Panic attacks

1. Panic attacks

2. My personal story

3. Early events
• At that time I did not know yet about the existence of
panic attacks.
• I remember being asleep on the plane and then
suddenly waking up disoriented and grasping for air.
• On several other occasions I woke up form the sleep
feeling the lack of air.
• On one occasion I woke up panicked, screaming,
running from the bedroom to the hallway, desperately
wanting to turn on the light. I was very frightened,
panicked and it took me some time to calm down.

4. The first panic attack
• I was on a postdoc in France.
• Few days before the attack I started feeling chest
pain. I was afraid I was going to have a heart
attack.
• Then one day, on my way to work, my head
started spinning, I felt a strange feeling that I
could not describe. I felt I barely made it to work.
• I noticed my pulse was about 150 although I was
not running or anything.
• I felt very frightened.
• Later a doctor explained I was having a panic
attack. I felt relieved.

5. • I was afraid to experience the same thing, since I did not
understand what it was.
• I had spontaneous replicas in the following months.
• My heart rate would suddenly go up fo no apparent reason.
• I was squeezing my jaw until it hurt.
• I had difficulties concentrating.
• Immediately after panic attacks my brain went crazy with
hundreds of thoughts rushing thorough my head at the
same time.
• Sometimes I could not sleep.
• I felt fear all the time. Especially a fear of people. I could
not stand being close to them.
• Sometimes the first symptoms included dry mouth and a
perception where I felt separated from reality which
seemed as if I was watching a TV.
Subsequent attacks

6. Treatment
• A general physician treated me with some pills
which prevented attacks but not the cause.
• When I was back in my country of residence, I
experienced arrhythmia.
• A general doctor gave me some pills which turned
out to cause panic attack instead of preventing
them.
• I went to a psychiatric hospital, where they gave me
some opioid based medicine.
• Later I found a good psychiatrist who I am visiting
still after 5 years. He prescribed some pills that did
not knock me down and I engaged in a therapy.
• Panic attacks are no longer part of my life. I have
changed from a neurotic person, which I have been
for all my life, to a reasonably healthy individual.

7. About panic attacks

8. Symptoms
• Intense fear
• Palpitations
• Sweating
• Shaking
• Shortness of breath
• Chest pain
• Derealization
• Depersonalization
• Intrusive thoughts
• Dry mouth
• Dizziness

9. Causes
Predisposing factors
• Genetic
• Personality
• Lack of well-being
Biological causes
• Obsessive-compulsive disorder
• PTSD
• Hypoglycemia
• Hyperthyroidism
• Wilson's disease,
• Mitral valve prolapse
• Pheochromocytoma
• Inner ear disturbances
(labyrinthitis)
Other
• Short-term stress
• Accumulative stress
• Overcautious view of
the world
May result when up-regulation by the sympathetic nervous system (SNS) is n
Affected neurotransmitters: serotonin, GABA (gamma-aminobutyric acid), dop

10. Pathophysiology
1. Sudden onset of fear
2. Release of adrenalin
3. Fight or flight response
4. Increased heart rate, rapid breathing, shortness of breath, sweating
5. Drop in CO2 levels in blood and lungs.
6. Shift in blood pH (respiratory alkalosis)
7. Metabolic acidosis
8. Vasoconstriction
9. Less blood flow
10. Dizziness and lightheadedness

11. Treatment
• Lifestyle changes
• Less caffeine
• More aerobic exercise
• Breathing exercises
• Meditation
• Therapy
• Combination of cognitive and behavioral
therapies
• Medication

12. Epidemiology
• Europe
• 3 % of population
• United States of America
• 11 % of population

13. How did this course help me understand panic
• I learnt about parasympathetic and sympathetic
nervous systems.
• I learnt about neurotransmitters.
• I learnt about parts of the brain involved in
emotions.
• I could figure out where the commands that
caused the symptoms came from.
• I could understand panic attacks as I experienced
them to the functioning of different organs involved.