Panik Bozukluk Tedavisi

Panic Disorder Treatment

DDevelopmental Hypothesis:

Psychiatrist and Psychoanalyst John Bowlby developed a hypothesis. He takes the attention of instinctual motives while describing anxiety. The most instinct is addiction is attachment. Attachment and fear of loosing creates anxiety. Anxiety is a complex situation where fear exists within. (Kaya, 2010,110).

Prognostic: In panic disorder the prognostic of the sickness varies from patient to patients depending of patient’s adaptation to the treatment, choosing psychotherapy as well as the medicine and other supporting treatments. Panic disorders usually start during 16-25 but may start later. It is very rare panic disorders to start after 45 or during childhood. Panic disorder is repeatable and constant. (Kaplan ve Sadock 1995, 1998, 594-602). According to some researches, 25%-72&% of patients recover within the two years of the treatment, within five to ten years 10%-30% of the patents are fully recovered. (Altıntaş, 2006, s, 16). If there is agoraphobia with panic disorder since there are avoidance behaviour, the sickness takes longer and more severe. Although avoidance behaviours happen because of agoraphobia decreases treatment speed and panic attacks continue.

If there is depressions with panic attacks the sickness takes longer and with the anxiety; signs are more severe, more frequent phobic avoidances and more panic attacks happen. (Noyes, et al 1990, 809)

Panic attacks ruin the life quality. Patience face many negative emotions and behaviours. This unpleased situation ruins patients’ financial situation, work, family relations and once the life quality ruins patience’s social functions ruins.

Patients diagnosed with panic disorder have severe anxiety because of psychical symptoms. They live with having cerebral haemorrhage fear because of increasing blood pressure, they fear of being a cardiac patient, because of having hypertension although they are young, and they have the fear of dying suddenly because of a heart attack during panic attacks. Although after the treatment most of the patients recover later on tin life it is possible the disorder reoccurs. Some patients use medicine for the rest of their life.

Differential Diagnoses: Before the patients diagnosed with panic disorders differential diagnoses needs to be done. Recent researches shows that some patients have panic attacks because of physical symptoms. (Kök- nel, 2004, s, 154).

Panic disorder sometimes mistaken with below physical and mental sicknesses

Physical Disorders Differential Diagnosis: • Withdrawal syndrome (alcohol, benzodiazepines, barbiturates) • Entoksikasyon (alkol, benzodiazepin, amfetamin, kafein,kokain) • Menopoz • Anemi Endokrin hastalıklar: • Hipertiroidi • Hipoglisemi • Feokromositoma • Hipoparatiroidi • Cushing hastalığı

ÇEVİR

Heart disease: •Paroxysmal supraventricular tachycardia •Angina pectoris •Mitral valve prolapse

Breast disorders: • Bronchial asthma • Pulmonary embolism • Cchronic obstructive pulmonary disease

Neurological diseases: •Transient ischemic attack •Complex-partial seizures •Migraine

Psychiatric disorders that may cause a panic attack: 1.Depression 2.Agoraphobia 3.Common anxiety disorder 4.Obsessive Compulsive Disorder 5.Social phobia 6.Alcohol and substance use disorders 7.Post-traumatic stress disorder 8. Manic depressive (bipolar disorder) 9.Some schizophrenic disorders 10.Somatoform disorder 11.Hipokodriasis (hypochondria)

Panic Disorder Treatment

Patients diagnosed panic disorder ruins the life quality of the patients with physical symptoms of panic attacks, agoraphobia (avoidance behaviour) and this becomes intolerable anxiety.

Today panic disorder is a physiological sickness with which is easily treatable

Panic disorder is a psychiatric disorder that can be treated very easily today. This form of treatment is continued until a specialist physician follow-up and provided with the necessary relief for patients with patient ‘s compliance with treatment. The following describes methods used in the treatment of panic disorder:

Drug treatment: with the panic disorder drug treatment for anxiety and attacks medicine, agoraphobia (avoiding conception), depression obsessive-compulsive neurosis psychotropic drugs can be used. These drugs affect the central nervous system; the correct behaviour deteriorated due to illness and the person’s functionality corrects harmony with the outside world. With these drugs behaviours and skills are rearrange but new behaviours and skills cannot be obtained.

Antidepressants: Patience with panic disorder uses antidepressant medicines. Antidepressants are used for other psychiatric for years. This group of medicine is used with panic disorders with trust. Even there are depression symptoms or not ,in order to cure the panic and anxiety these medicines helps to achieve the desired treatment. (Köroğlu, 2006, 117).

Antianxiety Drugs: benzodiazepine type of medicines prescribed as antianxiety treatment with anxiety treatment. In Turkey; Alprazolam (Xanax), Diazepam (Diazem), clonazepam (Rivotril) ve Klonazpamin are most commonly used drugs. (Köroğlu, 2006, 120).

Other Drugs: The effectiveness of suplematary medicine is not proven are not because not enough researches are conducted to cure the panic attacks such as (karbama- zepin, valproat), beta blockers (propra- nolol, atenolol, pindolol), calsium channel blockers and buspiron. (APA 1998). For this reasons these medicines cannot be used as primary treatment. (Alkın, 2002i,26) These are usually supplementary medicine. Psychotherapy: Broad description to psychotherapy is changing and treating the emotions and behaviours with patience and doctor collaboration. Specialist can evaluate patience diagnoses and emotions; and psychoanalytic, cognitive, humanist psychochemical can be applied. It has been proven that for panic disorder and with other anxiety disorders (anxiety disorders) cognitive-behavioural treatments are effective. Also in panic disorders this approach helps together with medicine. Once psychotherapy is especially used with cognitive-behavioural as well as the medicine treatment the treatment of patients is shorter and the results are permanent.

The importance of psychotherapy in panic disorder can be described as this; imagine your brain is a computer and you need a keyboard to use the computer. Computer does the order of the keyboard. Psychotherapy reminds the importance of panic button to the patient and tells the importance of this button to the patients. Positive thoughts trigger the negative thoughts, negative thoughts and emotions reveals the somatic symptoms. This will end up with panic attacks. Psychotherapy aims to recover this negative thoughts, emotions and behaviours once the panic button is used. If you think your brain as computer psychotherapy resets the computer and aims to learn and apply the keys and the functions while treating the panic disorder medicine and psychotherapy device and be used in addition alternative treatments. Not all the treatments are right for each patient. Alternative treatments are (Kaya, 2010, 171-176): Acupuncture, EFT, TMS, yoga, meditation and NLP.

Diğer alternatif tedaviler: Panik bozukluk tedavisinde ilaç+psikoterapi harici bazı alternatif tedavilerde ek olarak uygulanmaktadır. Bu tedaviler bazen her hastaya uygun olmayabilir. Alternatif tedaviler şunlardır (Kaya, 2010; 171-176): Akapuntur, eft, tms, yoga-meditasyon, nlp.