Panic is the first thing to do. What to do during a panic attack. Algorithm of actions in the development of a panic attack

Panic attack (or episodic paroxysmal anxiety) is a subtype of anxiety disorder that is a neurotic level disorder associated with stress. A panic attack is a well-defined episode of intense anxiety or discomfort that comes on suddenly, peaks within a few minutes, and lasts no more than 10 to 20 minutes.

A characteristic feature is the unpredictability of occurrence and the huge difference between the severity of subjective sensations and the objective status of the patient. According to modern psychologists, panic attacks are observed in approximately 5% of people who live in big cities.

What is a panic attack?

A panic attack is an unpredictably occurring attack of severe fear or anxiety, combined with a variety of vegetative multiorgan symptoms. During an attack, a combination of several of the following symptoms may occur:

hyperhidrosis,
heartbeat,
labored breathing,
chills,
tides,
fear of madness or death,
nausea,
dizziness, etc.

Signs of panic attacks are expressed in attacks of fear that arise completely unpredictably; the individual is also very anxious, she is afraid of dying, and sometimes thinks that she will become crazy. In this case, the person experiences unpleasant symptoms from the physical side of the body. They are unable to explain the reasons and cannot control the timing or severity of the attack.

Step-by-step mechanism for the development of a panic attack:

release of adrenaline and other catecholamines following stress;
narrowing of blood vessels;
increased strength and heart rate;
increased breathing rate;
decreased concentration of carbon dioxide in the blood;
accumulation of lactic acid in peripheral tissues.

Panic attacks are a common condition. Every fifth person suffered from it at least once in their life, and frequent and recurring disorders longer than a year, affects no more than 1% of people. Women are 5 times more likely to get sick, and the peak incidence occurs at the age of 25-35 years. But the attack can occur in a child over 3 years of age, in a teenager, and in people over 60 years of age.

Causes

Today, there are many theories about the occurrence of panic attacks. They affect both physiological and social levels. However, the root cause of a panic attack is considered to be physiological processes occurring in the human body under the influence of stress factors.

The condition can be triggered by any illness, fear, or surgery that the person was worried about. Most often, an attack develops against the background of mental pathologies, but it can also be caused by:

transferred;
coronary heart disease;
mitral valve prolapse;
childbirth;
pregnancy;
the beginning of sexual activity;
pheochromocytoma (a tumor of the adrenal glands that produces too much adrenaline);
taking cholecystokinin drugs, glucocorticoid hormones, anabolic steroids.

U healthy people Without bad habits, the appearance of panic attacks usually provokes a psychological conflict. If a person constantly lives in a state of stress, suppressed desire, fear for the future (for children), a feeling of personal inadequacy or failure, this can result in panic disorder.

Besides, predisposition panic attacks have a genetic basis, approximately 15-17% of first-degree relatives have similar symptoms.

In men, panic attacks are much less common. This, according to research findings, is explained by complex hormonal changes during menstrual cycle. No one will be surprised by the presence of sharp emotional leaps in women. There is a possibility that men are less willing to ask for help due to their feigned masculinity. They would rather turn to drugs or drink to avoid obsessive symptoms.

Risk factors:

Psychological trauma.
Chronic stress.
Disturbed sleep-wake pattern.
Lack of physical activity.
Bad habits (drinking alcohol, smoking).
Psychological conflicts (suppression of desires, complexes, etc.).

Kinds

Modern medicine allows us to combine PA into several groups:

Spontaneous PAs. They appear without any reason.
Situational. They are a reaction to a specific situation, for example, a person is afraid of speaking in public or crossing a bridge.
Conditional situational. They appear in most cases after exposure of the body to stimulants of a biological or chemical nature (drugs, alcohol, hormonal changes).

Symptoms of panic attacks in adults

At panic attack pronounced fear (phobia) arises - fear of losing consciousness, fear of “going crazy,” fear of death. Control over the situation, understanding of the place and time of stay, and sometimes awareness of one’s own personality are lost (derealization and depersonalization).

Panic attacks can plague healthy and optimistic people. At the same time, they occasionally experience attacks of anxiety and fear, which end when they leave the “problematic” situation. But there are other cases when the attacks themselves are not as dangerous as the disease that caused them. For example, panic disorder or severe depression.

Symptoms that most often occur during panic attacks:

The main symptom that sends an alarm bell to the brain is dizziness. Panic attacks contribute to the release of adrenaline, a person feels the danger of the situation and escalates it even more.
If you do not overcome this onset of an attack, shortness of breath appears, the heart begins to beat strongly, rises arterial pressure, accelerated sweating is observed.
Throbbing pain in the temples, a state of suffocation, sometimes heart pain, tightness of the diaphragm, poor coordination of movements, a foggy mind, nausea and vomiting, thirst, loss of real time, severe anxiety and a persistent feeling of fear.

Psychological symptoms of PA:

Confusion or narrowing of consciousness.
Feeling of a “lump in the throat.”
Derealization: the feeling that everything around is unreal or is happening somewhere far from the person.
Depersonalization: own actions the patient is perceived as if “from the outside.”
Fear of death.
Anxiety about some unknown danger.
Fear of going crazy or doing something inappropriate (screaming, fainting, throwing yourself at a person, wetting yourself, etc.).

A panic attack is characterized by a sudden, unpredictable onset unrelated to the existence of a real danger, an avalanche-like increase and gradual subsidence of symptoms, and the presence of a post-attack period.

On average, a paroxysm lasts about 15 minutes, but its duration can vary from 10 minutes to 1 hour.

After suffering a panic attack, a person is constantly thinking about what happened and pays attention to his well-being. This behavior can lead to panic attacks in the future.

The frequency of panic attacks in panic disorder can vary: from several per day to several per year. It is noteworthy that attacks can also develop during sleep. So, a person wakes up in the middle of the night in horror and cold sweat, not understanding what is happening to him.

What should a person do during a panic attack?

