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The crisis of anxiety: how to calm his anxieties? Symptoms causes and treatment

Definition of the anxiety attack

The anxiety attack or panic attack is one of the possible manifestations of anxiety disorders. It is a crisis of acute anxiety that appears suddenly and lasts a few minutes to a few hours. The person will feel an intense fear (of dying, becoming mad), a feeling of immediate danger and unpleasant physical sensations (palpitation, sweating, tremors, chest pain, etc.).

The physical symptoms that accompany the panic attack will be more or less spectacular and will fuel and aggravate the fear felt by the person who feels completely lost control .

Note: It would be wrong to say that breathing difficulties or tetany problems are always synonymous with an anxiety attack. Many diseases can cause this type of symptoms (asthma, for example), and it is important to consult your doctor in any case to get the correct diagnosis.

Causes of anxiety attack

The mechanisms of the anxiety attack are not very well known, but they make interact many biological, psychological, genetic and cardiorespiratory factors.

According to some theories, it would be an inappropriate or excessive reaction to stress.

Thus, different situations of fear and anguish (including that of no longer being able to breathe) can trigger hyperventilation , which can itself cause certain symptoms, especially dizziness, limb numbness, tremors and palpitations.

In turn, these symptoms aggravate fear and anxiety. It is therefore a vicious circle that is self-sustaining.

Finally, research has shown that the administration of certain substances (sodium lactate, nitrogen dioxide, etc.) acting on the regulation of certain neurotransmitters would trigger panic attacks.

In the psychoanalytic approach, the anxiety neurosis of which panic disorder is part, finds its origin in an accumulation of sexual arousal. The sexual drive would turn into nervous tension.

Associated disorders

In the context of panic disorder, we find mainly associated psychopathological disorders. However, it is difficult to know if it is the appearance of panic disorder that will cause these disorders or if the presence of these disorders will lead the person to develop a panic disorder.

According to some studies, the main psychological disorders associated with panic disorder are:

  • the Depression
  • social phobia (anxiety induced by social situations)
  • Generalized Anxiety Disorder (GAD)
  • the obsessive compulsive disorders (OCD)
  • post-traumatic stress disorder (trauma-induced anxiety)

Prevalence

It can be estimated that 21 out of 100 people will experience a panic attack at some point during their lifetime, while only 1 in 100 will develop panic disorder. Finally, panic attacks occur most often in young people (between the ages of 15 and 45) and are more common among women than men.

The people most affected by panic attacks are:

  • the  women  (they are 1.5 to 2 times more affected than men)
  • the  young  (between 15 and 20 years)
  • people with a family history of  panic disorder
  • people with an  anxious personality
  • people with depression and anxiety disorders
  • people with a history of sexual abuse  or  abuse

Evolution and possible complications

Anxiety and panic attacks are not serious as such, but they can be impressive, even traumatic, for the person with the disease and those around them.

Some people will develop what is called anticipatory anxiety, that is, between two panic attack attacks, they will live in fear of suffering a panic attack again. This fear of seeing the panic attack reappear anywhere, anytime can result in a significant drop in the person’s quality of life.

Some psychiatric disorders (agoraphobia, depression) may appear secondarily to the repetition of panic attacks. The fear of being invaded by a new attack in a public place without the possibility of being rescued may induce new fears such as the fear of going out, being in the presence of strangers or participating in various social or professional activities.

Finally, in some people, the frequency of seizures is very high (several per day), it is called panic disorder. The risk of depression, suicidal thoughts, suicidal acts, drug or alcohol abuse is increased with frequent panic attacks.

However, with proper care, it is possible to control this anxiety and reduce the frequency of seizures.

The opinion

As part of its quality approach, Passeportsanté.net invites you to discover the opinion of a health professional.

It is important to consult quickly if you are prone to panic attacks. Indeed, only the doctor will be able to make the difference between episodes of acute anxiety is a somatic pathology having a symptomatology quite close. Pharmacological treatment (antidepressants and anxiolytics) associated with psychotherapy help to get out of this vicious circle of anxiety. In today’s world, where stress is everywhere, our body tries to adapt and sometimes sends us distress signals. For some low back pain and for others panic attacks. These acute anxiety attacks are very physically and psychologically demanding. Do not hesitate to talk about it and to accompany you.

Céline Brodar, Clinical Psychologist Specializing in Neuropsychology 

Symptoms of the anxiety attack

The main symptoms of panic attack are psychic, physical and behavioral.

Often, the symptoms occur suddenly, reach a maximum intensity in a few minutes and last on average half an hour.

Physical disorders 

These disorders can vary from one person to another and from one panic attack to another. These unpleasant physical sensations will increase the anxiety and fears felt by the person creating a real vicious circle.

In all cases, you should consult your doctor who is the only one who can distinguish these disorders from a somatic condition (asthma, heart problems, etc.) that may include anxiety symptoms.

