Database of diseases - Practical psychiatry and psychogeriatry

  Panic attacks are undoubtedly one of the most common psychiatric emergencies due to which patients report to the emergency room or emergency room. Most often, however, these are general hospitals, because applicants usually have a sense of physical health rather than mental balance. Numerous authors estimate that anxiety disorders occur in any period of life in more than 30 million Americans, and the cost of their treatment reaches 42 billion dollars a year. Although they are as common as depression, they occupy less space in the scientific literature, and in everyday practice are not often recognized and treated. This applies in a special way to primary health care, in which the percentage of oversights is estimated at 64-85%. Usually, before a panic attack occurs, the patient learns different milder forms of anxiety. Therefore, it is necessary to mention them, because the continuum of anxiety can at some point become a new pathological quality - a panic attack. Anxiety is a normal, natural and necessary element of our lives. It is the same emotion as joy or anger and is a component of our emotions. Anxiety usually appears as an alarm signal due to a specific threat to which we are exposed and modifies our behavior, our body's reactions, emotions, and the efficiency of our intellect. Anxiety reactions can have a variety of severities and manifest themselves in many ways. An extreme manifestation of fear are panic attacks. The attack usually comes unexpectedly. No rational reasons need to trigger it. It can take place in the shower, at the wheel, at work, during a family dinner, shopping or walking. Symptoms of the disease usually suggest a heart attack. Man suffocates, gets trembling hands and the whole body, can not breathe. Stuttering chest pain and heart palpitations mean that he is often convinced that he is dying. This condition can last a few minutes and usually passes spontaneously. That's what a panic attack looks like. What remains is the fear that such a state may come back at any moment. And unfortunately, he often comes back! Panic is not a new discomfort, but it has never been suffered by so many people. For now, however, only about 25% of people suffering from ill people seek help from a psychiatrist or psychologist. Usually only when they are already on the verge of mental and physical exhaustion. Meanwhile, this disease, not allowing people to function normally, in the US is compared to depression and alcoholism and will soon be the most common disease of civilization (according to the American National Institute of Mental Health is a disease of the 21st century, and perhaps soon becomes the bane of highly developed societies and may affect the tenth part their population). Data for the study of English-language epidemiological studies from 1980-2004, which clearly showed not only that anxiety disorders are common, but also that they involve a number of other abnormalities, and thus have a significant impact on overall morbidity. The overall incidence of anxiety and panic disorder throughout the year and throughout life is 10.6% for women and 16.6% for men respectively. The risk group includes people in a wide age range of 18-64 years. Differences between individual populations in the incidence of anxiety disorders are observed, although they concern particular types of disorders rather than their total number. It is considered that: 25-30% of primary care patients suffer from anxiety or depression or both. Over one-third of these disorders remain unrecognized during the first contacts with doctors. 10-12% of the general population suffer from anxiety disorders with a somatic manifestation: panic attacks or a disorder resembling somatic diseases. Such patients are seven times more likely to use medical services (compared to the general population). Panic disorder is a common form of neurosis that affects approximately 2.5-10% of the general population throughout life. Two forms of panic disorder are codified in American psychiatry: with agoraphobia or without agoraphobia. In the case of panic disorder with agoraphobia, the patient avoids or tolerates with considerable suffering places or situations where escape may be difficult or embarrassing, or where during a panic attack help will be unavailable (crowded streets, shops, enclosed spaces such as tunnels, bridges and elevators or closed vehicles such as metro, buses or airplanes). The level of avoidance of phobias can be very different, from mild to serious, condemning the patient to a life full of many restrictions, with the need to take measures to eliminate the fear of space before leaving the house. This is sometimes called an "inner prison". According to the findings of the Congress on anxiety disorder and panic disorder from 1995, the frequency of their occurrence in some somatic ailments is: In cases of chest pains (negative results of somatic examinations) - 33-43%. In the irritable bowel syndrome - 29-38%. In those complaining of dizziness (without a clear organic cause) - 13%. In the case of complaints about migraine headaches - 6.5%.

