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Knowledge and information about panic disorder and square anxiety disorder

People with panic disorder focus on internal feelings

By Taufik OluPublished about a year ago 10 min read
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Knowledge and information about panic disorder and square anxiety disorder
Photo by Solen Feyissa on Unsplash

I. What are panic disorder and agoraphobia?

Almost everyone has felt anxiety. A panic attack, on the other hand, is characterized by severe anxiety, and the timing of the attack incorrectly interprets the symptoms as a sign that

about to have a heart attack or organic disease problem, about to go crazy, or completely out of control. During a panic attack, you may feel shortness of breath, a tingling sensation, abdominal discomfort, ringing in the ears, a sense of near death, shaking, dizziness, a feeling of suffocation, chest pain, sweating, and a pounding heart.

You should first see an internist to rule out organic disease factors such as hyperthyroidism, caffeine addiction, heart valve prolapse, or other causes. Once the organic illness is ruled out, it is important to be evaluated by a mental health professional to determine if you have a "panic disorder".

Panic disorder is often referred to as "fear of fear" because people with this disorder become afraid of experiencing fearful symptoms (or "panic attacks"), which the person interprets as meaning that something is going to happen to the body soon. problems.

Normally, fear is felt when we are in real danger and it sends an alert or signal to our brain that we are in danger so we can protect ourselves from it. The symptoms of fear (heart pounding, hyperventilation, etc.) give us the energy to help us escape or fight the danger (this is called the "fight or flight" response). For example, when we are in danger, the heart beats rapidly to pump more blood, and the blood that is pumped is carrying oxygen. When we are in danger, oxygen supplies us with more energy to motivate us to run or fight. This is a natural response to actual danger, which we call a "real alarm," a theory that has been in place for thousands of years.

With panic disorder, your body thinks you are in danger even when there is no actual danger. We call it a "false alarm" when you feel fear when there is no real danger. It's like sounding the fire siren when there is no fire. Over time, these "false alarms" become "learned alarms," meaning you begin to fear the symptoms of fear that occur when you are in real danger because you cannot understand why you are experiencing them. You begin to assume that panic attacks are dangerous, which means that something is wrong with your body. Once you begin to realize that panic attacks are dangerous, it triggers more fear or more panic attacks in the future as a way to cope with the danger you perceive.

The irony of panic attacks is that you begin to fear the very symptoms that protect you from danger. By "thinking" you are in danger, the brain begins to produce more and more fear (or more and more panic attacks) because, in a sense, it "doesn't recognize" that what you are afraid of is the fear symptom itself and not the actual danger.

Once people with panic disorder believe that panic attacks are dangerous, they begin to worry about having future panic attacks. They also begin to fear and avoid any symptoms and feelings that are similar to panic (fever, exercise, sunlight, pleasure or excitement, sexual arousal, anger, etc.). People with the panic disorder begin to focus on these internal feelings: "My heart is pounding, which means I'm going to have a heart attack," or "I feel weak and dizzy, which means I'm going to faint. Many people with panic disorder also experience panic attacks during sleep.

Many people with panic disorder also experience "agoraphobia". People with agoraphobia are afraid of certain places or situations: they fear that if they have a panic attack, it will be difficult to escape from these places or situations (e.g., "I might have an anxiety attack in the subway and lose consciousness in front of people"). They avoid going out alone, being home alone, going to the supermarket, trains, planes, bridges, high places, tunnels, open plazas, driving, elevators, and so on. They are afraid of having panic attacks in these situations and try to avoid or escape from these situations. Many people with panic disorder and agoraphobia get help from a "safety figure" - someone who accompanies them, prevents them from becoming anxious and helps them escape.

Even if their avoidance/escape causes few or no anxiety attacks for several months, people with panic disorder and agoraphobia may still fear the next panic attack. As a result of their avoidance behavior, the world becomes smaller and smaller. Because of the many limitations in their lives, many patients develop chronic anxiety and depression and begin alcohol, valium, and alprazolam to treat themselves.

In addition, while the patient's efforts are successful in the short term, in the long term they reinforce the message that they are in danger and need protection, and in turn choose to run away. The therapist helps the patient to "retrain" the brain to perceive that the fearful situation is not dangerous and that panic attacks are harmless fear symptoms that do not require safety behaviors.

What are the factors that contribute to the development of panic disorder and agoraphobia?

Although 30% to 40% of the general population will have a panic attack, most people do not assign a catastrophic interpretation to panic attacks and develop panic disorder. Patients with panic disorder and agoraphobia have a predisposition. Studies have shown that they are familially aggregated, possibly due to a combination of genetic, personality, biological and psychological susceptibility factors. Anxious individuals may be more likely to develop a personality for panic disorder. Studies have also shown that anxiety can be inherited, which may be the result of biological factors and/or the learned nature of early life experiences. The link between early experiences and panic disorder is that early experiences teach patients to view the world as a dangerous place, and in particular to view internal body sensations as harmful. Patients with panic disorder tend to focus too much attention on somatic sensations and assign catastrophizing interpretations to somatic sensations. For example, they focus on the heart rate, i.e., they rush to the conclusion that a heart attack is imminent.

