A panic attack is a short period which is characterized by intense discomfort, anxiety or fear, which occurs suddenly and with physical and / or cognitive symptoms. A panic disorder refers to the repeated occurrence of panic attacks and is typically associated with fears that these attacks could repeat, or changes in behavior to avoid situations where panic attacks might occur. The diagnosis is made clinically. Isolated panic attacks may not necessarily be treated. Panic disorder is treated with drugs and / or psychotherapy (z. B. exposure treatment, cognitive behavioral therapy).
Panic attacks are common; the 1-year prevalence of about 11%. For most sufferers of panic attacks stop without treatment; in some, a panic disorder develops.
A panic attack is a short period which is characterized by intense discomfort, anxiety or fear, which occurs suddenly and with physical and / or cognitive symptoms. A panic disorder refers to the repeated occurrence of panic attacks and is typically associated with fears that these attacks could repeat, or changes in behavior to avoid situations where panic attacks might occur. The diagnosis is made clinically. Isolated panic attacks may not necessarily be treated. Panic disorder is treated with drugs and / or psychotherapy (z. B. exposure treatment, cognitive behavioral therapy). Panic attacks are common; the 1-year prevalence of about 11%. For most sufferers of panic attacks stop without treatment; in some, a panic disorder develops. The pure panic disorder is rare with a 1-year prevalence of 2-3%. Panic disorder usually begins in late youth or early adulthood and affects women two times more than men. Symptoms and signs A panic attack involves the sudden onset of intense fear or discomfort accompanied by at least four of the symptoms listed in symptoms of a panic attack. 13 The symptoms usually reach within 10 minutes peaked and then resolve within minutes, so the doctor can determine very little. Although-sometimes panic attacks may be extreme discomfort, but they are not dangerous from a medical standpoint. Symptoms of a panic attack Cognitive afraid of dying Fear of going crazy or losing control feelings of unreality, strangeness (derealization) or detachment from oneself (depersonalization) Somatic pain or discomfort in the chest dizziness, mood swings or weakness choking fever or chills nausea or abdominal pain numbness or tingling palpitations or accelerated heart rate Emfindung of shortness of breath or smothering sweating trembling or swaying Panic attacks can occur in any anxiety disorder, usually they are bonded to the core elements of the disorder (eg. B.) a Schlangenphobiker suffer a panic attack when he sees a snake. Such panic attacks called expected. Unexpected panic attacks are those that occur spontaneously, for no apparent trigger. Most people with panic disorder await with concern the next panic attack (anticipatory anxiety) and avoid places or situations where they had previously suffered a panic attack. People with panic disorder often fear of suffering from a dangerous heart, lung or brain disease, and seek repeated the family doctor or to the emergency room assistance. Unfortunately you but right here frequently focuses on the general physical symptoms and proper diagnosis is sometimes not provided. Many sufferers simultaneously have the symptoms of major depression. Diagnosis Clinical criteria The diagnosis of panic disorder occurs after exclusion of physical diseases that can mimic anxiety symptoms, and established using the in Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) diagnostic criteria. Patients must recurrent panic attacks have (frequency not specified), where ? 1 attack by one or both of the following for ? 1 month followed. Persistent worries to suffer a renewed panic attack or worrying about the consequences (for example, losing control, going crazy) Maladaptive behavioral response (to the panic attacks z. B. prevention of joint activities such as sports or social situations to try to prevent further attacks) treatment often antidepressants and / or benzodiazepines often non-pharmacological measures (such . as exposure treatment, cognitive behavioral therapy) some sufferers sounds the disorder without treatment, especially if they continue to situations where Panic attacks have occurred, ask. In others, v. a. untreated concerned takes the panic disorder a chronic fluctuating course. Patients should be informed that treatment usually helps to bring the symptoms under control. Has no avoidance behavior developed, it may be enough to calm the patient, to warn him of the fear and encourage him to continue to seek places and situations where panic attacks have occurred. If there is a panic disorder, however long and includes her frequent panic attacks and avoidance, drug therapy combined with intensive psychotherapy is probably necessary. Medicines Many medicines can prevent or substantially reduce the anticipatory anxiety that phobic avoidance behavior and the number and intensity of panic attacks. Antidepressants: The various classes of selective serotonin reuptake inhibitors (SSRIs), selective serotonin-norepinephrine reuptake inhibitor (SNRI), serotonin modulators, tricyclic antidepressants (TCAs) and monoamine oxidase inhibitors (MAOIs) -are of comparable effectiveness. However, SSRI and SNRI have the advantage of lower unwanted effects compared to other antidepressants. Benzodiazepines: These Anxiolytika-: while (see Table benzodiazepines) have a more rapid onset of action as antidepressants, but cause more likely to physical dependence and adverse effects such as somnolence, ataxia and memory impairment. In some patients, the long-term use of benzodiazepines is the only effective treatment. Antidepressants plus benzodiazepines: These drugs are sometimes used initially in combination; the benzodiazepine is then tapered slowly when the antidepressant takes effect (although some patients respond only to the combination treatment on). Panic attacks occur after discontinuation of the medication often again auf.Psychotherapie Various forms of psychotherapy are effective. The exposure treatment, in which patients face their fears, helps to reduce the fear and complications that are caused by the timid avoidance curb. For example, patients who are afraid to faint during a panic attack are encouraged to turn around or in a swivel chair so long to hyperventilate until they feel dizzy or faint, so they learn that they in a panic attack not will fall unconscious. In cognitive behavioral therapy, patients learn to recognize their distorted thought patterns and false beliefs and to control and to change their behavior so that it is adapted. Describe patient z. As the acceleration of their heart rate or shortness of breath in certain situations or at certain locations and have a heart attack, the fear, they are taught the following: unavoidable to understand these situations that their concerns are unfounded Instead, slow, controlled breathing or to respond other relaxation-promoting methods