Dealing with panic attacks

A panic attack is a feeling of sudden and intense anxiety which can also have physical symptoms like breathlessness, shaking, rapid irregular heartbeats, and feeling disoriented, among others.

Experts say the symptoms can make you feel like you are having a heart attack or going to collapse or even die.

According to the president of the Association of Psychiatrists in Nigeria (APN), Prof.  Taiwo James Obindo,  panic attacks are a form of mental illness in which an individual has episodic or repeated episodes of irrational excessive fears which are then accompanied by some physical symptoms like increased heartbeat, sweating, breathing and there is also an impending sense of doom or that something bad is about to happen, even though there is no obvious or tangible evidence to suggest that.

He said, “The person will feel as if he is going to die and if nothing is done he will be afraid. It could happen at any time and when it is recurrent or happening several times, we call them panic disorder or panic attacks.”

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Prof Obindo said while there is no established cause of panic attacks, there is some genetic predisposition to it. “If family members had it, there are chances the individual may have it. The closer the relationship of that person to the one that had it, the more likely he or she could have it.”

He said recent significant life events in the life of an individual such as loss of loved ones, loss of jobs, rape, near-death experiences, some economic or financial issues, as well as some social factors such as issues between husband and wife are predispositions for people to develop panic attacks later.

“But genetics play a major role. Women are more at risk than men. Because women tend to present more than men. Generally, it is a form of an anxiety disorder,” he added.

On prevention, the expert said  the major thing is for one to as much as possible have a balanced, good mental health  developed well along the way so that one’s resilience is well built , that challenges may come but one is able to overcome them.

He said, “Largely living well, living mentally right will be what will form the foundation and if it occurs, one is expected to seek help as soon as possible so that it doesn’t prolong because the longer it is before presentation the more difficult it is to treat .”

He said while there are no major triggers per se for panic attacks, overtime some people may associate it with a particular event or situation. “For instance over time someone may realise that when ‘I am in this situation or when this kind of thing happens, chances are that it will occur.’ And over time tends to avoid such situations or environment.

“Because for people who have it, the fear of it happening when nobody is around makes them want to stay where people are and make them cling to the presence of people.

“Some of them may even be afraid of going out because it may happen while they are outside.”

The psychiatrist said most times panic attacks just occur. “Some people  just wake up and it happens, some people may be on the road, in the vehicle, for instance someone who has had a very bad accident before they probably develop panic in the event of entering a vehicle.

“A wife could suffer it because her husband is traveling and she fears anything can happen when he is a way.”

He said treatment for panic attacks range from biological where you give medications and drugs, psychotherapy and social ones through manipulation of the social environment, and identify what is beneath or what is underpinning the attacks.

He said, “Psychotherapy possibly behavioural therapy where one is able to manipulate the source  and then making sure the person realises that well this is not sinister; this does not have medical background.

“For instance the person could be thinking am I going to have heart attack, stroke, and panic that well this is likely going to lead to death.”

He explained that some people have thyroid gland that is hyperproducing and can also cause increase heart rate, increased heartbeat.

So one of the things medical experts do is  to investigate and rule out such issues, through a  thyroid function test, electrocardiogram (ECG), general checkup, and  ECHO to check the heart, adding, “so long as those things are not there, that tends to be reassuring.”

He said, “The irrational thoughts also need to be organised for the person to realise that “even if I feel this way, it is not that I am going to die, Not that I have heart attack”. That will tend to reduce the feelings they have that could aggravate the symptoms. That is psychotherapy.

“There are also medications that can be given that could help them and the social environment if they are able to identify one or two things that are linked to it.

“Like the thoughts that your husband is going to take a second wife which may not be and even if the man is going to take a second wife the husband may be made to realise that this maybe one of the reasons why the wife is having this.

“So it is either they discuss it better or he puts on hold the idea of getting married to another wife. Or if there is no thought about that he may need to reassure the wife that ‘it is not going to happen; you are my only wife’, so the social environment can also be manipulated.”

Prof Obindo explained that this could take a long while but then the assurance that this is not sinister tends to help in that initial period.

On the difference between panic attacks, anxiety disorder and mental breakdown, he said a panic attack is a form of anxiety disorder, adding that panic attacks could actually lead to phobias too,  such as irrational fear of going out, and irrational fear of going into a vehicle among others.

He explained further that a mental breakdown is any mental illness in which the individual is not able to cope or function like he used to think or behave as he used to. He said this includes depression, anxiety disorder, schizophrenia and others.

He advised people to get help as soon as they suffer panic attacks. “If the panic attack happens once or twice, seek help. One of the questions sufferers ask is ‘Am I going mad? Or losing it.’ The major thing is that it is an illness and could be handled, so seek help. The fact that you are looking for a psychiatrist doesn’t make you mad. Those who have mental illnesses or psychological issues can be helped therefore they need to seek help as soon as possible so that the illness isn’t prolonged, and becomes chronic and difficult to treat or handle.”