Panik Bozukluk Belirtileri

Symptoms of Panic Symptoms of Panic Disorder

We can describe panic disorder in two ways:

13.Nausea or diarrhea, Physical Symptoms: 1.Heart palpitations, feeling of the heartbeat and heart beat reaching high numbers. 2.Feeling weight in the chest, 3.Shortness of breath, 4.Pressure and pain in the 14.Dryness in the mouth, 15.Feeling a punch in the throat, 16.Having unreal thoughts, 17.Inability to think clearly, 18.Feeling of being partially paralyzed chest 5.Feeling of suffocated, 6.Dizziness, feeling of falling down and imbalances in the Main Psychological symptom of panic disorder is dying as well as; body, 7.Blackout, 8.Hypertension, 9.High or low blood, especially hot flashes in ears and cheeks 10.Excessive body shake, 11.Feeling like something falling down to stomach 1.I am dying 2.I am having a heart attack 3.I am loosing my mind 4.I will loose my control 5.I will not breath and die 6.I am having a stroke 7.My blood pressure is so high, I will have cerebral ha12.Palms sweating, My Psychology, May 20/4 emorrhage 8.Counting the pules and panicking if its less than 60 or more than 80 in a minute, 9.Thinking of being a hypertension, blood pressure and cardiac patient.

Agoraphobia

Some researches indicate that agoraphobia happens together with panic attacks. But today psychiatry diagnoses criteria state that panic attacks can happen without agoraphobia. ring the panic attacks patients feels that there is no escape so avoid the places where they cannot get help. Patients with agoraphobia avoid situations such as; going to a shopping mall, metro, metro bus, bridges, ferry; stuck in the traffic, flights, long bus trips, going to a hair dresser, not going to hospitals, not getting blood pressure checks, cannot hang out at local bazaars or crowded streets. lerler.

Statistics show that psychological disorders are increasing. But way?

For some people agoraphobia is a mild situation such as they can only scare to have a panic attack during flights, and some of them avoid this situation. For some patients agoraphobia happen very stronglt that the person even cannot leave their home. Patients with panic disorder have a mixture of these situations. (Köroğlu, 2006; 15).

Patients with panic attack diagnoses, agoraphobia happens to 50% to 70%. According to a research conducted by DEPAM states that 65% of panic disorder patients have agoraphobia. (Kaya, 2010; 112).

DSM-IV Agoraphobia diagnosis criteria:

A.Feeling anxiety during unexpected or situational disposition or having symptoms similar to panic, avoiding places or situations where feeling not able to get help or hard to escape (or may cause anxiety). Being alone outside the house, being in a crowded place or waiting in a line, being on a bridge or in a bus, having a train or bus journey are acrophobia fears. B.Person avoids these situations in order not to have panic attack/panic like symptoms or put up with the situation or needs someone to accompany to them.

C.The anxiety or avoidance phobia, social phobia (e.g. Avoiding social situations because of shame), specific phobia (e.g. avoiding single situations like elevators), Obsessive Compulsive Disorder (e.g. avoiding dirt due obsession about contamination), posttraumatic stress disorder (e.g. avoiding a severe stressor associated with stimuli), or separation anxiety disorder (e.g. avoid being separated from home or relatives) cannot be explained with any other mental disorder.

Relations between panic attacks and agoraphobia

Many researches conducted in order to find out the relationship between panic disorder and agoraphobia. If agoraphobia accompanies the panic disorder the treatment is longer and harder. According to many reaches, panic attack patients without agoraphobia response time to the treatment are shorter. Agoraphobia is coming from the Greek word “agora”. May writers described agoraphobia as the fear of being outside.

Marks described agoraphobia as scared of being in crowded places. Considered agoraphobia is a phobic disorder occurring because of outside stimuli. (Marks, 1970; 538-553).

Clinical observations show that being away from the environment or people that ones used to or feel safe psychologically, comes with agoraphobia as well as being in common places. Honestly it is attention grabbing that, with agoraphobics in situations where going to a safe zone is not possible (e.g. home or familiar environment) tendency to fear

Marks described agoraphobia as scared of being in crowded places.

occurs. (Tükel, 2002; 2).” de, agorafobiklerin kolayca “güvenli bölgelere” (ev, alışık olunan çevre vb.) çekilmelerinin mümkün olmadığı durumlardan korkma eğilimleri dikkat çekicidir (Tükel, 2002; 2).”

Anticipation Anxiety

Patients taken to the hospitals after the first panic attacks are nervous and anxious. Patients are feared of having a new attack. This anxious waiting is called “anticipation anxiety” (Kalyoncu, 2011). Patients have intense fear because of the outcomes of a possible attack. Restlessness, anxiety, and a new panic fear because of the anticipation anxiety causes another panic attack risk. ( Tükel, 2012).

Anticipation anxiety had three elements:

1.Waiting anxiously for a new panic attack to come, intense negative thoughts

2.I will have another panic attack. I will be vulnerable

3.Because of the anxious anticipation patients focus on to physical symptoms.

The lifetime prevalence of panic disorder was found to be 0.7 to 2.0%. Panic disorder often begins between the ages of 18-25 but may start later. (T u kel, 1997 s, 12). In women panic attack happens 2 to 3 times more than men. (Kalyon¬cu, 2011 s, 94).