If control over oneself is maintained and self-control is not lost, then, sensing an approaching attack, the patient needs to try to “distract himself.” There are many ways to do this:

counting - you can start counting the number of chairs in the hall or seats on the bus, the number of people without headwear in a subway car, etc.;
singing or reading poetry- try to remember your favorite song and hum it “to yourself”, carry a verse written on a piece of paper in your pocket and start reading it when the attack begins;
Know and actively use breathing relaxation techniques: deep belly breathing so that the exhalation is slower than the inhalation, use a paper bag or your own palms folded in a boat to eliminate hyperventilation.
Self-hypnosis techniques: convince yourself that you are relaxed, calm, etc.
Physical activity: helps get rid of spasms and cramps, relax muscles, eliminate shortness of breath, calm down and take your mind off an attack.
Make it a habit to massage your palms when panic strikes you by surprise. Press on the membrane that is located between your index finger and thumb. Press down, count to 5, release.
Help in relaxation can be provided by massage or rubbing certain parts of the body: the ears, neck area, shoulders, as well as the little fingers and the bases of the thumbs on both hands.
Cold and hot shower . Every 20-30 seconds you should alternate pouring cold and hot water, in order to provoke a response from the hormonal system that will extinguish the anxiety attack. It is necessary to direct water to all parts of the body and head.
Relax. If the attacks appear against the background of chronic fatigue, it’s time to get some rest. Take a bath with aromatic oils more often, sleep more, go on vacation. Psychologists say that 80% of people are cured in this way.

Often, over time, patients develop a fear of a new attack, they anxiously await it and try to avoid provoking situations. Naturally, this constant pressure It doesn’t lead to anything good and the attacks become more frequent. Without proper treatment such patients often turn into recluses and hypochondriacs who are constantly searching for new symptoms, and they will not fail to appear in such a situation.

Consequences of PA for humans

Among the consequences it should be noted:

Social isolation;
The emergence of phobias (including agoraphobia);
Hypochondria;
The emergence of problems in personal and professional spheres of life;
Violation of interpersonal relationships;
Development of secondary depression;
The emergence of chemical dependencies.

How to treat panic attacks?

As a rule, after the first panic attack occurs, the patient is sent to a therapist, neurologist, or cardiologist, and each of these specialists does not identify disorders according to their profile. The patient usually sees a psychotherapist, who is needed initially, at the moment when he or she reaches a significant deterioration in the quality of life.

At the appointment, the psychotherapist explains to the patient what exactly is happening to him, revealing the characteristics of the disease, then a selection of tactics for the subsequent management of the disease is made.

The main goal of treating panic attacks is to reduce the number of attacks and alleviate the severity of symptoms. Treatment is always carried out in two directions - medicinal and psychological. Depending on the individual characteristics one of the directions can be used or both at the same time.

Psychotherapy

The ideal option for starting treatment for panic attacks is still considered to be a consultation with a psychotherapist. By considering the problem from a psychiatric perspective, success can be achieved more quickly, since the doctor, having identified the psychogenic origin of the disorders, will prescribe therapy in accordance with the degree of emotional and vegetative disorders.

Cognitive behavioral therapy is one of the most common treatments for panic attacks. The therapy consists of several stages, the goal of which is to change the patient’s thinking and attitude towards anxiety states. The doctor explains the pattern of panic attacks, which allows the patient to understand the mechanism of the phenomena occurring to him.
Very popular, relatively the new kind- This is neurolinguistic programming. In this case, a special type of conversation is used, the person finds frightening situations and experiences them. He replays them so many times that the fear simply disappears.
Gestalt therapy – modern approach for the treatment of panic attacks. The patient analyzes in detail the situations and events that cause him anxiety and discomfort. During treatment, the therapist pushes him to search for solutions and methods for eliminating such situations.

It is also practiced auxiliary treatment herbal therapy, in which patients are recommended to take decoctions of certain herbs every day with a calming effect. You can prepare decoctions and infusions from valerian, speedwell, oregano, nettle, lemon balm, mint, wormwood, motherwort, chamomile, hops, etc.

Medications for the treatment of panic attacks

The duration of the medication course is usually at least six months. Discontinuation of the drug is possible against the background of complete reduction of anticipatory anxiety, if a panic attack has not been observed for 30-40 days.

For a panic attack, your doctor may prescribe the following medications:

Sibazon (diazepam, Relanium, Seduxen) relieves feelings of anxiety, general tension, and increased emotional excitability.
Medazepam (rudotel) is a daytime tranquilizer that relieves panic fears, but does not cause drowsiness.
Grandaxin (antidepressant) does not have a hypnotic or muscle relaxant effect and is used as a daytime tranquilizer.
Tazepam, phenazepam - relax muscles, give a moderate sedative effect.
Zopiclone (Sonnat, Sonex) is a fairly popular lung sleeping pill, providing full healthy sleep within 7-8 hours.
Antidepressants (mild - amitriptyline, grandaxin, azafen, imizin).

Some of the listed drugs cannot be taken for more than 2-3 weeks, because... possible side effects.

Feelings of anxiety and panic when starting to take certain medications can become stronger. In most cases this is a temporary phenomenon. If you feel that improvement does not occur a few days after starting to take them, be sure to tell your doctor about this.

There are also drugs that are not considered potent, like tranquilizers. They are sold without a prescription, and with their help it is possible to alleviate the patient’s condition in the event of an attack. Among these are:

medicinal herbs,
chamomile,
birch leaves,
motherwort.

For a patient who is susceptible to panic attacks, awareness greatly eases the situation: the more he knows about the disease, about ways to overcome it and reduce symptoms, the calmer he will be about its manifestations and behave adequately during attacks.

The use of herbal preparations

To take a medicinal herbal tincture, you can prepare the following mixture: take 100 g of tea rose fruits and chamomile flowers; then 50 g of lemon balm leaves, yarrow, angelica root and St. John's wort; add 20 g each of hop cones, valerian root and peppermint leaves. Brew with boiling water, infuse and drink slightly warm 2 times a day
Peppermint should be brewed in this way: pour two tablespoons of mint (dry or fresh) with a glass of boiling water. After this, you need to infuse mint tea under the lid for two hours. Then we filter the infusion and drink a glass at a time. To calm the nervous system and treat panic attacks. It is recommended to drink three glasses of mint tea per day.

