Anxiety and Panic Attacks

Every one suffers from anxiety at one time or another, but for some people, it becomes an everyday event and anxiety rule their lives, for patients who have intense jobs it becomes very difficult because the anxiety does not allow them to perform their everyday functions at home or at work.



Anxiety Symptoms

Anxiety can be manifested with many symptoms, it is a sense of worry that something is going to happen you don’t know what but you can feel that something is going to go wrong and it’s a constant worrying that makes the individual feel uneasy and out of control. It is manifested in some patients by a knot in their stomach, tremors, shaking of the extremities, biting their fingernails, pulling on the hair, biting their lips and so on. All these symptoms are usually seen also in childhood, by this I mean that anxiety arises early in childhood.

If we take into consideration all the patients that suffer from anxiety and panic attacks the history will reflect that by early childhood they began to experience some of the symptoms that they are complaining about today, a child who pulls their hair or eyelashes, making odd looking faces, or having extremities tremors are secondary symptoms as a consequence of their stress or anxiety due to school social, or performance anxiety.   Whenever they have to come perform in class or in public such as sports activities, recitals, all this causes anxiety for them and if not treated, it carries on into adulthood.

Anxiety in adolescence sometimes can be manifested by an aggression because the individual is unable to control the anxiety so they compensate by becoming aggressive. Other times they tend to withdraw and isolate from the social events.

Medication and behavioral therapy are both helpful in successful treatment.

The difference between anxiety and panic attacks, patients with panic attacks experience the extreme of an anxiety crisis, and the analogy of a panic attack experience, is if one is in a room, and all of a sudden a lion comes into the room, at that moment, your heart rate starts going 120, 130 beats per minute, your mouth becomes dry, you might develop chest pressure pain, develop sweating of the palm of the hand, tremors, and fear.  These are classical symptoms of a panic attack, the patient feels that they are going to die, they get dizzy and the worst part is that there is no explanation why they are having these symptoms because there is no lion in the room.

As adults a lot of patients end up going to the emergency room, thinking that they are having a heart attack, and after expending lots of money on all types of work ups at the end of the six to eight hour period in the emergency room, they are told to go see a psychiatrist because they are suffering from Panic Disorder.

Patients experiencing Panic Disorder can suffer from episodes two or three or more times a day, or it can happen once or twice a week or one or twice a month without reason, the panic attack just shows up, the adrenaline starts pumping and then the patient reacts to it, it is very scary and uncomfortable, limiting the patient in their ability to function on a daily routine basis.

There are other symptoms of panic disorder, but the most classic are above described.

Panic Disorder can manifest with numb in their feet and they are unable to drive, or they become numb in their hands, and things fall off of their hands, visual perception can be impaired, people who are afraid of heights experience panic attacks, people who are afraid of the elevators can experience a panic attack even before they enter an elevator, and go through the same symptoms that I have explained above; other patients suffer panic attacks without any reason, and this is where psychotherapy is more helpful to discover the etiology of the Panic Disorder.

The treatment for this type of patients, both with Generalized Anxiety and Panic Disorder is usually with benzodiazepines, these are medications such as Ativan the generic is Lorazepam, Valium generic Diazepam, Xanax generic Alprazolam and Klonopin generic Clonazepam. Patients respond very well to the above named medications, and the dosage varies according to the degree of the illness; although these medications can be addictive, it is the job of the psychiatrist, with the cooperation of the patient, to minimize addiction versus treatment.  Additionally, antidepressants are also useful in the treatment of Generalized Anxiety; and are not habit forming.

Patients can also be affected at nighttime, people do not understand why they wake up in the middle of the night having a panic attack, and the reason is because when you dream you can have anxious dreams that are going to trigger the panic attacks.  Your body reacts physiologically to the anxiety triggered by the dream.

Other medications that are helpful for patients with panic attacks and anxiety, especially in those patients who have performance anxiety, are medications like Inderal.  Inderal generic Propranolol is a medication for high blood pressure, but it can also be used for the purpose to prevent panic attacks and anxiety.

Buspar is a non-benzodiazepine that is helpful in preventing panic attacks and anxiety

Antidepressant such as the SSRI’s like Lexapro, Prozac are also helpful in treating and preventing panic attacks and anxiety, however, once the patient is experiencing the attack, they will need medication that will act immediately, such as a benzodiazepine,

People are concerned about whether if these illnesses are inherited, in some cases, I think they are due  to genes and others are a result of the environment.

I hope to have clarified anxiety and panic attacks please make sure to sign up for our newsletter it is always a wonderful to share my experience with you, leave a comment if you liked this article or have any questions.