the threat situation. This includes the intensity of the fear experienced, including the time and effort it takes to deal with it. Essentially, it is about how far the affected individual is affected by the experienced fear or even panic in relation to the triggering situation. Thus, in life-threatening situations and panic before dying be appropriate.

However, it is difficult to pin down an exact point from when anxiety or panic now as pathological must apply. On the other hand, the panic attacks, which by definition suddenly occur without a specific threat situation, are always inadequate to the extent that they have a pathological character. The panic disorder as a special form of anxiety disorder it is easier to identify.

Another point is the suffering of those affected, which, of course, already by the nature of the uncomfortable basic feeling anxiety given is. To the troubled anxiety life, however, can also count on a lack of feeling of fear. However, there is also a lack of personal suffering and it could at most be regarded as a potential danger to the individual in the broad sense, if it leads to careless behavior.

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A phobia is always a fear or even panic, which has a very specific trigger. Phobias are always only in relation to something specific. This can be very different content. An example is the relatively common one arachnophobia (Arachnophobie). However, basically any animal species can be considered trigger. Another form is about that social phobia.

For the phobia as pathological on the one hand the inappropriateness is characteristic, which is very rationally understood by those affected, ie recognized and viewed. As a rule, a person with a spider phobia will know that spiders usually do not pose any threat to them. Another characteristic point of a phobia is the extensive avoidance behavior and the associated transfer of fear to other objects. In the case of the spider phobia, for example, the person concerned avoids the places where he suspects spiders, and these places are becoming more and more frequent and, in the end, even fearful. This expansion also happens contrary to a rational insight or the will of the person concerned.

Panic attacks: symptoms of panic disorder

The main symptom of a panic disorder is that repeated occurrence of the panic attack. This usually has a duration of a few minutes, but that can vary greatly. In some cases, it can last for several hours – but only with less intense symptoms.
In a panic attack, the following symptoms may occur:

  • Tachycardia, heart stumbling
  • sweats
  • Trembling all over
  • Feeling of tightness in throat and chest to shortness of breath
  • hyperventilation
  • Tingling sensation in the hands and face, muscle spasms
  • Dizziness
  • Nausea, sometimes until vomiting
  • Depersonalization and Derealisationsgefühle

In the process, panic thoughts usually appear, which act like a catalyst. The experienced bodily states are related to these thoughts in an interactive relationship. Especially the feeling of tightness, which can lead to shortness of breath, often leads to the mental fear and panic to suffocate.

At a panic attack Often those affected have in various forms in their mind the fear of dying (see Thanatophobia). The panic fear experienced is a very extreme situation that, from the purely subjective point of view, can actually give the impression of having to die directly. Objectively, however, there is no danger to the organism. Although the symptoms experienced are real in the quality of subjective experience, they are not so in terms of anatomical danger. The affected can z. For example, you may feel as if you have a heart attack, but your heart is actually perfectly healthy and will not be harmed by the panic attack.

Actually, too intense panic attacks purely physically not harmful than intense sports. There is no direct danger to health or even life, nor is there any long-term damage. There is also no documented case of someone fainting during a panic attack.

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The panicked thought-carousel: the vicious circle of panic

The accompanying thought carousel often starts in bed falling asleep. Sometimes it still leads just before falling asleep to an attack, sometimes waking up later.

Also, it may start at or after the consumption of certain substances. About coffee or alcohol. The expectation that z. As coffee speeds up the heartbeat and you begin to tremble with too much coffee consumption, to wait for exactly and finally thinking of it.

After this Principle of expectation and listening to one’s own body, looking for symptoms, the general also works Fear of illness. In this case, of course, it is always about a specific disease with specific symptoms, but at different times the fear of various diseases can lead to panic attacks. In a panic disorder, one has to understand the increase in symptoms of a particular illness as a kind of means or expression of just the panic disorder. Because of this, sufferers can always find new diseases whose symptoms they can actually feel.

A widespread form is the Fear of fear. So the fear of panic. Here, scenarios can be devised in thought, in which a seizure takes place in inappropriate and dangerous situations. For example, in unpleasant situations such as the dentist (Dentophobia) or before an MRI. Even before narcosis or certain tablets, the fear of panic can be built up and lead to a seizure. There are also thoughts like a panic attack while driving, which may lead to an accident. Often comes the fear of going crazy and having to go to psychiatry.

Connections with other diseases

Although the main symptom of panic disorder is the panic attack, it can also be a symptom of other mental illnesses.

