What if it's not about the psyche?

Updated 2 years ago on April 08, 2023

There is an opinion that panic attacks are a very rare mental pathology, and many people have never heard of it at all. In fact, an attack has quite a few different forms, including "banal" depression and apathy. So how do you distinguish a true attack from the effects of other diseases? And what diseases are at risk for attacks?

12 signs of an attack

The fact that a panic attack is accompanied by a sudden attack of fear is probably known to everyone. However, few people know that this is not enough to make a diagnosis.

According to the accepted recommendations, the conclusion "panic attack" is valid only in the presence of at least 4 of the following signs.

1. Mental

  • fear of death,
  • fear of going crazy or losing control over behavior,
  • feeling of unreality and alienation from oneself (depersonalization).

2. Somatic (bodily)

  • pain, discomfort, feeling of tightness in the chest (as in angina pectoris and heart attack),
  • dizziness,
  • difficulty breathing, choking,
  • a feeling of fever or chills,
  • nausea, sometimes vomiting,
  • numbness, tingling, "running goosebumps,
  • rapid heartbeat (tachycardia),
  • increased sweating,
  • trembling and hand tremors.

At the same time, panic fear, as seemingly the main sign of an attack, may not be among the symptoms, but there is only a strong inner tension (anxiety).

Thus, the vegetative form of attacks is characterized by sudden dizziness, palpitations, sweating, and severe trembling in the body.

Ventilation - shortness of breath and muscle pain.

Affective - the lability of mood with predominance of depressive disorders (melancholy, unbearable weariness, apathy).

However, whatever form the attack may take, the patient remembers the situation which provoked its occurrence and subsequently panically avoids its repetition.

Similar conditions

A reliable mechanism for the development of attacks has not yet been disclosed. However, it is already known that such symptoms may also be present in a number of bodily diseases:

  • Thyrotoxicosis (extreme excess of thyroid hormones),
  • hypertensive crisis,
  • heart disease (arrhythmia, angina pectoris, heart attack),
  • asthma and other respiratory diseases accompanied by shortness of breath,
  • adrenal gland diseases (excess of stress hormones - cortisol, adrenaline).

Panic attacks can "lead" to: regular stress, lack of sleep, excessive mental and physical exertion.

The point here is an imbalance of calming (gamma-aminobutyric acid) and excitatory (glutamate) neurotransmitters in the brain, and the risk factor is the excessive action of some hormones (cortisol, adrenaline, T4), reduction of the amount of beneficial gut microflora and some other factors.

If symptoms similar to a panic attack occur, you should see a doctor immediately, and take the results of tests with you:

1. TTG + T4 and T3 free = to rule out thyroid abnormalities,

2. blood cortisol

3. Urinary catecholamines (adrenaline, noradrenaline, dopamine) = to rule out adrenal pathology.

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