Panic attack is defined as a clear period of intense fear or discomfort in which four (or more!) Of the following symptoms have occurred: .
● Palpitations, faster heart rate.
● Sweating.
● Shaking or convulsions.
● A feeling of lack of air or suffocation.
● The feeling of choking.
● Chest pain or discomfort.
● Nausea or abdominal pain.
● Dizziness, faintness.
● Feelings of unreality or depersonalization.
● Fear of losing control or madness.
● Fear of dying.
● Paresthesia.
● Chills or hot flushes.
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Note: The diagnosis of a panic attack is complemented by the dynamics of the above-mentioned symptoms, which develops rapidly and reaches its peak within 10 minutes!
The principle of verification, that is, the differentiation of disease symptoms
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Even if the diagnosis of anxiety attacks (with or without agoraphobia) is quite clear - in most cases it should be verified for the overlapping of similar symptoms of many diseases that are dangerous for the health and life of the disease. Verified, or diversified for this reason, diagnosis must exclude a large number of general-medical conditions and diagnoses.
Verified, i.e. differentiated diagnosis of a panic attack,
excludes the symptoms of the following diseases:
• Cardiovascular disease
- Angina.
- Overpressure.
- Atrial tachycardia.
- Dropping of the mitral valve.
• Lung disease (asthma).
• Neurological diseases (epilepsy, migraine, Ménière's disease).
• Endocrine diseases (hyperthyroidism, pheochromocytoma, hypoglycaemia).
• alcohol abstinence.
• Drug addiction.
• Drug poisoning.
NOTE: Due to the fact that even in relatively young people in the case of panic attacks, cardiovascular symptoms prevail, the differentiation with them is the most important.
. General conditions of panic attacks
• Panic attacks usually begin between 20 and 30 years of age.
• Panic attacks are more common in women.
• People with panic attacks are almost always afraid of death during an episode of anxiety.
• In people with panic attacks, anticipatory anxiety is significant, often restricting their functioning.
• People with panic attacks "strive" for numerous and varied diagnostic tests of the circulatory system.
• Factors triggering the development of panic attacks may be actual psychophysical complaints with a similar disease picture ("penicillin shock").
When it comes to mental illness, the doctor must determine whether panic is unexpected, situationally or with situational predispositions.
The latter indicates a different diagnosis, such as social phobia or specific phobia (when the patient is exposed to anxiety), obsessive-compulsive disorder (when trying to resist coercion) or depressive disorders. However, difficult patients often suffer from coexisting disorders, such as panic disorder combined with social phobia. Other diverse psychiatric diagnoses are post-traumatic stress disorder, depersonalization disorders and disorders in the form of somatic.
One of the forms of panic attacks are seizures occurring at night. No evidence was found to support the hypothesis suggesting that night panic attacks were a more severe form of panic disorder or one of the manifestations of increased susceptibility to sleep disorders. They occur in 18-45% of patients with panic disorder.On the other hand, a less frequent correlation between nocturnal seizures and agoraphobia has been demonstrated, which may be explained by the weaker association of nocturnal panic attacks with situational factors.
Often, panic attacks are combined with complaints of dizziness. Patients identify dizziness as an uncertainty when moving, an impression of floating or swimming, they are afraid of falling. Although the dizziness is objectively less severe, reactions to this ailment are exaggerated and cause excessive anxiety. Many psychiatrists believe that some patients identify fear of being dizzy with him. In a series of papers published over the past dozen or so years, he described the phobia of vertigo as a separate disease entity, considering it a particularly common cause of dizziness. These patients are dominated by the feeling of constant shaking or rocking (without objectively perceived disturbances in the balance), aggravated by anxiety and combined with feelings of fear of falling and anxiety.
The severity of panic disorder may be related to the intensity and frequency of panic attacks, the degree of intrusiveness of anticipatory anxiety and impairments associated with avoidance behaviors. Resignation, depressive symptoms or classic depression are often present in patients with panic attacks and agoraphobia, studies have also shown that the risk of suicide attempts is increasing. Other common comorbid psychiatric problems are all other anxiety disorders, disorders in the use of alcohol and other substances, and personality disorders. A special place in the differential diagnosis of anxiety and panic attacks is depression.
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Anxiety; Author - MD, psychiatrist Janusz Krzyżowski; Edition: Medic. 2005
Doctor of Medicine Janusz Krzyżowski
Psychiatrist
Private office tel. 22 833 18 68
00-774Warszawa, Dolna 4 lok. 15
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