PANIC ATTACKS OR HEART ATTACK
DR. AMBRISH SINGAL
M.D [PSYCHIATRY] MIPS,
MAPA, AIASP, MIAPP, MCSEPI
WHAT IS PANIC ATTACK
People with panic disorder have feelings of
terror that strikes suddenly and repeatedly with no warning. One
can’t predict when an attack will occur, and many develop
intense anxiety between episodes, worrying when and where the next
one will strike.
If you are having a panic attack, you can
hear your heart beat / heart will pound and you may
feel sweaty, weak, faint, or dizzy. Your hands may tingle or
feel numb, and you might feel flushed or chilled.
You may have nausea, chest pain or difficulty
in breathing, tightness in chest a sense of unreality,
or fear that something bad will happen or loss of control.
Feeling of going crazy.
You may genuinely believe that you ’re having
heart attack or losing your mind, or on the verge of death.
Panic attacks can occur at any time, even during sleep.
An attack generally peaks within 10 minutes,
but some symptoms may last up to 30 minutes.
Panic disorder affects about 2.4 million adult
Indians and is twice as common in women as in men. It most often
begins during late adolescence or early adulthood. Risk of
developing panic disorder appears to be
SYMPTOMS OF PANIC DISORDER?
It’s in the form of
intense and overwhelming fear
that seem to come on for
no apparent reason?
It may occur even if you are laughing or having good
time with your friends, and may not have any sort of stress on your
mind. Such a presentation
makes it feel like a serious episode,
resembling a heart attack.
many patients land up with
Specialist rather than a Psychiatrist.
Racing, pounding, or skipping heartbeat
pain, pressure, or discomfort
Difficulty catching your breath
Choking sensation or lump in your throat
Lightheadedness or dizziness
Nausea or stomach problems
Tingling or numbness in parts of your body
Chills or hot flashes
Shaking or trembling
Feelings of unreality, or being detached from your
these episodes, you have the urge to flee, or the feeling that you
need to escape?
these episodes, you think something terrible might happen—that
you might die, have a heart attack, suffocate, lose
control, or embarrass yourself?
After the episode you remain terrified
as the episode leaves you in a very frightened state so much so that
you start worrying and get fearful that it might not happen again?
And this fear causes you to avoid places or situations that you
think might have triggered the attack?
answered yes to most of these questions, chances are you are
suffering from panic disorder. If so, you are not alone. Panic
disorder is very different from everyday anxiety. More than 3
million American adults have, or will have, panic disorder at some
time in their lives. Most frequently, it starts in young adulthood.
Usually, it does not go away by itself. But with proper treatment,
people with panic disorder can be helped.
Not everyone who experiences panic attacks will
develop panic disorder —for example, many people have one attack
but never have another. For those who do have panic disorder,
though, it ’s important to seek treatment. Untreated, the
disorder can become very disabling. Many people with
panic disorder visit the hospital emergency room repeatedly or see a
number of doctors before they obtain a correct diagnosis. Some
people with panic disorder may go for years without learning that
they have a real, treatable illness. Panic disorder is often
accompanied by other serious conditions such as depression, drug
abuse, or alcoholism and may lead to a pattern of avoidance of
places or situations where panic attacks have occurred. For example,
if a panic attack strikes while you ’re riding in an elevator, you
may develop a fear of elevators. If you start avoiding them, that
could affect your choice of a job or apartment and greatly restrict
other parts of your life.
EFFECTS OF PANIC DISORDER ON ONES LIVES
Some people ’s lives become so restricted that
they avoid normal, everyday activities such as grocery shopping
or driving. In some cases they become house bound. Or, they
may be able to confront a feared situation only if accompanied by a
spouse or other trusted person. Basically, these people avoid any
situation in which they would feel helpless if a panic attack were
to occur. When people’s lives become so restricted, as happens in
about one-third of people with panic disorder, the condition is
called agoraphobia. Early treatment of panic disorder can
often prevent agoraphobia.
