Panic attacks in men: how they manifest themselves and how to treat them

Consequences of stress, How to cope with stress, For specialists, Fear, anxiety Irina Vasilyeva Anxiety, fear, panic may simply indicate psychological difficulties, or may be a sign of a disease. Excessive anxiety is exhausting. And it is quite capable of leading to the appearance of phobias and panic attacks. As a rule, a person experiencing anxiety does not “sound the alarm” until the situation becomes critical. “Am I really hopeless?” he thinks, no longer hoping for treatment for anxiety, fear and attacks of horror. However, there is a solution.

Good afternoon, dear reader! More and more people are suffering from sudden attacks of anxiety, fear and panic. The symptoms of what is happening vary from person to person, but the all-consuming feeling of danger, hopelessness, and sometimes approaching death remains unchanged. This unpleasant state can seem endless, worry and anxiety grow exponentially and it seems that there is no escape.

However, salvation from these unpleasant symptoms is much closer than you think. It is stored within you. You just need to deal with him.

The more often a state of inexplicable anxiety occurs, the more a person fears its repetition. For example, if panic attacks occur at night, then the person begins to be afraid to sleep, and a fear of the dark develops.

What is a panic attack

Panic attacks are not such a rare occurrence. In every hundred people, one person experiences panic attacks regularly. Five out of a hundred have experienced such an attack at least once. Moreover, the peak of diseases occurs at a young age. According to statistics, this is a period from 25 to 35 years, although this can happen at any age - both with a child and with an elderly person. Most often women are affected by this disorder. Among the six patients, one man and five women were diagnosed with panic attacks.

A panic attack in women and men is a state of sudden, intense fear for which there is no external reason. Fear quickly builds up to a point of highest intensity, then goes away on its own. The duration of the attack is from ten minutes to half an hour, less often up to two hours. As a rule, an attack leaves behind a fear of its repetition.

Important! A panic attack is not life-threatening, although it may be accompanied by frightening physical symptoms (strong heartbeat, difficulty breathing, nausea, and others). They pass with the end of the attack. But it doesn’t get any easier psychologically, since the fear of a repeat attack continues to torment. This leads to their development again and again.

The mechanism of a panic attack is similar to the mobilization of the body when a real threat arises or when performing unusually heavy physical activity. The likelihood of repeating your first panic attack is high. If attacks begin to occur regularly, this is already called panic disorder. It can provoke the development of phobic disorders in a person and lead to a change in his personality.

Causes

The reason for the development of fear in case of physical illness is the patient’s fear of his own illness. At the initial stage, there is a feeling of depression and weakness, to which are added shortness of breath, pain in the chest and heart, accompanied by anxiety. Physical discomfort from symptoms is more pronounced than emotional discomfort.

Panic attacks can accompany diseases and conditions:

• cardiovascular system (angina pectoris, vegetative-vascular dystonia, heart attack);
• endocrine system;
• the beginning of the menstrual cycle, sexual activity, pregnancy and childbirth;
• taking certain medications.

What Causes Panic Attacks

The causes of panic attacks in women are divided into general, independent of gender, and specific, determined by the physiological characteristics of the female body. Common causes of panic attacks:

1. The presence of a serious illness (for example, heart disease). The disease and the patient’s attitude towards it causes anxiety, which doctors call somatized. A depressed and broken state, instability of emotions can cause PA. But in such cases, she is emotionally impoverished, and vegetative manifestations come to the fore. Anxiety, although very strong, is weaker in intensity than physical symptoms.
2. Hereditary component. Research points to a genetic basis for PA: 20% of sufferers have close relatives with similar problems. If panic attacks are observed in one of the identical twins, then in every second case this condition also occurs in the second. A person’s psychotype and character are also largely genetically determined.
3. Hormonal imbalances in the body. Panic attacks and hormones in the female body are closely related. The hormone adrenaline plays a major role in the mechanism of formation and course of a panic attack. Its excessive release into the blood by the adrenal glands causes the appearance of signs of PA. With an adrenal tumor, the synthesis of hormones, including adrenaline, increases sharply. Its increased concentration in the blood generates excitement, fears, and anxiety. This condition can result in a panic attack. The hormone thyroxine, produced by the thyroid gland, also has a stimulating effect. When its functioning is disrupted (thyrotoxicosis), it is produced in excess, increases motor and mental activity, and provokes insomnia. Against the background of such increased arousal, an attack of panic, as well as rage and anger, may occur. This is explained by the fact that under the influence of thyroxine, tissues become more sensitive to adrenaline.
4. Pharmaceuticals. These include drugs that have the generation of increased anxiety as a side effect - anxiogens. These are medications that increase the secretion of an active anxiety stimulant in the body - the hormone cholecystokinin. Drugs related to steroids (anabolic steroids, anti-asthma drugs) can also cause panic attacks. Another drug, bemegride, used for anesthesia, the treatment of alcoholism, and in case of overdose of barbituric acid-based sleeping pills, causes stimulation of the central nervous system and can provoke an attack.
5. Psycho-emotional factors - depression, phobias, post-traumatic disorders, mental illness.

Specific causes of panic attacks in women include their increased emotionality, impressionability, tendency to worry about any reason, timidity compared to men, and suspiciousness. Against this background, stressful situations can be experienced more painfully, create anxiety, and lead to panic attacks.