Prevention

Methods for preventing PA include:

Physical exercise - best prevention in the fight against panic attacks. The more intense your lifestyle, the less likely you are to experience panic attacks.
Walking on fresh air- another way to prevent panic attacks. Such walks are very effective and have a long-lasting positive effect.
Meditation. This method suitable for those who can cope with their habits and perform complex exercises daily;
Peripheral vision will help you relax, and therefore minimize the risk of a panic attack.

Panic attack (or episodic paroxysmal anxiety) is a mental disorder in the form of an inexplicable, painful attack of severe anxiety, which is accompanied by fear and various somatic (bodily) symptoms. Panic attacks can be like separate disease, and the manifestation of another disorder, it is impossible to predict their onset. Drug and psychological treatment successfully helps fight pathology, and preventive procedures can be performed independently at home.

Symptoms

Panic attacks occur 3-4 times more often in women than in men. An attack can last from several minutes to several hours, but on average it lasts 10-20 minutes. At this time, the stress hormone adrenaline and other catecholamines are released into the blood - biologically active substances that have a stimulating effect on the body. They have a vasoconstrictor effect and cause the following conditions:

Hot or cold flashes, increased sweating.
Frequent urination, nausea, vomiting, diarrhea.
Delayed salivation, dry mouth.
Increased pressure - against the background of hypertension, derealization is possible, when a person does not understand where he is and what is happening to him.
An increase in heart rate (tachycardia) can cause shortness of breath, a feeling of lack of oxygen, pain in the heart, which further increases fear.
Increased breathing intensity (hyperventilation) - the patient tries to breathe deeper and more often, while the level of carbon dioxide in the blood decreases and the acid balance, causing dizziness, weakness, numbness of the limbs. Lactic acid (lactate), an anxiety stimulant, accumulates in the tissues.

Thus, the mechanism of the attack involves vicious circle- the more panic, the more severe symptoms(suffocation, numbness), which only increases fear.

Among the psychological signs of the disorder are the following sudden fears:

feeling of danger;
pointless fear, including fear of death;
stiffness or restlessness;
lump in throat;
inability to maintain gaze on one object;
a feeling of unreality of what is happening (distortion of sounds, outlines of objects, remoteness of perception);
waking up at night while sleeping.

There are also panic attacks without fear - the so-called masked anxiety or alexithymic panic, when emotional stress and physical symptoms are practically absent, and the following temporary disorders occur:

aphonia (loss of voice);
mutism (lack of response to other people’s treatment);
amaurosis (decrease or complete absence vision);
ataxia (impaired coordination of movements);
twisting of arms.

Kinds

Spontaneous– occurs suddenly, without reason.
Situational– manifests itself in certain conditions that are psychologically traumatic for a person or due to his expectations similar situation.
Conditional-situational– occurs as a result of exposure of the patient to a chemical or biological activator (alcohol, changes in hormonal levels), and the connection is not always clearly visible.

Causes

Most doctors note that a panic attack occurs as a reaction of the body to stress - a kind of reflection of a person’s internal struggle with aggressive manifestations outside world. Panic disorder is also caused by unresolved psychological conflicts that are not recognized by the person.

People with a weak defense system against stress, whose nervous system lacks serotonin and norepinephrine - substances that help withstand physical and emotional stress, are susceptible to attacks.

The trigger for panic can be any emotionally significant event and even lack of sleep, and attacks can appear at any time, regardless of the presence of an immediate threat.

Factors that provoke disorders are combined into several groups:

Mental illness

In this case, emotional symptoms are clearly expressed, the main manifestation is causeless, uncontrollable, paralyzing fear - a feeling of imminent disaster.

Seizures most often occur against the background of the following diseases:

Phobias (fear of something) – are accompanied by panic attacks in 20% of cases.

Depression - in this case, attacks often provoke suicidal behavior.

Endogenous mental illnesses (especially schizophrenia, acute paranoid, schizotypal disorders).
Obsessive-compulsive disorder – obsessive fearful thoughts (for example, fear of infection or fire) that cause compulsive actions (constant hand washing, checking electrical wiring).
Post-traumatic stress disorder– usually occurs as a result of severe burns, road accidents, or disasters.
Adaptation disorder.

Somatic diseases

Emotional manifestations are not expressed, physical symptoms predominate. The main provoking factors are:

Cardiovascular diseases (myocardial infarction, angina, coronary heart disease).
Endocrine diseases - lesions of the adrenal glands (pheochromocytoma) and thyroid gland(thyrotoxicosis).
Some physiological conditions that the body perceives as stress (puberty, onset of sexual activity, menopause, pregnancy, childbirth).
Taking anxiogens – medicines, the side effect of which is anxiety.

Social reasons

Panic attacks most often occur in people with high level life, and primarily affect citizens rather than residents rural areas. Therefore, the causes of the disorder are also technological progress, fast pace of life, a large number of stressful situations.

Factors that provoke attacks are:

lack of physical activity;
bad habits;
many unresolved conflicts;
lack of sleep and proper rest.

Diagnostics

The diagnosis is made on the basis of repeated attacks that appear suddenly and unpredictably with a frequency ranging from several times a week to once every six months. The criterion is the spontaneity of a panic attack in the absence of an objective threat, as well as the absence of a pronounced anxiety state between attacks.

Also used for diagnosis:

scales for determining the level of anxiety and depression;
tests to identify fears;
clinical observation;
studying the medical history (identifying diseases, stress, changes in life that provoked the development of the disorder).

To exclude other diseases, they are examined by a cardiologist, endocrinologist, oncologist, psychiatrist, and take into account the possible influence of medications.

Why are they dangerous?

Panic disorders can have negative consequences:

The occurrence of unpleasant symptoms prompts people to resort to remedies traditional medicine, take medications, give injections of various drugs, without understanding the causes of the attack and the compatibility of drugs. Often patients call an ambulance and ask for an injection from heart attack, high blood pressure or prescribe cardiac medications.

Panic attacks intensify hidden phobias and provoke new ones - victims fear a second attack and avoid going out or, conversely, being alone. Such fears significantly complicate a person’s life and lead to other mental disorders.