    

Anxiety; Author - MD, psychiatrist Janusz Krzyżowski; Edition: Medic. 2005

 

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Doctor of Medicine Janusz Krzyżowski
Psychiatrist
Private office tel. 22 833 18 68
00-774Warszawa, Dolna 4 lok. 15

 

  These disorders are characterized by spontaneous appearance of short-term seizures (about 10 minutes) of periods of intense fear, anxiety and discomfort. Symptoms include a variety of physiological and cognitive symptoms of anxiety that may be accompanied by behavioral disorders. During panic disorder, attacks are recurring and unexpected, followed by at least one month of constant fear of another panic attack (anxiety of anticipation), anxiety about its possible consequences or consequences or significant changes in behavior associated with attacks. These attacks should not suggest panic disorder, and must be distinguished from other disorders that may be associated with anxiety or similar clinical features, such as: classic depression, phobia, obsessive-compulsive disorder, post-traumatic stress disorder. Panic attack course: The beginning of anxiety | Concerns about your own health, concerns about heart attack or stroke | hyperventilation | No carbon dioxide Deregulation No oxygen sympathetic in the brain nervous system | | Fast heartbeat Feeling faint Potentiation of the drug | Panic attack   A slight hyperventilation only leads to a slight tingling sensation in the extremities, especially to the fingers. Strong and prolonged hyperventilation can lead to more serious consequences, even to convulsions. A panic attack leads to acceleration and deepening of the breath. The body is supplied with too much oxygen, and too much carbon dioxide is excreted, and then the blood binds the calcium ions contained in it. This one is necessary for the proper functioning of nerves and muscles. Its deficiency causes muscle cramps and tingling nerves in the arms and legs. Calcium deficiency causes the smooth muscles of the bronchi to clench, and this gives the sensation of dyspnea. Dyspnea intensifies anxiety, and this hyperventilation closes with a vicious circle. Significant deficiencies in free calcium and too much oxygen in the blood can even cause full body convulsions. The characteristics of hyperventilation are: The patient breathes very quickly Breaths are usually deep The patient feels a tingling in the fingers and toes The patient's hands are contorted inwards and the fingers are joined together The lips resemble the round shape of a fish that breathes in the air The patient is in anxious state, suffers from shortness of breath   Usually, patients in a state of intense anxiety are trying to find the nearest hospital sooner or later in the emergency room or the emergency room. And here is how one of my patients describes a panic attack: I have suffered from depression for several months. That day, however, I felt good enough that I decided to go with my husband to go shopping to the supermarket. So we came and left the car in the underground parking lot and went to the store. I felt a little strange in the shop room. There were a lot of people and I got used to this loneliness by this disease. I tried, however, not to pay attention to my mood and calmly choose products. The nightmare had just started queuing up. It was quite long. I remember that by setting myself in it, I thought: how good that I am not afraid anymore. And almost immediately in my mind the question arose: Am I not afraid for sure? I looked around me and suddenly it seemed to me that everything that surrounds me - objects and people - are moving away from me and become something unreal. I feel numb and start to tremble, not enough - my hands become hot and wet with sweat. The legs bend and each of them weighs perhaps a ton - I can barely move them. For this I have trouble breathing - I breathe faster and - paradoxically - I feel that I am losing that breath. It starts to spin in my head. All panicked - I will fall soon - I try to loosen the scarf, but I have quite numb fingers and I can not do it. I am so shaky on my husband's shoulder, I close my eyes and I am afraid that something terrible will happen in a moment. I will probably fall soon and lose consciousness or die of a heart attack or some shortness of breath. I'm shaking like a jelly. Perhaps a doctor would be useful? But where to get it from here in the store? My husband sees that something is happening to me and tries to calm me down, but his arguments do not speak to me. It seems to me that in this nightmarish queue I stand an eternity, but I could not read the time from the watch. I do not have the strength to pack my bags in my bag. I stand on the counter, which I have behind me, panicked and terrified. Only when we leave the queue with my husband, I slowly begin to regain a sense of reality and I realize that this entire nightmare lasted no longer than 8-10 minutes. . Doctor of Medicine Janusz Krzyżowski
Psychiatrist
Private office tel. 22 833 18 68
00-774Warszawa, Dolna 4 lok. 15