Basically, it can occur in all forms of anxiety disorders. In the various phobias, panic attacks often occur in direct contact with the particular object of anxiety or at the mere expectation of it. In social phobia z. For example, sufferers can suffer from panic attacks even when the anxiety-stricken social situation is just ahead. This is similar for other phobias and anxiety disorders. Often, this form of panic anxiety has a mental counterpart. The affected persons expand mentally into certain ideas, which then become a kind of self-fulfilling prophecy. Although the panic can be done for no reason, but it usually accompanies a corresponding thought-carousel. The content can be individually very different. This, in turn, depends on the specific type of anxiety disorder. At a social phobia This can be a panic before work or for special social occasions like a wedding. It often happens the evening before falling asleep and also just before falling asleep to a panic attack / a panic attack.

Another common form is the general fear of disease, which is usually focused on specific diseases (see Defeating fear of disease). About the fear of cancer. Or to stifle by the fear as well as the tachycardia or heart stumbling in a panic attack, often also before a heart disease or a stroke.

Also at the post-traumatic stress disorder (see PTSD) as well as depression and burnout can lead to panic attacks and panic disorders. Many anxiety disorders often appear together and / or in connection with other mental disorders (“comorbidity”). Thus, social phobia often occurs along with depression.

In addition to other mental illness, however, one can Over or under-function of the thyroid gland lead to panic attacks.
Neurobiologically, an anxiety disorder develops in the amygdala. This is a core area of ​​the brain that is heavily involved in the emotional evaluation of medial stimuli. This includes fear conditioning. Therefore, anxiety disorders can also indicate a malfunction in the amygdala.

Therapy, healing and treatment options with panic attacks / panic disorders

Treatment for panic symptoms depends on the particular cause. If the overactive or underactive thyroid is the trigger, appropriate medication can be used to eliminate this cause of recurrent panic attacks.

In general, psychotherapists can treat anxiety disorders such as panic disorders very successfully. Often, a mixture of medical and behavioral therapy is used. Especially behavioral therapists have great success with cognitive behavioral therapy. This therapy provides an important core that can also be an emergency aid for those affected (eg, breathe out together with the panic). relaxation techniques also help very well. For special phobias come cautious confrontation therapies for use.

The elemental role of avoidance behavior

Avoidance behavior plays a very important role in many mental health problems and disorders. The vicious circle is that the Avoid anxiety situations or acts usually both the fear itself confirmed and enlarged as well as can widen. Panic and panic attacks can even triggers it downright, because the basis for the panic is the thought carousel already described. It does not matter if there is panic before work or before the wedding, before diseases such as cancer, before the MRI, before anesthesia or psychiatry. If the appropriate situation is avoided, this is a kind Self-confirmation of fear. If, for fear of panic at the dentist (see fear of the dentist) or while driving no longer gone to the dentist or no car is driven, this can have far-reaching consequences. In simple words leads anxious behavior like avoidance even more scared.

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Behavioral therapists have so much success with the cognitive approach because, among other things, it attacks exactly this avoidance behavior (see delaying behavior). It is about breaking through the irrational mental vicious circle by understanding the perceived panic as part of the mental illness. Behavioral therapists help with conversations and special techniques. The goal of the therapy is ultimately help for self-help.
This includes emergency aid for acute seizures. One technique is that those affected breathe away the panic. There are different breathing techniques. Above all, it is in the behavior therapy but that’s why, in small ones exercise steps Gradually dealing with anxiety situations (better). This works, among other things, by similar, minor anxiety and anxiety situations in behavioral exercises and tasks The first positive learning experiences (success experiences) are achieved, giving the client (patient) courage to the next, next-difficult step. The person concerned learns that fear does not occur, and that, even if, the consequences and the Situation can be endured.

Treatment with tablets is an additional important factor (see anxiolytic drugs). Psychotherapists use, especially at the beginning of a therapy or in particularly severe cases anxiolytic drugs for support. It is about alleviating the symptoms until the therapy was successful. Essentially, mostly antidepressants are prescribed. In severe cases, for a short time also anxiolytic drugs such as benzodiazepines. However, these have both a high impact and addictiveness.

Homeopathy can also offer healing options. Although the effect of homeopathy is generally not undisputed; However, those who are in principle open to homeopathic treatments have some chances of achieving improvement here (even if only through placebo effects or not)..

Less controversial are herbal medicines for the treatment of mild forms of mental suffering. Especially for St. John’s wort as a means of herbal treatment of anxiety disorders (and depression) there are many positive experiences (see high-dose St. John’s wort for depression).

Basically, healing is individually different and dependent on many individual factors. Sporting, artistic, creative or creative activity can also have a therapeutic effect. It depends heavily on the particular life situation from which the anxiety or panic disorder has developed. With professional help, however, everyone can have the chance of recovery.

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Christina Cherry
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