Panic attacks: features of seizures, methods of overcoming and treatment.

The article discusses panic attacks: features of seizures, methods of overcoming and treatment. The questions concerning the features of treatment and coping with panic attacks are disclosed, and some features of panic attacks with an unexpressed emotional component are described. Let's start with questions about the duration and regularity of seizures. Frequency and duration of seizures These two characteristics are very critical for the choice of both individual coping methods and treatment methods. In most cases, the attack lasts no more than half an hour, but due to its emotional saturation, it may in principle not cause psychological discomfort, accompanied only by somatic symptoms. Speaking of statistics, most of those faced with this problem complain of 2-4 attacks per month. The choice of a specific method of coping with seizures is related to these characteristics, namely: the more frequent and longer individual seizures are, the more the treatment is "saturated" with medications. Irregular, spontaneous, short and emotionally intense seizures, for the most part, require successful overcoming of psychotherapy and mastering relaxation techniques and breath control. Frequent, prolonged and also emotional attacks will require more medication and, probably, psychological examination in order to more accurately determine the causes of the development of these conditions. Important! Many somatic diseases cause conditions similar to panic attacks, therefore, before seeking psychological help, a medical examination and examination of a person should be carried out. In particular, it is worth observing this rule if attacks are accompanied by an increase in somatic symptoms, but there is practically no emotional side to them — these are the cases most often found in the practice of doctors. Self-overcoming an attack Basically all methods of self-overcoming panic attacks are reduced to three categories: relaxation techniques; control over breathing (and body); methods of "grounding" (distraction). Methods of psychological self-regulation. The first is the technique of neuromuscular relaxation. To master it, it is recommended to undergo a special psychotherapeutic training (usually no more than 7 classes), or try to do it yourself. It is possible, but it will take more time. The essence of the technique is that a person exists simultaneously on the physiological and emotional levels, which are closely intertwined with each other. Strong emotional reactions affect the state of the body (although we may not notice it), and the state of the body affects our emotions. The idea is that a relaxed body is associated with calmness and tranquility, and a tense, constrained body is associated with stress, which is what a panic attack is. When teaching this method, the group members, under the guidance of a therapist, alternately and consistently strain and relax various muscle groups, observing their feelings. The warm relaxation that comes after a strong muscle contraction is accompanied by pleasant experiences, and it is this experience that is important for mastering the technique. During the training, the group members find in their body those muscle groups that are easy for them to control and gradually learn through them to relax the whole body, thereby controlling their condition. With persistent and successful training during panic attacks, it will be easy for a person to switch to the sensations from his body, relaxing it, thereby affecting the severity of the attack. This method will not remove the causes of panic attacks, but it can help reduce the time of the attack to an absolute minimum, and also help a person to survive attacks without harming the effectiveness of their current activities. Ideomotor training This method is also associated with sequential tension — relaxation of the muscles of the body, but in this case all the exercises (and the final binding to some area of the body) are done at the level of imagination. This is a more difficult to master, but no less effective method of overcoming a panic attack. Its advantages over neuromuscular relaxation are that it is not necessary to turn to an "external device" - the body. Sensory reproduction of images: This method of calming and relaxing is based on the representation of holistic situations that are associated with a sense of relaxation and relaxation in a person. For the most part, these are purely individual paintings, however, the development of the method is carried out according to specially prepared texts of sessions by a psychotherapist. With successful training, a person can independently create his own picture of a relaxing situation and successfully use it during seizures. The main associative moments within this method are: warmth — calmness; lightness — relaxation; coolness — cheerfulness. In normal situations, this method is not very good for coping with an attack, since it requires concentration and distraction from current activities, as well as time (at least half an hour). However, if a panic attack unfolds, for example, on an airplane, this is a great way to suppress it. Firstly, with the correct use of the method, a person goes through a full cycle of calm-relaxation-wakefulness. Secondly, the duration of the relaxation procedure leaves no room for residual phenomena after an attack (anxiety). Breathing practices : When faced with stressful situations, one of the first reactions of the body is an increase in heart rate and a decrease in depth, coupled with an acceleration of the breathing rhythm. Accordingly, breath control allows you to influence the emotional state during an attack. The first way is to slow down breathing with