According to some reaches 18% of adult and adolescent patients with panic disorder starts to have panic attack symptoms before they are 10 years old (Gökler, 2005, 83-91). In a study conducted with samples from ten to seventeen years of age the prevalence of panic disorder it has emerged by 0.6% (Aysev ve Taner, 2007).

Comorbidity

Comorbid psychopathology and panic disorder are common with other psychiatric disorders. Other anxiety disorders; phobias and depression are seen more common in patients with panic disorder in the general population. (Aysev ve Taner 2007).

In panic disorder depression (50-65%), epidemic anxiety disorder (25%), social phobia (15-30%), specific phobia (1020%), obsessive-compulsive disorder (10-20%). The emergence of a sudden attack in the panic disorder, the lack of evidence for other diseases other psychiatric disorders from panic disorder. (Tural, 2012 s, 19).

Etiology Psychoanalytic Views

Psychoanalytic theory claims that panic attacks happen because of failed stimulus against a defence. Parental loss and separation anxiety experienced during childhood are stated in the emergence of agoraphobia. To be alone and abandonment anxiety in social life leads to the re-emergence of childhood anxiety. Once childhood separation anxiety reoccurs defence mechanisms such as suppression, relocation and avoidance will come into place again.

The separation anxiety experienced during childhood can affect the developing nervous system of children. During development of the nervous system is affected, in adulthood the person may predispose to anxiety. On ground neurophysiological, environmental factors and interactions may occur as a result of stress or panic attacks (Kaplan ve Sadock, 2004).

Biological Factors

In researches on the biological effects its been focused of panic disorder, the limbic system (it is stated to have impact on anticipation anxiety), brainstem (locus ceruleus noradrenergic neurons and medium serotonergic neurons of the raphe nucleus), prefrontal cortex (probably is responsibility for the emergence of phobic avoiding) (Kaplan and Sadock, 2004, 189-219). The results of this study showed that, in panic disorder, biological causes are extremely important.

Genetics

Several researches on panic disorder show that environmental conditions based by genetic predisposition and interactions with genetic predisposition. There are some researches conducted amongst the twins’ shows that panic attacks develop with genetic influences. (Tükel, 1997).

In a family study, three children out of four started to have panic attacks at certain ages. Two brothers had the panic attacks when they are eighteen. One of the brothers had panic disorder accompanied by agoraphobia, but the other brother panic disorder accompanied by without agoraphobia. The other brother had the panic attack later when he was 38. After evaluating their parents it was revealed that the mother had pandemic anxiety disorder. Even this brief family research shows the importance of genetic Panic disorders starts with sudden explosions. It’s a kind of disorder that the patient having anticipation disorder for coming attacks and acting agoraphobia (avoidance behaviour).

predisposition in panic attacks.

Theory of Learning

Learning is the result of the experience and information. Time to time wrong stimuli caused by negative learning (opposite to positive learning) causes panic attacks in patience with panic disorders. We come under the influence of negative thoughts and emotions that wrong stimulus caused by panic disorder.

Learned helplessness is a boundary against panic disorder treatments. According to researched Seligman conducted learned helplessness is a root cause of panic disorders, depression, phobias and obsessive-compulsive disorder (Köknel, 2007, 47). Learned helplessness in panic disorder causes the patient to have constant anxiety and fear. Patient might not aware of helplessness.

Cognitive Model

According to cognitive model, key to the panic disorder is a catastrophic scenario. After the first panic attack experienced, patients have cognitive distortions. According to Clark psychical indications that are interpreted as catastrophic (such as tachycardia interpreted as hear attack) causes panic attacks. (Tural, 2012).

Cognitive distortions in panic attacks create a vicious circle. This vicious circle makes patience more anxious and causes new panic attacks.

Early Life Situations

Some researches on panic attack show that loosing a parent, sexual harassment and rape physical abuse are influential during early life. One study shows that out 8% of patients experienced sexual and 12% of the patients experienced physical abuse. (Breier et al. 1985; 787-797).

Separation anxiety

It has been argued that separation anxiety during childhood is an important factor for panic disorder to develop. Some reaches show that patients experienced separation anxiety that diagnosed with panic disorder. (Aysev ve Taner, 2007).

DO YOU HAVE PANIC DISORDER?

Stressful Life Events

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Some reaches shows that patients diagnosed with panic attacks were in stressful environments before the disorder starts. This stressful situation causes the disorder to occur.

2/3 of these patients had a stressful situation six months before the panic attack starts. (Breier et al. 1985; 787-797).

According to researches these stressful life events such as loosing a close person(17%), problems a the work place(17%), breaking up with a loved one (14%) are the findings. (Tükel, 2014 s, 4). This negative stressful life events causes psychological and neurobiological ground panic disorders to develop. (Sevinçok ve Akoğlu, 2001; 215-227).

Existing problems, working hard or daily problems may trigger the panic attack in the patient. This is resulted as the avoidance from daily unpleasant situations. This avoidance is different than agoraphobia. This behaviors can be considered as avoiding to get hurt. (Onur vd. 2004; 215-227).

Genetic susceptibility and experiencing stressful situations patients diagnosed with panic disorder have anxiety, depression and somatization more. (Se¬vinçok ve Akoğlu, 2001; 215¬227).