The appearance of symptoms of the disorder disorganizes the person, he loses control over himself, and cannot perform certain actions (for example, drive a car).
Chronic diseases worsen against the background of panic attacks.
Anxiety in combination with other mental disorders can lead a person to suicide.

What to do during an attack

There are several simple steps to help alleviate the condition and get rid of a panic attack faster:

When you feel a lack of oxygen, it is very important to calm your breathing, make it even and measured. You can count to 8 while inhaling and exhaling, or take a bag and breathe into it, exhaling as deeply as possible.
It is advisable to try to relax the muscles of the face (for example, smile, even through force) and the body (rubbing, massage, pinching).
You should remember that there is no real danger, you can repeat encouraging words to yourself or carry a piece of paper with a calming text (for example, “Panic is just a figment of my imagination, it will go away now, I can handle it!”).

It is necessary to switch from internal experiences to what is happening around at the current moment in time - count passers-by or birds, read inscriptions from right to left, or try to return to the work performed before the attack.

You can mentally imagine your anxiety scale and how the level of panic on it gradually decreases.
When prescribing certain medications, you should carry them with you - this already has a calming effect. If all of the above methods do not help, you need to take medicine.

Treatment

Pills

For stopping an attack take anti-panic drugs with a rapid mechanism of action - tranquilizers from the group of benzodiazepines, available in the form of tablets, injection solution, rectal suppositories: Diazepam (Apaurin, Valium, Relium, Seduxen), Midazolam (Dormicum, Fulsed), Temazepam (Signopam).

For control over recurrences panic attack, the doctor may prescribe different groups of drugs:

Anti-anxiety drugs (anxiolytics)- are assigned as in acute period, during a panic attack with pronounced motor agitation, and during long-term treatment to prevent new attacks: Adaptol, Alprazolam (Alzolam, Zolomax, Xanax, Helex), Afobazole, Bromazepam (Lexotan), Hydroxyzine (Atarax), Clonazepam (Rivotril), Lorazepam (Lorafen), Selank, Tofisopam (Grandaxin), Phenazepam (Tranquesipam) , Fezanef, Phenorelaxan).
Tricyclic antidepressants– are especially effective for panic attacks with a risk of suicide. Treatment is recommended for 6-10 months, the effect occurs after 2-3 weeks: Desipramine (Petilil), Imipramine (Melipramine), Clomipramine (Anafranil, Clofranil).
MAO inhibitors indicated in case of predominance of vegetative symptoms and in the absence of effect from tricyclic antidepressants: Moclobemide (Aurorix), Pirlindol (Normazidol, Pyrazidol).
Serotonin reuptake inhibitors (SSRIs)– a modern group of antidepressants with high degree efficiency and small number side effects: Paroxetine (Adepress, Paxil, Plisil N, Rexetine), Sertraline (Asentra, Zoloft, Serenata, Sirlift, Stimuloton), Fluvoxamine (Fevarin), Fluoxetine (Prozac, Profluzac), Citalopram (Pram, Siozam, Umorap, Cipramil), Escitalopram (Selectra, Cipralex).
Beta blockers– eliminate frequent heartbeats, reduce blood pressure, relieve the effects of catecholamines: Bisoprolol (Concor), Metoprolol (Betalok, Metocard, Egilok), Propranolol (Anaprilin, Obzidan).
Combination antidepressants (atypical)– often prescribed for panic attacks due to depression: Bupropion (Wellbutrin, Zyban), Venlaxor, Mirtazapine (Mirazep), Trazodone (Trittico).
Neuroleptics (antipsychotics)- used for mental disorders, accompanied by anxiety states: Aminazine, Haloperidol, Quetiapine (Seroquel), Clozapine, Olanzapine, Rispolept, Sonapax, Sulpiride (Eglonil), Teraligen, Truxal.
Nootropics– improve brain function, stimulate blood circulation and metabolic processes in nervous tissue, increase the body's resistance to stress, are prescribed in combination with antidepressants or tranquilizers: Glycine, Cortexin, Mexidol, Picamilon, Piracetam, Pyritinol (Encephabol), Tenoten, Phenibut, Phenotropil, Eltacin.
Sedatives, including on plant based: Valocordin, Corvalol, Novopassit, valerian tincture, motherwort tincture.
Vitamins, macro- and microelements– support the body, help cope with stress: magnesium, calcium, iron, B vitamins (Magne B6, Milgamma, Panangin).

Please note the list of antidepressants that can be purchased at a pharmacy without a doctor's prescription

Psychotherapy

It is an integral (often basic) direction in the treatment of panic disorder. May include the following methods:

Cognitive behavioral therapy– aimed at changing the patient’s thinking and attitude towards anxiety states. The psychotherapist explains the mechanism of attacks, teaches the patient to control panic and its accompanying symptoms. The course lasts 8-20 sessions.
Psychoanalysis– helps to identify the cause of panic attacks (for example, childhood psychological trauma, change of place of residence, guilt). Treatment may take several months or years.
Classic hypnosis– the doctor puts the patient into a hypnotic state and gives him instructions for getting rid of panic attacks. The method is quite fast, but is only suitable for suggestible people.
Ericksonian hypnosis– the patient in a state of trance remains conscious, can communicate with the doctor and concentrate on his experiences, find and resolve internal conflicts.
Body-oriented psychotherapy– a set of techniques for working with bodily sensations to reduce anxiety levels. This includes relaxation and breathing exercises.
Systemic family psychotherapy– with this approach, panic attacks unique to one person are seen as a consequence of a lack of understanding among family members. The doctor explains the patient’s feelings to the relatives, teaches them to support him and help him fight fear, and also determines the causes of disharmony in the family.
Neurolinguistic programming (NLP)– according to this method, it is believed that fear arises under certain circumstances and is fixed in the patient as conditioned reflex, but a person’s reactions to these circumstances can be changed.
Desensitization (reduction of sensitivity) and eye movement reprocessing (EMDR)– under the supervision of a doctor, the patient performs certain exercises, repeating the movements of the eyeballs during the REM stage of sleep. Thus, the patient experiences blocked information about the situation, which causes panic, and triggers recovery mental processes. The doctor controls emotional condition patient, talks through experiences and negative feelings with him.
Gestalt therapy- the idea of this modern techniques The point is that in the course of life a person has a certain number of needs, when satisfied, people experience psychological comfort, and blocking desires leads to an imbalance in mental balance.

