Sudden palpitations, sweating, choking, feeling terrified are all symptoms of a panic attack. It can happen unexpectedly and take you by surprise. And it is completely incomprehensible what to do with it and whom to turn to so that the attacks of fear stop.
The call came closer to night. The voice on the other end of the line was calm, even, firm. This happens very rarely.
“The doctor referred me to you. I have a very serious problem. Vegetovascular dystonia.
I remember that doctors make the diagnosis of VVD quite often, but rarely does anyone turn to a psychologist with it. The manifestations of such a diagnosis are different, from cold feet to fainting and rapid heartbeat. The interlocutor continues to tell that she went through all the doctors: a therapist, a neurologist, a cardiologist, a gynecologist, an endocrinologist. And she was sent to a psychologist or psychiatrist, that’s why she called.
Could you please share what exactly is your problem?
— I can’t ride the subway. My heart beats uncontrollably, I sweat, I almost lose consciousness, I suffocate. And so the last 5 years, twice a month. But I don’t drive much.
The problem is clear — the client suffers from panic attacks. They manifest themselves in very different ways: an inexplicable, agonizing surge of intense anxiety. Unreasonable fear in combination with various autonomic (somatic) symptoms, such as palpitations, sweating, shortness of breath. That is why doctors make such diagnoses as vegetovascular dystonia, cardioneurosis, neurocirculatory dystonia. But what exactly is a panic attack?
What are panic attacks and where do they come from?
The symptoms of many serious diseases, such as various brain pathologies, thyroid dysfunction, respiratory pathologies, and even some tumors, are similar to the manifestations of a panic attack. And it’s good if the client comes across a competent specialist who will first refer you to the necessary medical tests, and only then to a psychologist.
The mechanism of a panic attack is simple: it is an adrenaline reaction to stress. In response to any, even the most insignificant irritation or threat, the hypothalamus produces adrenaline. It is he who, entering the bloodstream, causes a rapid heartbeat, tension in the outer layer of muscles, thickening of the blood — this can increase pressure.
Interestingly, at the moment of the first encounter with a real danger, a person manages to remain calm, control fear.
Over time, a person who has had the first attack begins to refuse to travel, does not use public transport, and limits communication. He tries in every possible way to avoid situations that provoke an attack, the horror that he once experienced is so strong.
Behavior is now subordinated to the fear of losing control over consciousness and the fear of death. The person begins to wonder: is everything okay with me? Am I crazy? Postpones a visit to a psychologist or psychiatrist indefinitely, which further affects the quality of life and mental state.
Interestingly, at the moment of the first encounter with a real danger, a person manages to remain calm, to control fear. Attacks begin later in situations that are objectively life-threatening. This makes it difficult to identify the true cause of panic disorder.
The main symptoms of panic disorder are repeated, unexpected panic attacks. A panic attack usually occurs against the background of external damaging factors, such as chronic stress, the death of a loved one, or an acute conflict. The cause may also be a violation of the body due to pregnancy, the onset of sexual activity, abortion, the use of hormonal drugs, the use of psychotropic drugs.
How to deal with a panic attack
There are two stages in the treatment of panic disorder: the first is the relief of the panic attack itself; the second is the prevention (control) of a panic attack and syndromes secondary to it (agoraphobia, depression, hypochondria, and many others). As a rule, psychotropic drugs are prescribed to remove the symptom, reducing the severity or suppressing anxiety, fear, anxiety, and emotional stress.
In the spectrum of action of some tranquilizers, there may also be an effect that is associated with the normalization of the functional activity of the autonomic nervous system. The physical manifestations of anxiety are reduced (pressure instability, tachycardia, sweating, gastrointestinal dysfunction).
However, frequent (daily) use of these drugs leads to the development of an addiction syndrome, and in the usual dosages they cease to act. At the same time, irregular medication use and the associated rebound phenomenon can contribute to an increase in panic attacks.
It won’t take long to ride the subway again, go to thousands of concerts and feel happy
Drug therapy is contraindicated at the age of up to 18 years, individual intolerance to the drug, liver failure, severe myasthenia gravis, glaucoma, respiratory failure, dysmotility (ataxia), suicidal tendencies, addictions (with the exception of the treatment of acute withdrawal symptoms), pregnancy.
It is in these cases that the work on the method of desensitization with the help of eye movement (hereinafter referred to as EMDR) is recommended. It was originally developed by American psychologist Francis Shapiro to work with PTSD and has shown to be very effective in dealing with attacks. This method is used by psychologists who are further involved in stabilizing therapy. It is aimed at consolidating the results, restoring social activity, overcoming fears and avoidant behavior, and preventing relapses.
But what if the attack happened right here and now?
- Try breathing techniques. The exhalation should be longer than the inhalation. Inhale for 4 counts, exhale for XNUMX counts.
- Turn on the 5 senses. Imagine a lemon. Describe in detail its look, smell, taste, how it can be touched, fantasize about the sound that you can hear when squeezing a lemon.
- Visualize yourself in a safe place. Imagine what smells, sounds, what you see, what your skin feels.
- Were ezumike. Try to find five objects on «K» in the surrounding area, five people in blue clothes.
- Zuo ike. To do this, alternately tighten all the muscles of the body, starting with the feet, then the shins-thighs-lower back, and abruptly release, release the tension.
- Return to a safe reality. Lean your back on something hard, lie down, for example, on the floor. Tap the whole body, starting with the feet and moving up towards the head.
All of these are quite effective methods, but then attacks can happen again and again. Therefore, do not postpone a visit to a psychologist. The client mentioned at the very beginning of the article took 8 meetings with a psychologist to return to her previous quality of life.
When working with the EMPG technique, the intensity of the attacks is significantly reduced by the third meeting, and by the fifth, the attacks go away completely. It won’t take long to fly planes again, ride the subway, go to thousands of concerts and feel happy and free.