the transition to extremely deep inhalation and slow exhalation. At the same time, the type of breathing is important: it is advisable to switch to breathing with the diaphragm. A few workouts will help you quickly master this skill. Of course, during a severe panic attack, it is difficult to take control of breathing, but it is possible, and more importantly, this method also works as a distraction technique. The second variant of this method is breathing 4/4 or 6/6. Here it is also important to restore the rhythm of breathing, but here it is done under the clock count. Relatively speaking — the first four seconds there is a sigh to the limit, the second — an exhalation. Here it is extremely important to observe smoothness when performing exercises: the air should evenly exit all the time allotted for exhalation, and not be performed in the first second with subsequent "squeezing" of exhalation. And the most advanced method is the synchronization of pulse and breathing. It requires an effort to master this practice. To begin with, you can feel your pulse on the carotid artery. So, the task is to inhale for the first 4-6 heartbeats, and exhale for the second. This is important, because during a panic attack, the pulse jumps, but by equalizing the breathing along it, we can gradually reduce it afterwards. In its own way, it is an autogenic training. Panic attacks during pregnancy : During pregnancy, some women have a sharp jump in the number of seizures and their strength-duration. This is due to the fact that anxiety, which is fertile ground for a panic attack, is beginning to increase. This includes fears for your health, and fear for the fetus and long-forgotten fears. Unlike "normal" seizures, these require special attention. First, it is necessary to work on pre-empting attacks. To do this, it is recommended to perform simple breathing exercises or relaxation techniques daily — allocating from 5 to 30 minutes for this. Such relaxation training will help maintain optimal tone and reduce the likelihood of an attack. Secondly, it is not recommended to use strong sedatives and sedatives during or after an attack. This advice is purely medical in nature — it is far from clear how the fetus will react to the oppression of the nervous system. Also, to reduce the frequency and strength of seizures, some experts recommend spending more time on general physical activity — allocate time for walks, exercises for pregnant women and special gymnastics. Medications for panic attacks are important! The description of the drugs is not a call for use. Psychopharmacological agents are prescribed strictly after consultation with a specialist! Treatment is carried out in a short course (no more than 1 month), and maintenance therapy should not exceed 1 year. If there are pronounced side effects, the drug is replaced. To describe the drugs, their chemical names are used: paroxetine is a good individual tolerance, has a hypnotic and sedative effect, acts quickly and does not need third—party effect enhancers; sertalin reduces anxiety, has a moderate sedative effect, stimulates the central nervous system; fluoxetine is a potent anti—anxiety agent, can cause dependence, the dose should be reduced gradually; citalopram — requires long—term administration to achieve the effect (up to 4 weeks), however, it is easily tolerated and has undetected side effects; escitalopram is a specific remedy prescribed when panic attacks occur against the background of alcohol / drug withdrawal. Also, while taking these medications, general medications are used to prevent negative gastrointestinal effects and symptomatic medications. It is noted that the use of drugs alone for the treatment of panic attacks is ineffective, their reception should be accompanied by psychotherapeutic treatment. Attempts to treat panic attacks exclusively with pills lead to dependence on the drug and an increase in seizures when they are canceled. Psychotherapy : It does not make sense with attacks of organic origin. In mixed and purely psychological variants of panic attacks, it is effective. The main areas that have shown good results in the treatment of panic attacks of psychological origin are: gestalt therapy; psychoanalysis; existential analysis and logotherapy; emotional-image therapy; cognitive-behavioral therapy; hypnotic-suggestive therapy; body-oriented psychotherapy (perfectly complemented by body relaxation techniques); systemic family psychotherapy is effective for adolescents and children. Most of these directions work with the cause of this symptom, helping patients independently, in a safe environment for him, to resolve contradictions that were expressed in panic attacks. Panic attacks can develop against the background of depression and asthenic conditions, which, accordingly, require correction to relieve the symptom. Direct work with bouts of fear in these cases will not give results. Similar causes of seizures are typical for teenagers. Special attention is paid to the correction of panic attacks in hysterical disorders and accentuations. In such cases, a panic attack is often a welcome symptom that helps to achieve what you want. As an example: fear, headaches in a child who does not want to go to school. At the same time, such attacks are often accompanied by a pronounced somatic component, which quickly fades away as soon as the goal of manipulation is achieved. And finally, group classes among people suffering from attacks have shown their effectiveness. In such groups, there is a discussion of seizures, which often helps to achieve insight, which is the reason that the trigger of the attack. Accordingly, such an understanding helps a person to find ways to overcome negative states more effectively and independently.