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Panic Attacks: Effective Ways to Cope
Michael G. Rayel, MD
Jill is a 21 y/o college student who used to do well until
about a few months ago when she started to experience
"weird" attacks almost daily. She described her experience
as "horrible." When she has the attack, she feels that she's
about to die or develop a stroke.
One day while she was in a mall, she suddenly developed an
"overwhelming" sensation all over her body. She was sweaty
and tremulous and felt that her heart was pumping so fast.
Within a few seconds, she also suffered from chest pain and
shortness of breath. This episode lasted for about 10
minutes but she felt that this was her worst ten minutes of
her life.
Overwhelmed by her experience, she has stayed away from
malls and has avoided being in a crowd of people. Because of
the frequency of the attacks, Jill can't anymore function
normally. She is afraid to leave the house and go to work.
Jill's experience is typical of someone with Panic Disorder.
A person with panic disorder develops anxiety attacks
associated with the thought that he or she would die or
develop a stroke or heart attack. Physical changes such as
fast heart beat, shortness of breath, fainting episodes,
sweating and tremulousness are some of the accompanying
symptoms.
A typical episode usually comes "out of the blue" and not
precipitated by any triggers. It can therefore happen any
time and anywhere. An attack can last for a few to several
minutes.
One episode can make a person feel scared of having another
one. In fact, a lot of people feel distressed anticipating
the occurrence of another attack. So most individuals prefer
to stay at home and isolate themselves from friends,
co-workers, and even relatives. Eventually they become
incapacitated.
If you're like Jill, is there any treatment that can help?
Yes, there is. Individuals with this condition are
successfully treated with an antidepressant such as the
serotonin-reuptake inhibitors. Usually, the dose should be
started low, for instance 10 mg/day of citalopram. After a
few weeks, the dose should be gradually increased depending
upon the person's clinical status.
Cognitive behavior therapy is likewise very effective. This
type of "talk psychotherapy" helps the individual to
restructure his or her thinking. Negative cognition
associated with the illness should be addressed in therapy
because it creates more harm than good. Relaxation
techniques such as breathing exercises should also help.
During treatment, patience is very important because it
takes a while before any intervention helps. However, don't
despair. After a few weeks, the medication should start
working and should give you a feeling of comfort.
What's the role of benzodiazepines (e.g. lorazepam or
clonazepam) in the treatment of panic disorder? This type of
drug can provide acute relief but should be used only on a
short-term basis because of its addiction potential. For
long-term treatment, antidepressants and psychotherapy are
still preferable.
About the Author:
Copyright © 2005. Dr. Michael G. Rayel – author (First Aid
to Mental Illness–Finalist, Reader's Preference Choice Award
2002) psychiatrist, and inventor of Oikos Game: An Emotional
Intelligence or EQ Game. For more information, please visit
www.oikosgame.com and www.soardime.com
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