What are the causes of panic attacks? Diagnosis and treatment options

Updated 13 months ago on April 03, 2023

Panic attacks refer to anxiety disorders and are characterized by recurrent attacks of pronounced anxiety that are not limited to a specific situation or circumstance.

Symptoms most common during an attack include a "coma" in the throat, shortness of breath, palpitations, sweating, trembling, nausea, loss of voice, hearing and vision problems.

Varieties

  1. Vegetative panic attacks are accompanied by palpitations, increased sweating, dizziness, and shiver-like chills.
  2. Hyperventilation panic attacks - this type of attack is characterized by muscle pain, shortness of breath, and increased breathing.
  3. Phobic panic attacks are related to a specific situation or place.
  4. Conversion panic attacks are manifested by temporary loss of voice, discomfort in the left side of the chest, and may lead to preconsciousness. This type of panic disorder is not accompanied by feelings of anxiety or fear of death.
  5. Senestopathic panic attacks - cause feelings of numbness and "crawling goosebumps" over the body.
  6. Affective panic attacks are characterized by changes in mood with the prevalence of depressive disorders: melancholy, fatigue, feelings of exhaustion.
  7. Depersonalization-depersonalization panic attacks are accompanied by a feeling of unreality about oneself or the world around.

Causes of panic attacks

Panic attacks can be caused by stress, increased anxiety, depression, and general exhaustion of the body. Sometimes they can be caused by hormonal disorders, pathologies of the central nervous system and some somatic diseases. For example, cardiovascular diseases (arrhythmia, coronary heart disease, arterial hypertension), diseases of the respiratory system (chronic acute bronchitis, bronchial asthma), endocrine disorders (thyroid and parathyroid gland disease, diabetes, pheochromocytoma). It is also worth considering the relationship of the onset of seizures to the side effects of a number of drugs, narcotic substances, or alcohol abuse. A hereditary factor also plays a role.

What doctors do I go to?

In order to determine the cause of a panic attack, it is necessary to see a psychotherapist. If the somatic nature of panic attacks is suspected, the doctor may refer you to specialists such as a general practitioner, general practitioner, cardiologist, neurologist, pulmonologist, and endocrinologist to determine the cause of the panic disorder.

Diagnosis

A laboratory-instrumental examination is required to identify the physiological basis of panic attacks.

Assessment of cardiovascular function includes:

  1. Blood chemistry: lipid profile (total cholesterol, HDL, LDL, LDLNP, triglycerides, atherogenicity coefficient);
  1. External respiration function studies with determination of blood gas composition.

Often, panic attacks are the result of endocrine disorders, so it is recommended to evaluate the function of the thyroid and parathyroid glands by determining the level of free T3, free T4, thyrotropic, parathyroid hormones, antibodies to thyroid peroxidase and to thyroglobulin, and also, ultrasound examination.

In cases of arterial hypertension and ineffectiveness of its treatment (i.e. in the absence of the effect of drugs taken to reduce blood pressure) it is necessary to make a differential diagnosis with pheochromocytoma using an ultrasound examination of the adrenal glands,

measurement of methanephrine, normetanephrine, adrenaline, noradrenaline, and vanillylmindalic acid levels in urine and plasma.

Treatment

Panic attack therapy is prescribed by a doctor and conducted strictly under his supervision.

Conservative treatment of panic disorder unrelated to organic pathologies involves the following options:

I. Psychotherapy:

  • cognitive-behavioral psychotherapy is aimed at clarifying the nature of symptoms, correcting them and teaching people to cope with them independently;
  • short-term psychodynamic therapy helps to identify the source of a panic attack and realize that it is not life-threatening;
  • relaxation psychotherapy consists in teaching techniques for controlling breathing and muscle tension, which help to cope with anxiety;
  • Supportive psychotherapy is aimed at exploring the interpersonal problems that cause panic attacks;
  • group psychotherapy provides an opportunity to uncover and process internal psychological conflicts in order to achieve psychotherapeutic goals;
  • Gestalt therapy, as a method of practical psychology, helps to develop self-awareness and to create and strengthen a coherent image of the personality;
  • psychoanalytically oriented psychotherapy is a method of treatment in which the emphasis is on individual personal dynamics;
  • In family psychotherapy, the entire family is the object of intervention.

II. Psychopharmacotherapy is prescribed when indicated and is conducted under medical supervision. Depending on the cause of panic attacks and their severity, antidepressants, benzodiazepines, atypical antipsychotics, etc. may be prescribed.

III. Cyclic transcranial magnetic stimulation is a method of exposure to magnetic impulses of different frequency, which have a local stimulating effect on the neuronal activity of the brain.

What should I do if I have a panic attack?

  1. The first step is to see a doctor in time to diagnose and begin treatment in order to avoid increasing the frequency and severity of panic disorder symptoms.
  2. It is necessary to include in your daily routine regular physical activity, which reduces the manifestations of anxiety.
  3. Stop abusing alcohol and psychoactive substances.

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