The main physical symptoms are:

  • heart palpitations
  • an increase in heart rate (tachycardia)
  • breathing difficulty with a feeling of suffocation
  • pain or discomfort in the chest
  • tremors or muscle twitches
  • discomfort, dizziness, vertigo
  • itches
  • blurred vision
  • whistling or ringing in the ears (tinnitus)
  • pain in the lower abdomen
  • nausea, vomiting, diarrhea
  • sweats, chills, hot flashes

Psychic disorders

Psychic disorders are dominated by catastrophic thoughts fed by the physical symptoms and the feeling of loss of control felt by the person. Among the most common fears accompanying the panic attack include:

  • the fear of choking
  • the fear of fainting
  • the fear of having a cardiac malaise
  • the fear of going crazy
  • the fear of dying

In order to fight against these fears, the person will adopt different behaviors . Some people will quickly run away from the place they are in, trying to hide the trying experience they are experiencing. Others will be ashamed, unable to move.

In the most severe forms of panic attack, people may have feelings of depersonalization and / or derealization .

Sequence of a crisis

The beginning of the crisis is often preceded by a period when the degree of anxiety increases gradually. Then comes the moment when the panic attack crisis reaches its peak and where the physical and psychic symptoms are the most intense. The crisis can last from a few minutes to a few hours (average duration 30 minutes ) during which the symptoms regress gradually, giving way to physical and mental fatigue.

The frequency of panic attacks ranges from only 1 or 2 in all lives to many a day and then fall into a panic disorder or generalized anxiety disorder (GAD).

Risk factors of anxiety attack

Several factors can trigger a panic attack. These vary greatly from person to person, and in many cases there is no clearly identified triggering factor, although several studies have shown the influence of traumatic events experienced in childhood, including in connection with separation anxiety (fear of separating from parents).

Among the factors frequently found are:

  • a context of relational difficulties (divorce, dismissal …)
  • bereavement or disease
  • the consumption of alcohol , cannabis or drugs (LSD, amphetamines …)
  • certain anxiety-provoking situations , such as public transport, the plane, the crowd …
  • taking or stopping certain drugs , especially certain antidepressants.

 

Prevent and calm an anxiety attack

Can we prevent?

There is no really effective way to prevent anxiety attacks , especially as they usually happen in an unpredictable way.

However, appropriate management, both pharmacological and non-pharmacological, can help to learn how to manage stress and prevent seizures from becoming too frequent or too disabling. It is therefore important to consult a doctor quickly to stop the vicious circle as soon as possible.

 

Basic preventive measures

To reduce the risk of anxiety attacks, the following measures, which are mainly common sense, are very useful:

– To follow his treatment well , and not to interrupt the drugs without medical advice;

– Avoid consuming exciting substances , alcohol or drugs that can trigger seizures;

– Learn how to manage stress to limit triggers or interrupt the crisis when it starts (relaxation, yoga, sports, meditation techniques …);

– Adopt a healthy lifestyle : good nutrition, regular physical activity, restful sleep …

– Find support from therapists (psychiatrist, psychologist) and associations of people with the same anxiety disorders, to feel less alone and to benefit from relevant advice.

It can be difficult to overcome  panic attacks , but there are effective treatments and therapies. It may be necessary to try several or combine them, but the vast majority of people manage to reduce or eliminate their  acute anxiety attacks  through these measures.

therapies

The effectiveness of psychotherapy for treating anxiety disorders is well established. It is even the preferred treatment in many cases, before having to resort to drugs.

To treat anxiety attacks, the therapy of choice is  cognitive and behavioral therapy , or CBT. However, it may be interesting to associate another type of psychotherapies (analytic therapy, systemic, etc.) to prevent the symptoms from moving to reappear in other forms.

In practice, CBT is usually performed on 10 to 25 sessions spaced a week, individually or in groups.

The therapy sessions are intended to inform the state of panic and  gradually change the “false beliefs” ,  misinterpretations  and  negative behaviors  associated with them, to replace them with more knowledge. rational and realistic.

Several techniques can teach you how to  stop seizures , and calm down when you feel anxiety rising. Simple exercises must be done from one week to the next in order to progress. It should be noted that CBT is useful for reducing symptoms, but its purpose is not to define the origin, the cause of the emergence of these panic attacks.

In other methods, assertiveness  can be effective in improving emotional control and developing new behaviors that are appropriate for responding to situations that are considered distressing.

The  analytic psychotherapy  (psychoanalysis) can be interesting when there are conflicting elements underlying related to psycho-emotional development of the individual.

pharmaceuticals

Among the pharmacological treatments, several classes of drugs have been proven to reduce the frequency of acute anxiety attacks.

The  antidepressants  are the treatment of choice, followed by  anxiolytics  (Xanax) which, however, have greater risk of addiction and side effects. The latter are therefore reserved for the treatment of the crisis, when it is prolonged and a treatment is necessary.

In France, the two types of antidepressants recommended  to treat panic disorders over the long term are:

  • selective serotonin reuptake inhibitors (SSRIs) whose principle is to increase the amount of serotonin in the synapses (junction between two neurons) by preventing the recapture of the latter. It is recommended in particular  paroxetine  (Deroxat / Paxil), the escitalopram  (Seroplex/ Lexapro) and  citalopram  (Seropram / Celexa)
  • tricyclic antidepressants such as  clomipramine  (Anafranil).

In some cases,  venlafaxine  (Effexor) may also be prescribed.

Antidepressant treatment is first prescribed for 12 weeks, then an assessment is made to decide whether to continue treatment or change it.

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