At home

There are several methods to help cope with panic attacks on your own:

Meditation– is one of the techniques of relaxation and concentration. It is necessary to take a certain pose (with a straight back) and concentrate on your sensations, feelings or any objects. It is advisable to perform the exercises 2 times a day for 15-20 minutes. Regular exercise improves mood, strengthens will and character, improves memory and intelligence, reduces the impact of stress and sensitivity to it, helps to calm down and not succumb to fears, and develops the ability to look soberly at oneself and surrounding events.
Breathing exercises– combines effectively with meditation. By learning how to do the exercises correctly, you can more easily endure a panic attack. Gymnastics techniques include breathing with the stomach (not the chest), holding your breath, alternating inhalation through the nose and exhalation through the mouth.
Physical exercise– help relieve stress and improve mood, and are an excellent method for preventing attacks.
Cold and hot shower– effective in the initial stages of a panic attack. Alternating hot and cool water triggers a hormonal response that can stop an anxiety attack.

During pregnancy

Changes in hormonal levels can provoke panic attacks in pregnant women. If a woman has suffered from attacks before, now they may occur more often or, conversely, stop.

The disorder negatively affects the course of pregnancy, and muscle tension, which occurs during an attack, can lead to hypertonicity of the uterus and provoke miscarriage or premature birth. Therefore, it is important to learn how to meet and control attacks, experience as many positive emotions as possible and eliminate factors that can cause anxiety.

In children

The occurrence of panic attacks in children and adolescents is largely due to the peculiarities of the child’s adaptation to modern world. A panic attack can be triggered by the following factors:

sexual violence (first);
competition among peers, when a child tries to be popular and physically attractive;
fear of punishment;
fear of possible failure (for example, at competitions, before an exam);
family conflicts.

Panic attacks in children can worsen chronic diseases(for example, asthma attacks), and also cause nighttime or daytime enuresis(urinary incontinence). The child feels vulnerable and unprotected; in this situation, the support of parents and loved ones is very important. You need to spend more time together, you can come up with an interesting hobby for your child.

Prevention

Help prevent panic attacks:

treatment of somatic diseases;
minimizing stress, conflicts, neuroses;
development of stress resistance;
increased self-esteem;
a healthy lifestyle, which includes giving up bad habits, eating right, playing sports, following a sleep and rest schedule;
increase in the number of positive emotions;
controlled medication intake (in particular, sedatives, antidepressants).

Panic attack - sudden onset of extreme anxiety, fear, tension and bad feeling: palpitations, sweating, dizziness, shortness of breath...

For anyone who has had this, there is no need to explain how unpleasant this condition is, especially when it occurs for no reason, and you feel like you are going crazy. Please note: these are all just feelings and physical states. This state is turned into panic, that is, into chaotic thoughtless behavior, by the person himself if he does not know how to behave correctly.

Panic attacks are causeless and occur as an attack, usually lasting about 10 minutes, but can be short-term for about 1-5 minutes and lasting up to 30 minutes, but the feeling of anxiety can persist for 1 hour.

If panic attacks become regular, occur weekly, or even more so daily, we are talking about a disease: panic disorder.

Not to be confused: if the anxiety is constant and there are no “bright spots”, this is a different disease: generalized anxiety disorder. And if strong fear predictable, if there was a reason for it, then it’s not a panic attack, but...

Panic disorders can often begin at a young, socially active age. The prevalence is 1-2 people per hundred, more often (2-3 times) it is observed in women, since women are less able to cope with it, begin to be afraid of it, and this only intensifies its course. The disease has an undulating course, about half of the patients generally recover, the rest lead a relatively normal life, despite the persistence of symptoms and the presence of relapses. Fears, in any case, become weaker over time.

A panic attack is a very unpleasant thing, but from a health point of view it is practically harmless. A panic attack turns into a serious problem when secondary fears are attached to it: fears of being alone, fears of crowded places, fears of the subway, fears of repeated panic attacks...

When this happens for the first time, many people begin to think about some serious illness heart, endocrine or nervous systems, digestion, they are in a hurry to call an ambulance, but by the time the ambulance arrives, everything passes. People start going to doctors, trying to find the causes of “attacks” - it is useless, which causes even greater anxiety. A fear reflex is developed, an expectation of an attack arises, and this in turn reinforces the repetition of attacks... For those who do not know how to cope with such situations, life turns into a nightmare. Both for you and for your loved ones.

Exit? Learning to cope with panic attacks faster is quite possible. Awareness is the first step to recovery. Fear is possible only in a situation of uncertainty. When you know what is happening to you (or someone else), you feel calmer about it, and your fear subsides.

Now the most important thing: no matter how terrible you (or the person next to you) feel, no one has ever died from panic attacks. That's for sure. Fears and feelings are difficult to experience, but they cannot cause harm to health. Fear itself does not lead to death; our body systems are able to withstand it. You will hold out. Our feelings in themselves are not damaging - it is the consciousness that perceives them as a signal of physiological distress, since a panic attack is triggered regardless of a real external threat. Everything will work out, just follow the rules.

How to help someone experiencing a panic attack? Don’t give in to his panic yourself; remember that only by maintaining inner peace and expressing it externally with your intonation, posture and actions, can you really help a person close to you. Stand opposite the person, if allowed, take him by the hands and, looking into his eyes, say in a confident tone: “Look at me. What is happening to you is not life-threatening. Now you and I will breathe deeply and evenly together.” And start breathing deeply and confidently, making sure that the person does the same.

It helps a lot if you visually show how to breathe. Hold his gaze, point your hand up (when you need to inhale), your hand to the side, preferably to the right (pause), your hand down (exhale), your hand to the side (to the left) - exhale...

