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  • Vidyasagar Vangala

Panic Attacks

Panic attack is not a disorder, it's a cluster of symptoms manifested in many medical, psychological conditions. Associated with 4 or more of the following symptoms, an abrupt onset and surge of symptoms or intense fear. Included are: palpitations, sweating, trembling, short of breath, choking sensation, chest pain or discomfort, nausea, dizzy feeling, hot and cold chills, numbness or loss of sensation, feelings of unreality, fear of losing control over oneself, fear of dying. The onset of these symptoms is sudden and sometimes out of the blue, while individual is not expecting any danger.

Where as Panic Disorder is having a panic attack and followed by having either an intense worry of having another one, or avoiding certain situations and places with fear having another panic attack-for a month or more. Agoraphobia is having the panic disorder and either avoiding the closed places, open places, standing in lines, crowded places like supermarkets, not wanting to go out of the home etc. with fear of having another attack and worry that there wont be any help for them. There are many causes for being Panic: Medical-(hypoglycemia, pheochromocytoma, thyroid disease and more), psychological- (PTSD, Social Phobia, specific phobia, OCD and more ), drug use and withdrawals from drugs (alcohol, Benzodiazepines, illegal drug use), and many more. A good history and physical exam of the individual by a qualified doctor, laboratory tests and urine drug screen etc. while treating the Panic attacks as appropriate depending on the cause of the problem. In general a Benzodiazepine injection, will abort many of the panic symptoms, if they are related to psychological causes. Long term treatment include Cognitive Behavior Therapy, teaching relaxation technique, medication such as SSRI’s or SNRI’s may be useful. Long term use of Benzodiazepines need to be avoided as there is potential for addiction and side effects.

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