Panic disorder is one of the most treatable of the
anxiety disorders, responding in most cases to medications or
carefully targeted psychotherapy.
WHY SEEKING TREATMENT IS CRITICAL
Repeated episodes of fear—commonly called panic
attacks—that are typical of panic disorder can be devastating. The
panic attacks, or avoidance of them, can completely take control of
treatment, you may continue to have panic attacks for years. The
disorder can seriously interfere with your relationships with
family, friends, and co-workers.
treatment, your life may become severely restricted. For example,
you may start to avoid certain situations where you fear you will
experience a panic attack—even normal, everyday activities, such as
grocery shopping or driving. In extreme cases, people with untreated
panic disorder grow afraid to leave the house, a condition known as
treatment, you may find it difficult to be productive at work. Your
symptoms may keep you from getting to your job or staying there once
you arrive. You may turn down promotions or job assignments that you
believe will make you more likely to have panic attacks. Some people
with panic disorder even quit their jobs. Many can keep working but
otherwise rarely leave home.
treatment, you may become severely depressed. You may try
unsuccessfully to numb the symptoms of panic disorder or depression
with alcohol or other drugs. You may even begin to have thoughts
not have to live this way. You need to know that panic disorder is
treatable. In fact, proper treatment completely prevents panic
attacks in 70 to 90 percent of people. Many people feel substantial
relief in just weeks.
Unfortunately, some people are reluctant to pursue treatment.
Perhaps they think their condition is not serious. Perhaps they feel
embarrassed. They may blame themselves or have trouble asking for
help. Perhaps they dislike the idea of medication or therapy. Or,
maybe they have sought help but are frustrated because their
condition was not diagnosed or treated effectively.
let these or any other reasons stop you from getting proper
treatment. If you have panic disorder, you should get whatever help
is necessary to overcome it, just as you would for any serious
medical illness. Do not be discouraged if some people say, "It's
nothing to worry about," "It's just stress," "It's all in your
head," or "Snap out of it." While they often mean well, the fact is
that most people who do not have panic disorder do not understand
that it is REAL and, therefore, tend to doubt its seriousness.
importantly, do not try to numb the effects of panic attacks with
alcohol or other drugs. This will only make the problem worse.
GETTING A DIAGNOSIS IS THE MOST IMPORTANT STEP
Since panic disorder can mimic a variety of medical
HEART PROBLEMS/ HEART ATTACK
DIGESTIVE COMPLAINTS, the first thing you should do
is have a full Psychiatric evaluation.
it is important for you and your doctor to concentrate on your
physical symptoms, you should not overlook the emotional aspects
of your attacks. You should tell your doctor anything you notice
about how your attacks make you feel and when they usually occur.
Information on both the physical and emotional aspects of the
attacks can be very useful to the doctor in making a diagnosis. For
example, the doctor will want to know if your attacks, or fear of
having attacks, keep you from carrying out any of your normal
people with panic disorder also suffer from depression—feelings
of intense sadness, even hopelessness, an impaired ability to think,
concentrate, and enjoy the normal pleasures of life. Be sure to make
your doctor aware of these symptoms as well. If you have been
drinking or using drugs to try to control your symptoms, let
your doctor know about that too..
TREATMENTS FOR PANIC DISORDER
for panic disorder can consist of taking a medication to adjust the
chemicals in your brain. Its Just like that you take medicine to
correct a thyroid imbalance or the treatment might involve working
with a Psychiatrist to gain more control over your anxieties--just
as some people work with specialists to learn techniques to control
their blood pressure. Research shows that both kinds of treatment
can be very effective. For many patients, the combination of
medication and psychotherapy appears to be more effective than
either treatment alone. Early treatment can help keep panic disorder
medications act by altering the ways by which
chemicals interact in the brain,
and thus they stop as well as prevent panic attacks
and decrease anxiety. Two major categories of medication that have
been shown to be safe and effective in the treatment of panic
antidepressants and benzodiazepines.
There are several types of antidepressants available nowadays and
your Psychiatrist is the best person who can select the drug which
can best suit you according to your symptoms
Each medication works differently.