Additionally: if you are a specialist, you can immediately do EMDR: this will normalize the condition faster. There is a need to prevent possible negative anchoring of the scene, stay in place and do positive anchoring. At least give a suggestion: “You see that you can feel good here. Look around and understand that in the subway (for example) you feel good, comfortable.”

In any case, do not let the person go until the attack passes; let him speak out, remaining confident and calm. After the panic attack is over, it makes sense to talk to him about the need to seek professional help.

About medications. Dietary supplements, leeches, glycine and other self-medication in this case are pointless. Vegetotropic drugs (anaprilin, pyrroxan, belloid, bellaspon) in combination with vascular-metabolic therapy (cinnarizine, cavinton, trental, nootropil, piracetam, cerebrolysin) are ineffective, neuroleptics are rather harmful. SSRI antidepressants and occasional (not a course!) use of tranquilizers to relieve anxiety and acute panic attacks help. In some cases, especially when generalized anxiety occurs, anticonvulsants can be used. Medicines to prevent panic attacks need to be tested, i.e. start with very small doses and gradually increase them to medium or high doses, especially since the therapeutic window for these drugs is wide.

It is clear that self-medication is not an option; be sure to consult a psychotherapist.

If this is a problem for your friend, who is as afraid of psychotherapists as she is of the panic attack itself, tell her that the psychotherapist has special pills that help quite quickly and effectively (this is true), but which the doctor cannot prescribe on his own without examining the patient (relative truth). The visit will convince her that psychotherapists are very nice people. And they even help you heal.

Dear colleagues, psychologists and psychotherapists! Be careful, there is always a good chance that the client is not having panic attacks at all, but specific ones or anchors on the past. This happens often. If these are really panic attacks, you can try to work with (sometimes very repressed) memories. No one knows whether these memories or fantasies are true, but the reality is that after such emotional work, panic attacks disappear for a fairly decent period.

What should you do if an anxiety attack begins immediately upon remembering the first panic attack? The technique depends on the personality. If a girl is “rattling,” you first need to remove the rattling, otherwise nothing will help. If the body is calm enough, you need to master at least the beginning of auto-training, learn to relax. When you have the skill of relaxation, the standard version is used. All!

Are you having a panic attack: what to do?

You can help yourself during a panic attack. The rules are short: Calm your head. Relax and try to switch your attention to something external. If possible, create physical comfort for yourself. Reduce the image of anxiety. Stay where you are. Tablet under the tongue. Breathe evenly and measuredly. Accept your feelings, let them flow through you. Get back to business. See more details.

Panic attack refers to the condition unreasonable fear in people who cannot be controlled. Sometimes the seizures last a few minutes; in others they can last for hours. In such a situation, it is important not to get lost and understand what to do if a panic attack occurs.

During seizures, people remain in anxious state, want to run away, are afraid of communicating with other people. Unusual fears, fussiness, and a desire to leave the place where the attack began appear.

Symptoms: rapid heartbeat, increased pulse rate, intense sweating, chills, shaking hands, feeling of discomfort in the stomach, headache, nausea, trembling limbs, convulsive condition, lack of air, a lump appears in the throat, changes in gait.

Causes

Residents of megacities are often subject to attacks of uncontrollable fear. Experts attribute this to increased levels of stress and the presence of numerous unresolved problems. Chronic attacks are dangerous because they can lead to addiction psychotropic drugs. This is a way to fix the problem.

To effectively interact with this disease, you need to understand the reasons for its occurrence, which are based on the following:

Unresolved difficulties and conflicting relationships. Because of them, patients are constantly in a state of stress and nervous tension. This leads to the nervous system reacting to panic attacks.
An unpleasant event awaits patients, which they feel afraid of. The body manages to remember such a feeling and then reproduce it again suddenly.
Social phobia– fear of a specific person or group of people.

How does a seizure go?

If the patient or their loved ones are constantly exposed to stress, it is necessary to understand how the seizure occurs. Panic often goes away under such circumstances. The seizure occurred after an unpleasant incident, a stressful situation or nervous strain.

If the current state is normal and no difficulties arise, the body will still be able to respond to such nervous situations panic attack.

People worry a lot during depression or the development of any pathology, for this reason they are highly susceptible to stress. Panic attacks occur with a variety of psychological defects, for example, depression or bipolar disorders.

Panic in the morning and evening

The occurrence of night and morning attacks can be caused by significant changes in people's lives. change of place of residence or work, loss of loved ones. Panic attacks occur more often in patients with a high degree of self-control. Such citizens try to behave correctly in society and try to prevent the release of negative emotions.

Their self-control is maintained only in daytime. In the mornings or evenings, when the body relaxes and there is little exposure to behavioral stereotypes, suppressed emotions burst into consciousness.

The patient may wake up in the evening with a panic attack, determine the relationship between his own condition and bad sleep. But not in all cases, seizures are preceded by such nightmares. Panic in the morning can be caused by having to get up and go to work again. The unpleasant feeling is aggravated after the alarm clock rings, which after some time on a subconscious level indicates a signal for a panic attack.

An evening or morning attack provokes fear of sleep. There may be a fear of not hearing the alarm clock and being late for work. The dream takes on an episodic character and appears. Due to regular sleep problems, the load on the body increases, and people have more frequent seizures.

Patients often try to eliminate stress and cope with depression with the help of alcohol. Alcoholics always quickly find a solution to the problem of a panic attack by increasing the dose. Alcohol has a negative impact on nervous system.

The number of panic attacks increases. Therefore, alcohol only worsens the well-being of patients. While the disorder is being eliminated and the course of therapy is being completed, you should give up alcohol.

How to help a sick person?

Patients prone to panic attacks come to trusted specialists with whom they maintain trusting relationships. In relation to them, it is carried out taking into account the basic medications, psychotherapy and gliosis.

During a seizure, the help of loved ones and surrounding people can be effective. To improve the patient’s well-being, it is necessary to provide psychological support, distraction, physical therapy, and use of medications.

Psychological support

Various caring people can provide emotional support to the patient. At the same time, you need to understand that boilerplate words will not help solve the problem, a person will not respond to a banal request to calm down, strengthen, be strong, and not worry.

