“I thought I was dying”: how to treat panic attacks that overtook the Russians

Coat as a seizure trigger

Panic attacks are one of the most common mental health problems today and can affect people of all ages.

“A panic attack is a sudden outburst of intense fear or discomfort that may last for several minutes but seems to last forever. A panic attack is often accompanied by physical symptoms such as chest pain, shortness of breath, dizziness, sweating, and trembling,” says the clinician. psychologist, member of the Cognitive Behavioral Association Ekaterina Klimenko,

Professor of the Department of Psychiatry, Psychotherapy and Psychosomatic Pathology of the Peoples’ Friendship University Yuri Sivolap notes that a panic attack is most often a manifestation of panic disorder, although it can also occur with other diseases, or manifest itself as a separate phenomenon: “Individual panic attacks are not a disorder. About panic disorder ( PR) you can speak if they are repeated. And here you need the help of a specialist – a doctor or a psychologist. “

Panic attacks can be difficult to recognize because their symptoms can vary from person to person. Possible symptoms include: fast heartbeat, difficulty breathing, profuse sweating, feeling of choking, nausea or stomach discomfort, dizziness, chest pain or tightness, hot flashes or chills, fear of death, fear of losing control or “going crazy”. “These symptoms usually have in common that they start suddenly and end just as suddenly. Sometimes this happens rarely and does not cause trouble for a person, but if the attacks begin to become more frequent, this is a reason to be more attentive to your condition,” says Ekaterina Klimenko. – Along with panic attacks, people’s lifestyle often changes. For example, if a panic attack first occurred in an elevator, then a person goes so far as to change an apartment in a very good house where he lives on the 12th floor, for an apartment in a worse house, not in such a prestigious area as before, but in this house he can walk up to the third floor.

He begins to be afraid of those places where panic attacks can recur – this is called agoraphobia, which is understood as the avoidance of those spaces where panic attacks occur.

Literally translated from Greek, agoraphobia is the fear of squares and open spaces, but today this concept has expanded to any place where a panic attack can occur. Sometimes it starts in people during an airplane flight, most often when climbing. To the greatest extent, people of an anxious warehouse, suspicious, indecisive, unsure of themselves are prone to panic attacks. At the same time, my personal experience shows that panic disorder can also occur in courageous, determined, purposeful people, that is, in anyone at all.

Klimenko gives one example of a panic attack: “The girl had a reinforced concrete confidence that she was terminally ill, just what the name of her terrible disease was and where to look for it, mediocre doctors didn’t know. It seemed to her that she was about to faint or happen heart attack, lose consciousness, maybe even die right on the steps of the subway.

Life collapsed and added worries and restrictions. The girl avoided places where panic attacks occurred. She even stopped wearing the coat that had the most severe panic attack.

From the fear that something was wrong with her, control over her thoughts and behavior increased, anxiety for her health increased. She never went outside without a first aid kit. Traveling by public transport was impossible.

That is, she was overgrown with a large number of restrictions that greatly complicated her life. The girl suffered from panic attacks, and what she considered protective or protective behavior just contributed to their maintenance. The main difficulty of protective behavior is that in the short term, catastrophic thoughts weaken, but fear increases.

I would go to the pilots

Experts note a significant increase in the number of people suffering from panic attacks due to the stresses associated with modern lifestyles, such as stress at work, financial problems and relationship problems.

“Constant media bombardment has also been linked to an increase in anxiety levels among people, which can lead to an increase in the frequency of panic attacks. Excessive drug or alcohol use can also contribute to an increase in anxiety levels. In addition, certain medical conditions, such as thyroid disease , can cause sensations reminiscent of those that occur during a panic attack,” says Ekaterina Klimenko.

Yuri Sivolap says that people who are prone to various phobias often suffer from panic attacks: fear of elevators, fear that the subway train will stop in the tunnel. “Very often I hear from patients that an attack develops in a situation where a person cannot control it. For example, one of my patients once told me: if I were an aircraft designer and knew how it works, I would not be afraid. Or if I were a pilot and understood what was happening in the cockpit now, I would also be calm.”

In recent years, panic attacks have become common among post-COVID patients. “A panic attack is a non-specific response to various effects on the brain and on the psyche. If something changes in brain functions against the background of covid, the likelihood of a panic attack increases.

Among the post-COVID manifestations, we see depression, sleep disturbances, cognitive impairment (that is, memory and attention disorders, difficulty in choosing words and formulating thoughts) and even psychosis – it all depends on what the person is predisposed to, Dr. Sivolap continues. – It is impossible not to say about the dangers of alcohol. When people are under stress, the temptation to drink is quite strong. But the next morning after a heavy drink, and sometimes even after a small dose, people prone to anxiety may have their first panic attack in their life. If panic attacks have occurred before, the likelihood of their occurrence in a hangover state is significantly increased.

The expert says that in mild panic disorder, panic attacks can be managed on their own: some people manage to overcome them with the help of even deep breathing: True, it happens that even with serious forms of PR, spontaneous remission suddenly occurs.

The fact that PR proceeds in a severe form is evidenced by such symptoms as fear of death during a panic attack; multiple panic attacks during the day; when a person wakes up at night from a panic attack and when it occurs without prior anxiety, literally out of the blue.

How to treat

With rare exceptions, panic disorders have a benign course and are treatable diseases. With the right support and treatment, panic attacks can be managed and prevented. The best way to deal with anxiety is to seek the help of a doctor who can diagnose the underlying causes of neurosis and recommend appropriate treatment.

Ekaterina Klimenko says that cognitive behavioral therapy (CBT) works effectively with panic attacks: “Drugs are prescribed quite rarely, but a stable positive result will be in combination with the work of a psychologist. Cognitive behavioral therapy allows you to determine the style of thinking that triggers a panic attack and influence negative attitudes In some cases, it is effective to keep a diary.

You can also make lifestyle changes to help reduce your risk of seizures. For example, incorporate regular exercise, adequate sleep, and relaxation techniques such as yoga or meditation into your life to help reduce pre-attack stress levels.

It is important for patients to explain the mechanism of occurrence of PA and to tell that there has not been a single death from PA in the world.”

“Panic disorders are categorized as anxiety disorders, which is the domain of psychiatry. But since it often happens that panic attacks are manifested by dizziness or palpitations, people with such symptoms often turn to neurologists or cardiologists.

Of course, these specialists can distinguish between panic disorders and either prescribe treatment themselves or refer the person to a psychiatrist or psychologist. Often a psychotherapist can deal with this problem. But sometimes psychotherapy does not help – and a psychiatrist is needed.

“Panic” rarely walks alone – PR often occurs after or against the background of depression. Even if depression is not too obvious, a person with PD almost certainly has it and needs to be identified. But there is one convenient thing here – depression is treated with antidepressants, and antidepressants are the first line drugs for the treatment of PR; in other words, one pill can treat both diseases.

Unfortunately, in our society there is an unfounded and unmotivated fear of antidepressants, they are demonized and seem to many to be some kind of hellish potion, just like hormones and vaccinations. In fact, the worst thing about modern antidepressants is that they may not help, says Yuri Sivolap. – The only thing that does not work at all is the advice to “pull yourself together.” “To pull myself together” with any mental illness, as well as with a disease of internal organs, unfortunately, is impossible, and such advice never helps.