Many of the situations that trigger panic and agoraphobia are also situations that were dangerous for our ancestors during their early evolution. For example, being trapped in a tunnel could cause suffocation or fainting; heights were dangerous; individuals in open fields were more likely to be attacked by carnivores (lions or wolves) and unable to escape; and in public, our ancestors were more likely to encounter hostile strangers. Thus, we now consider many of the fears of the square as recollections of early intuitive and adaptive fears. However, these contexts are not dangerous in the real present.

In susceptible people, initial panic attacks can also be first activated in stressful situations, such as leaving home, having an interpersonal conflict, having surgery, taking on a new task, or suffering from a somatic illness. Many people with panic disorder and agoraphobia also experience depressive symptoms, in part because they feel out of control and overwhelmed by how to deal with their problems.

Third, what is a common misconception about panic disorder and agoraphobia?

The misconception of most patients is that panic symptoms are a sign of a dangerous physical condition, a serious mental illness, or a loss of control. They think they are suffering from a heart attack or schizophrenia; that they may be out of touch with reality, are weak, or are about to have a stroke; or that something else terrible is about to happen. People with panic disorder and agoraphobia may also fear that having a panic attack indicates a flaw or weakness and become depressed, dependent, and prone to self-criticism.

Some people may also mistakenly believe that panic attacks are a deep-rooted problem. People with panic disorder and agoraphobia often have unrealistic beliefs about anxiety, such as "all anxiety are bad" and "I must get rid of my anxiety immediately. Others believe they will never get better because their panic attacks and agoraphobia have been going on for years and traditional medication has not helped their problem.

It is important for the success of the treatment that counselors tell patients that they must believe in the effectiveness of panic disorder and agoraphobia treatment. Cognitive-behavioral therapy, combined with or without medication, is extremely effective in treating both panic disorder and agoraphobia. This treatment helps people to revise their myths, misconceptions, and judgments about these disorders. It also helps people accept that the disorders they suffer from can be cured through psychotherapeutic strategies. It also helps them to understand that long-term treatment without tapping into the patient's childhood experiences can be very effective.

Fourth, how does cognitive-behavioral treatment for panic disorder and agoraphobia work?

Fortunately, the effectiveness of cognitive behavioral therapy for panic disorder and agoraphobia has been tested by many studies. Many relevant studies have been done at Oxford University in the UK, the University of Pennsylvania, the State University of New York at Albany, other universities, medical schools, and clinical institutions. After 12 to 15 sessions, the treatment can be 85% to 90% effective. And, once treatment is over, most patients maintain their effectiveness at a follow-up visit one year later.

Medications for panic disorder and agoraphobia.

Many medications are effective in treating panic disorder and agoraphobia. These include broad-spectrum antidepressants (e.g., fluoxetine, sertraline, promethazine), alprazolam, and other anti-anxiety medications. These medications help patients reduce symptoms of agoraphobia, but panic symptoms may recur once the medication is discontinued. Therefore, we recommend timely treatment with medication, and also cognitive-behavioral therapy is needed.

V. What are the steps of cognitive-behavioral therapy?

Cognitive-behavioral therapy for panic disorder and agoraphobia has several goals.

First, to help you understand the nature of anxiety, panic, and agoraphobia.

Second, to determine the range of contexts you avoid or fear.

third, to assess the nature, severity, and frequency of your symptoms and to assess the contexts that cause you to panic

Fourth, determine if other problems are also present - for example, depression, other anxiety disorders, substance abuse, bulimia, loneliness, interpersonal problems, etc.

Treatment includes all or some of the following: training about panic so you will stop being afraid of it; repeated breathing exercises; relaxation exercises; triggering panic (to show the brain that panic attacks are non-harmful and that you are not in danger); progressive exposure to the situation causing the panic; identifying and correcting your misinterpretation of panic and somatic arousal symptoms (e.g. "My heart is pounding, I'm going to have a heart attack"); identifying and correcting assumptions (e.g., "Somatic sensations are dangerous"), identifying and correcting beliefs (e.g., "I'm vulnerable, weak "), which are based on the patient's misinterpretation; coping with life stress; assertiveness training (when needed); and training cognitive skills during panic attacks to reduce panic symptoms. Other issues (e.g., depression) also need to be addressed in treatment.

VI. What is expected of the patient?

For the patient, cognitive behavioral therapy is not a passive experience. You are expected to have weekly sessions (sometimes more than once a week), to fill out forms to assess your problems, and to do the homework that you and your counselor have planned and assigned during the two sessions. The vast majority of patients expect their symptoms to improve in therapy - some expect rapid improvement. Even if your symptoms improve quickly, you will still need to complete the entire treatment regime. Treatment shedding increases the likelihood of relapse.

The planned course of treatment is 12 sessions, with the first few sessions used to assess and explain the treatment and the subsequent sessions used to implement the treatment strategy. After the acute phase of treatment, follow-up talks are planned at biweekly, monthly, or longer intervals to consolidate the efficacy and prevent a recurrence.

The treatment system we use combines treatment techniques researched at Oxford University, the University of Pennsylvania, and the State University of New York at Albany. We believe that therapy is the way to learn how to help yourself, which is why it is important to do homework in therapy.

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About the Creator

Taufik Olu

Money is round. It rolls away.

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