It is advisable for people around him to remain confident and calm, convinced that everything that is happening does not pose a threat to life, he will be able to cope with the situation. You need to independently show how to observe the breathing rhythm when panic attacks occur.

The use of physiotherapeutic techniques: massage procedures, contrast showers, muscle relaxation. The purpose of massage procedures is to relax muscle tissues that become tense during moments of stress. Rubbing and kneading are used. Often a successful effect can be achieved by massaging the neck, shoulders, and reflexogenic areas.

A contrast shower helps stabilize hormonal levels and improve well-being. Changing hot water to cold water after 30 seconds allows you to treat the whole body, head, and contain the first symptoms of panic. Breathing exercises, inhalations from the stomach, delay after drawing air into the lungs, using a bag to reduce the amount of oxygen in the blood during intense lung work.

Relaxing physical exercises are based on relieving tension in muscle tissue.. In a sitting position, the calf muscles, thighs, and arms become tense, followed by strong relaxation. Facial exercises are great for relieving tension. A person needs to open his eyes wide and stretch out his lips so that the letter “o” sounds. After 10 seconds, complete relaxation and a smile are required. You need to do this exercise several times.

Distraction from anxiety is very important when people focus on something negative during attacks. The following recommendations are followed together with patients:

Think about something pleasant or familiar.
Perform daily routine work.
Sing your favorite songs that will evoke pleasant emotions.

You can use light pinching or slapping of the skin so that minor pain distracts you from difficult experiences. Games always require imagination. Patients need to imagine the condition as a thermometer scale, then try to mentally lower its temperature.

What to do when a seizure begins?

It is possible to determine which of the proposed methods will be most suitable for each patient only experimentally. Therefore, you can conditionally rely on the recommendations of doctors in this sense. You need to try to use everything, periodically select what will best contribute to treatment.

In a notebook, they often record all the techniques used and give them some kind of evaluation of their effectiveness. Some are abandoned immediately in this way. It is possible and even necessary to alternate and combine methods of dealing with seizures.

Doctors offer their patients a rough plan of action, but you need to choose the appropriate option at your own discretion. It all depends on the age of the patient and his general condition health.

You can hold your breath for 10 seconds. A paper bag is used in a situation where, due to overactive lungs and intense heartbeat, a lot of oxygen enters the blood. Carbon dioxide in a paper bag allows you to regulate this indicator, which has a beneficial effect on the nervous system. You need to imagine how the surf and the sea roar.

It will be possible to organize this different ways. On the street you can count people passing by, customers near an ice cream stand, vehicles, etc. People need to choose taking into account what psychosomatic processes arise in different situations.

No need to panic and leave this place. Instinctively, people often make decisions that seem simple at first glance. If you make an effort of will, you need to learn to do what you have done so far, work, walk, move in the right direction, after a seizure you can eat something tasty in order to appease the body in this way.

More about paper bags

All over the world, a paper bag is used to overcome a panic attack. The essence of this method of saving from panic is given out different people who watches television or goes to cinemas. B People should always have toiletry bags with them in case of another attack.

When a seizure begins, you need to press the device to your mouth and nose.
The air should be inhaled as slowly as possible until the bag folds into an accordion.
Inhalations should also be taken slowly until the bag straightens.
Exhalation should also be done gradually until the bag straightens.
This exercise is performed for several minutes until the seizure ends.

Symptoms between attacks

When patients experience panic, the same symptoms always appear between attacks, which may or may not be noticeable. It is often difficult to determine where such an attack occurs and at what point the post-crisis period begins.

Let us list the symptoms: a complex premonition (a feeling of psychological pressure), fear of re-visiting the place where the seizure occurred (this area can expand indefinitely), the emergence of phobias, a depressive state, it is difficult for patients to stay in one place, negative, constantly disturbing thoughts, hysteria, a weakened body , fatigue.

Disorientation in society - the patient is afraid to talk with people who were with him during the seizure, to move around in sights Vehicle in which an attack occurs.

Today there is no defined period during which such disorders are treated. The average duration of therapy for normal control of panic attacks is 6 months. With more complex development of the disease, therapy can last up to 9 months.

Conclusion

It's useful to know what to do during a panic attack. IN difficult situation a person may find himself alone, there will be no people around who could help him. People who constantly fall into difficult circumstances, must understand the ways effective elimination panic attacks.

Before starting self-medication, it is necessary to determine the cause of the appearance similar condition. Panic can result from psychological problems or some pathologies. To determine the causes of the disorder, you need to contact a medical specialist.

When panic attacks are caused by other disorders, measures must be taken to treat them. At the same time, you need to undergo therapy to combat seizures. Patients need to understand that panic attacks are caused by stress or a nervous breakdown.

Good day, dear readers. Today we will talk about what to do during a panic attack. You will learn how to behave in such situations, how to cope without the use of medications. Let's talk about techniques in psychology and clinical manifestations the onset of the attack.

General information

Before you think about how to cope with a panic attack, you need to understand the mechanism of its occurrence.

It is necessary to realize that during an attack there is a strong tension in all the muscles of the body. In this case, excessive weakness may be felt, for example, the legs become “wobbly” or aching joints appear.
As a rule, the duration of an attack is up to three minutes, but sometimes it can last half an hour. At the same time, it seems to a person that time is passing very slowly, an eternity is passing.
At the end of the attack, a feeling of severe fatigue and weakness occurs, aching pain occurs throughout the body, dyspeptic disorders, saliva may be excessively produced and sweating may increase. The individual feels too depressed, insignificant, and a feeling of uselessness appears.

When a person first experiences an attack, he may think he is having a heart attack or may feel like he is suffocating. It is not surprising that the first action will be to try to call an ambulance. The arriving team will take certain actions to relieve symptoms and will recommend contacting specialists, for example, a cardiologist. However, you need to understand that such actions will not be beneficial in the process of dealing with panic attacks.

You can try to cope with folk remedies. A person may start drinking herbal infusions, take soothing baths. It is necessary to understand that it will not be possible to completely recover from attacks; you can only temporarily remove specific symptoms. At least for initial stages These methods are effective.