Some work quickly and others more gradually. All of them have to be
taken on a regular basis. Some medicines increase and some have to
be decreased over passage of time according to your symptom control.
treatment with medication lasts at least 6 months to
It takes approx 4- 8 weeks, to effectively block the
This much time is sufficient for panic attacks to get controlled.
Clinical experience suggests that for many patients with panic
disorder, a combination of CBT and medication may be the best
therapy (CBT) teaches you to anticipate and prepare yourself for the
situations and bodily sensations that may trigger panic attacks. CBT
usually includes the following elements:
A therapist helps you identify the thinking patterns
that lead you to misinterpret sensations and assume "the worst" is
happening. These patterns of thinking are deeply ingrained, and it
will take practice to notice them and then to change them.
A therapist can teach you breathing exercises that
calm you and that can prevent the over breathing, or
hyperventilation, that often occurs during a panic attack.
A therapist can help you gradually become less
sensitive to the frightening bodily sensations and feelings of
terror. Helping you, step-by-step, does this, to safely test
yourself in the places and situations you've been avoiding.
generally requires at least 8 to 12 weeks. Most panic disorder
patients are successful in controlling or preventing their panic
attacks after completing treatment with CBT. CBT requires a
motivated patient and a specially trained therapist. Make sure
any therapist you work with has proper training and experience in
this method of panic disorder treatment. Indeed, in our country,
there are limited professionals trained and experienced in CBT.
CHOOSE THE RIGHT TREATMENT FOR YOU
A Psychiatrist is the professional who have the
training and experience needed to treat panic disorder.
Sometimes panic disorder patients need treatment by
both by a Psychiatrist as well as psychologist. Many people begin
looking for treatment by visiting their family doctor or a local
clinic or. Other places to seek help include your local health
department or community mental health clinic. When seeking a health
care professional to treat your panic disorder, you may want to ask
the following questions:
How many patients with panic disorder have you
Do you have any special training in panic disorder
What is your basic approach to
treatment—cognitive-behavioral therapy, medication, or both? If you
provide only one type of treatment, how do I get the other if I need
How long is a typical course of treatment?
How frequent are treatment sessions? How long does
each session last?
What are your fees?
Can you help me determine whether my health insurance
will cover this?
HOW TO MAKE YOUR TREATMENT SUCCESSFUL
From the beginning, it is important to be a full participant in
your treatment. Be active and assertive. Ask questions. Maintain
open communication with your treatment professional and let him or
her know your concerns.
patient responds differently, but it is important to know that
none of the treatments for panic disorder works instantly. So,
you must stick with a particular treatment for at least 8 weeks
to see if it works. If you do not see significant improvement within
that time, you and your treatment professional can adjust your
treatment plan. It may take a bit of trial and error before you find
what works best for you. Be patient and be sure to communicate with
your Psychiatrist. Remember that Panic attacks are fully treatable.
treatment involves medication, talk with your doctor about how often
and in what manner your dosage will be monitored. No matter what
medication you are taking, your doctor is likely to start you on
a low dose and gradually increase it to the full dose, till you get
relieved of the attacks. You should know that every medication
has side effects, but they usually become tolerated or diminish with
time. If side effects become a problem, the doctor may advise you to
stop taking the medication and to wait a week or so before trying
another medication. When your treatment is near an end, your
doctor will decrease the dosage gradually and stop it in the end.
TAKE THE STEP TODAY
Panic disorder is far too serious—and far too
treatable—to delay getting help. Recognizing the situation is the
first step to recovery. Now take the next step. I am hope from this
article you may now be well informed about panic disorder and If you
think you or your loved one have panic disorder, act now. See your
Psychiatrist for a diagnosis and then follow the suggestions and
educate yourself about your condition. The more you know about panic
attacks and panic disorder, the better you will understand your role
like to finish my topic here with a positive note that:
DISORDER IS COMPLETELY TREATABLE, PLEASE DON’T PANIC-TRUST YOUR