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Panic attacksPanic attacks

Few experiences are more unnerving than the acute anxiety of a panic attack. However, the good news is that, with simple mental strategies and breathing techniques, you can learn to conquer those feelings of fear.

A panic attack is an abrupt surge of overwhelming anxiety and intense fear. Attacks may strike without warning or may be heralded by feelings of extreme apprehension and anxiety that build up until they become full-blown panic.

HOW THEY BEGIN

A panic attack starts with an overwhelming anxiety that something terrible is about to happen.

Physically, you may feel 'unreal', breathless, faint. dizzy and unsteady. You may find you shake and tremble, feel sick, suffer palpitations, go hot and cold, experience tingling, chest pain and feelings of suffocation. Not surprisingly, these sensations, brought on by a sudden rush of the stress hormone called adrenalin, can bring on fears that you're going mad, undergoing a heart attack or a stroke, or even about to die.

After having an attack, you may find you feel edgy, tired and shaky as the brain will take time to settle down.

A panic attack is an exaggerated form of the body's normal anxiety reaction. When faced with a threatening situation, our bodies deal with it by going on red alert.

There's a surge of the 'fight or flight' hormone adrenalin, which sparks off raised heartbeat and blood pressure and all the other unpleasant symptoms.

WHY THEY HAPPEN
In normal circumstances, this red alert reaction is a healthy response which is designed to prepare our bodies to deal with threatening or hazardous situations. However, with the increasingly stressful lives we all lead, it's all too easy for everyday stress to mount up and panic attacks to become a more common occurrence.

HOW COMMON ARE THEY?
Panic attacks have only been taken seriously by the medical profession in the last 30 years. It's now thought that around three per cent of us suffer from disabling panic. A similar number experience the occasional mild attack, although some experts believe that as many as a third of us experience panic attacks from time to time.

Panic attacks are particularly common in the young and twice as many women suffer as men. Some experts believe that the panic is brought on by a chemical imbalance in the brain, and research is being carried out with a view to finding a drug to correct this.

WHO IS VULNERABLE?
While anyone can experience a panic attack, those with a family history of anxiety or depression may be more susceptible than others. Many experts believe that people from such a background are more anxious than others because of their early childhood experiences, their inherited or genetic make-up, or because they have, over time, time, learned to react to stressful situations with anxiety. Sufferers may view difficult situations in the worst light and be highly attuned to the most minute bodily changes, which they interpret in a negative way. Having too much caffeine, found in coffee, tea or cola drinks, may also spark off symptoms, as caffeine can cause shaking, heart palpitations and trembling.

FEARS AND PHOBIAS
While panic attacks aren't dangerous as such, the fear of having one can limit sufferers' lives to the extent that they stop doing things in case they bring on an attack.

For instance, the sufferer may avoid being far from home or mixing with other people. In this way, panic attacks can develop into full-blown phobias.

Phobias are often treated by 'graded exposure' therapy where you are encouraged to face whatever it is that you are frightened of, whether it be spiders, flying in aeroplanes or going out alone, in a controlled situation over a period of time, until gradually the feared situation becomes manageable.

The key feature of a panic attack, as opposed to a phobia or other type of anxiety disorder, is that the feelings of panic are without obvious cause. The panic appears to come from out of the blue. If you've suffered at least four of the classic symptoms without any apparent reason, consult your doctor.

GETTING A DIAGNOSIS
Diagnosing a panic attack is difficult because the symptoms may mimic those of other illnesses. For example, diabetes and low blood sugar (hypoglycaemia) can bring on tremors or sweating.

Anaemia and Meniere's disease, which affects the sense of balance, can cause dizziness, while heart disease, pneumonia and indigestion can all cause sharp chest pains. Once a diagnosis is made, however, the first line of treatment usually involves drug therapy and medication.

DRUG TREATMENTS
Until not too long ago, sufferers were often given tranquillizers for panic attacks. However, the side-effects of some of these drugs, such as nausea and dizziness, are very similar to symptoms suffered by victims during a panic attack. And when they are taken for long periods, some types can be very addictive.

When the drugs are finally stopped, the sufferer may experience a very wide range of physical symptoms such as sweating, trembling shaking and heart palpitations. These are all typical signs of a panic attack.

Beta-blockers, which slow the heart rate and can reduce the physical signs of anxiety, such as sweating, tremor and palpitations, may help. However, they only combat the physical effects of anxiety and can't tackle the emotional problems that cause it. At the same time, they too may have side-effects - for example, they can trigger asthma attacks in people susceptible to this condition.

Drugs known as 5HT seratonin re-uptake inhibitors act to rebalance chemicals in the brain which are upset in many anxiety orders. Some doctors believe a short course of tranquillizers or anti-depressants can help in some cases of panic. However, there is increasing evidence to suggest that psychological treatments are far more effective and give more long-lasting results.

MENTAL STRATEGIES
Counselling or more traditional psychotherapy - talking treatment designed to enable you to look at the way patterns of emotion and behaviour have built up - can help many panic attack sufferers. However, many experts believe that the most effective type of treatment is cognitive therapy. This is based on the idea that the way we see ourselves and the world affects our behaviour.

Changing the way we think can also change the way we behave. This is based on the premise that people who suffer from anxiety or panic have a tendency to see things in an all or nothing way and to 'catastrophize' events - seeing them as the very worst thing that could happen. For example, at the first sign of an impending panic, you might feel terrified of losing control and even that you are going to die.

Cognitive therapy involves 'de-catastrophizing' - in other words, learning to recognize that what you fear is not actually going to happen. Combined with breathing exercises, it can help you control your fears and avert attacks.

The advantage of this type of therapy is that changes are usually seen after only a short course of treatment. Some doctors are trained in cognitive therapy but, if yours is not, he may be able to refer you to a cognitive therapist.

CONTROLLING BREATHING
Whatever the cause, the panic is real and it's not enough to tell yourself to snap out of it.

Realizing you're suffering an acknowledged disorder and that you are not going mad is a first step to bringing panics under control. Recognizing that attacks follow a particular course is another.

Many psychologists believe panic attacks are brought on by abnormal breathing patterns. When we're frightened, our breathing becomes much faster and more shallow. This can cause a number of biochemical changes which can trigger the alarming symptoms.

Working out what situations are likely to trigger an attack and then learning to control your breathing can reduce the number of attacks you suffer. Discovering that an attack doesn't have to get out of control can further stem an attack.

ALTERNATIVE TREATMENTS
A good diet can prove important, too. Fluctuations of blood sugar can bring on mild, panic-like symptoms. Eating little and often helps combat this problem.

Relaxation and meditation are two popular and effective therapies for any sort of stress-related condition, Through both of these techniques, you can learn how to slow down and direct your concentration. Practising relaxation is a good way of cutting yourself off from outside stresses that may trigger panic, while meditation calms the heart and slows your breathing.

Yoga is another tried and tested way of relaxing. It not only helps to release physical and mental tension, but it also improves your muscle strength, body tone and suppleness.

Aromatherapy, which is the use of aromatic oils extracted from plants, can be helpful, too. Both basil and rosemary oils are said to be especially good for anxiety.

     
     

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