Absolute inaction is unacceptable behavior in this situation. If the occurrence of attacks is completely ignored, serious health problems can develop. This will also increase the frequency of panic attacks, and the episodes will become longer and more intense. They will appear once a month, then a week, every two days, until a panic disorder occurs. That is why it is so important not to remain idle, but to engage in proper treatment in a timely manner.

Clinical manifestations

Have a panic attack a lot characteristic symptoms. The main features include:

lack of coordination;
weakness;
dizziness;
cramping pain in the abdominal cavity;
tremor of the limbs;
dyspnea;
muscle tremors;
dyspeptic disorders;
possible fainting;
strong thirst;
throbbing pain in the temples;
hypertension;
strong ;
cardialgia;
loss of sense of reality;
fever or severe chills;
increased sweating;
suffocation.

Basically, panic attacks can be diagnosed by the emergence of an overwhelming fear, gradually turning into a feeling of intense horror.

Actions during an attack

To prevent acute attack, you need to listen to such recommendations.

Total control over your breathing. The person must do something to slow down their breathing rate.
Using a paper bag helps a lot. Therefore, you should always keep it at hand. When there is a feeling of an approaching attack, you need to press the bag to your lips and nose and begin to slowly inhale air until the bag begins to shrink. You also need to exhale gradually until it straightens. These actions must be repeated until a feeling of calm arises. If you don’t have a bag, fold your palms into a boat shape and make breathing movements through them.
You can attach a special bracelet to your wrist or a ribbon (made of rubber). When some disturbing thoughts arise, an attack is approaching, you need to pull the elastic band back and release it so that it clicks on your hand. Sharp pain, arising in a limb, will immediately switch consciousness from a state of anxiety to these sensations.
Counting method. In order to calm down, a person begins to count numbers to himself, you can count the cars that pass by, the number of steps.
Use your senses to calm yourself. While in a room, try to find something that you like to look at. If this is not the case, then you can close your eyes and try to imagine these things in your mind. Stop, try to mobilize your hearing and hear sounds that come from afar, for example, the hum of cars somewhere on the highway or the buzzing of a bee in a clearing. Pay attention to the smells that surround you, perhaps lunch is being prepared somewhere or rain is approaching.
Surely, you have a favorite song that you often play while cleaning, cooking or driving a car. If you feel that an attack is approaching, then start humming it. Unless, of course, you're nearby strangers, and you are at home. If there are strangers present, you can sing to yourself. It is desirable that the song be funny, perhaps childish.
If the attack is accompanied by clouding of consciousness, high fever, then it is better to cool down. If you can’t get into the shower right now, you can simply wash your face, especially cooling the areas behind your ears.
Palm massage. To do this, you need to press on the membrane located between the fingers, thumb and index. Apply pressure, count to five, and then release the area. Actions should be carried out until complete calm occurs.
You can take it with you chewing gum. The moment you feel panic approaching, just start chewing it. This will allow you to temporarily escape from disturbing thoughts. IN this moment Your task is to switch to something else, get rid of anxiety. For example, you can call a relative by phone.
Take panic attack medication. The easiest way to cope with an attack is to use sedatives, such as Diazepam. If the first manifestations of an incipient attack appear, then mild medications can be used sedative effect, for example, motherwort tincture or Novopassit. You can also use herbal infusions, for example, brew mint leaves in 200 ml of boiling water (literally two tablespoons), leave for two hours in a closed container, then strain and drink before bed. But it is advisable to first consult a psychologist so that the specialist can prescribe a drug that is suitable for your particular case. It is possible that you do not need medications at all.

Psychological techniques

Cognitive behavioral therapy can help relieve panic attacks.

The specialist will explain what is happening to you, tell you about the reasons for the panic and the feelings you experience.
He will advise you to write down the date and time of panic attacks in order to better identify the reasons why they occur.
A psychologist will teach you how to breathe correctly and what ways you can relax to prevent panic attacks from occurring again.
The specialist will tell you how you can rethink the situation that arises during an attack. This is necessary to return to reality.
The psychologist will tell you how to identify things that cause panic in order to learn how to react to them correctly.

It can arise at the wrong moment, so it is important to learn how to resist it using psychological techniques.

Correct breathing. When you feel like you are having an attack, start breathing, your breaths should be deep. You can also sign up for breathing exercises, so-called Pilates. Experienced specialists will be able to teach you how to breathe correctly and at what moment to prevent attacks.
Accept your emotions. A person must realize what is happening to him and decide what causes the attack. We must try to resist this phenomenon so that attacks do not conquer your mind.
Relax. If chronic fatigue is to blame, then it’s time to relax and unwind. You can do yoga or meditation, it would also be nice to take a bath with herbal infusions, helping to relax. Maybe it's time to take a vacation.
Engage in self-hypnosis, affirm that you are a purposeful and strong person. Record your achievements and victories.

Art therapy - through creativity you can pour out your feelings, emotions and fears.
Establish a daily routine and strictly follow it. It is important to have enough time to rest, be active, devote physical activity, regularly spend time in the fresh air, take walks.
Particular attention must be paid to proper nutrition. It must be balanced. It is necessary to reduce your coffee consumption. It is important to give up bad habits, because they can also affect the human nervous system.
Learn, stop worrying about all sorts of trifles. Take life easier. If necessary, take care breathing exercises or meditation to relax, both mentally and physically.
Great importance must be given water procedures. They are the best way to help cope with stress, which means they will reduce the risk of developing panic attacks.
It would be a good idea to go for sanatorium-resort treatment. A change of environment, as well as a favorable climate, will help improve your mental health and health.
There is no need to run away if the attack begins in a room where you are surrounded by a large number of people. Try to control yourself, collect your thoughts, understand that you need to avoid this state. If at this moment you simply run away, you will remember the information that it is unsafe to be there. It is possible that a phobia will develop.

Now you know what to do during a panic attack. A person can learn to control himself and cope with a panic attack without anyone’s help. If you can’t cope on your own, don’t hesitate to visit the office of a psychologist or psychotherapist.