But the main specific cause of panic attacks in women are hormones that determine the physiology of the female body. Women's hormonal levels are constantly changing, and in some periods of life there is a serious imbalance. Thus, complex hormonal changes associated with the menstrual cycle regularly occur. Significant changes in hormonal levels begin in the first weeks of pregnancy and continue throughout its entire period and after the birth of the child. Finally, significant hormonal changes occur during menopause, or menopause. The likelihood of panic attacks in women increases during periods of:

• puberty;
• beginning of sexual activity;
• pregnancy;
• childbirth;
• the first months after the birth of the child;
• menopause.

The most large-scale hormonal changes in the female body occur during pregnancy, as well as after the end of the reproductive period - during menopause. The rest of the time, starting from puberty, changes in hormonal levels, which often affect the psycho-emotional state, occur regularly throughout each month.

Seizures in pregnant women

A woman carrying a child experiences increased mental stress. She fears for the health of her unborn baby and worries about the upcoming birth. Thoughts about upcoming everyday and financial difficulties may also be added. All this can become the basis for panic attacks. Sometimes the anxious state continues after childbirth. Fear for the baby, especially if no one helps the young mother, makes her afraid of her own actions. She may panic that she will lose control of herself, go crazy and harm the baby.

Hormonal changes are different at each stage of pregnancy. Their main goal is to ensure normal conditions for the gestation and development of a child throughout all nine months and the safe birth of the baby. Therefore, in the early and late stages they are multidirectional. Such constantly occurring hormonal changes also affect the balance of hormones responsible for anxiety. An increase in their levels can cause a panic attack. If panic attacks recur, doctors usually prescribe gentle treatment. But in severe cases, serious therapy may be required.

The likelihood of PAs is especially high if a woman has already encountered them before pregnancy. Doctors do not consider panic attacks to be a contraindication to pregnancy. But it is still recommended to undergo a course of treatment and then have a child, since pregnancy can contribute to a deterioration of the mental state.

Menopause and panic attacks

Closer to the age of fifty, a woman’s body begins to undergo serious hormonal changes—a decrease in the level of female sex hormones and loss of reproductive function. The symptoms of menopause and signs of a panic attack in women are very similar. Increased heart rate, headache, fever, increased sweating and others. If these physical manifestations are not accompanied by an uncontrollable feeling of panic, and the symptoms disappear when taking hormone replacement therapy drugs prescribed by the gynecologist, there is no need to worry - the attacks will end. They are associated with menopause and are not panic attacks.

Approximately 15% of women experience true panic attacks during menopause. The risk group includes those suffering from migraines, cardiac and vascular pathologies, and thyroid diseases. This also includes women who have already suffered panic attacks. Alcohol consumption, lack of adequate sleep, stress, and physical overload are also factors that provoke panic attacks during this period of altered balance of sex hormones.

Physiological conditions

Some functional changes in the body, accompanied by hormonal changes, are perceived as stress. Therefore, the emergence of fears may be accompanied by depressive disorders. Puberty and the onset of sexual activity can cause a crisis, accompanied by various phobias. After childbirth, some women experience depression, accompanied by constant or periodic anxiety and persistent bad mood. The panic caused by these conditions has a strong emotional burden.

The cause of a vegetative crisis may be the use of certain medications used in psychiatry, neurology and intensive care. Such drugs include:

• steroid drugs;
• drugs that cause the synthesis of the hormone cholecystokinin, which regulates fear and anxiety;
• bemegride, used for anesthesia and causing hallucinations.

Symptoms of panic attacks

Symptoms of a panic attack in women can be mental and physical in nature. Psychiatric symptoms include:

• acute sense of fear, impending threat;
• fear of dying from a heart attack, stroke, going crazy;
• feeling of faintness;
• what is happening around ceases to be perceived as real;
• one’s own personality and actions are seen as if from the outside.

A woman may be fussy and run somewhere. Or she is overcome by stiffness and cannot move. The presence and severity of symptoms differ both among different clients and in different cases within the same woman. The strength of emotional manifestation is also individual.

The physical symptoms and signs of panic attacks in women can be a long list. Here are the most common:

• heart contractions become more frequent and stronger;
• blood pressure increases;
• there are breathing problems;
• has fever or chills;
• sweating increases;
• dizzy;
• limbs become numb and cold;
• salivation slows down;
• Nausea and vomiting, abdominal pain, and diarrhea may occur.

Many of these symptoms are subjective, felt only by the patient. For example, heart pain in the absence of cardiac pathology. The difference between them and true pathology is that they pass quickly and do not bother the woman in the period between PAs.

The common feature of all symptoms of a panic attack in women is their sudden onset. They are not preceded by signals in the form of headaches or poor health. Symptoms begin unexpectedly and their intensity increases very quickly. Everything is accompanied by unaccountable fear - the woman cannot explain who or what scared her.

There are a number of atypical panic attacks in which none of the symptoms mentioned above are present. Anxiety can only be expressed in slight emotional tension. Such attacks are called masked anxiety, since it is replaced by a temporary disruption of the functioning of certain organs:

• the woman does not see for some time;
• cannot talk;
• cannot walk normally;
• her voice disappears;
• she feels the twisting of her arms.

Such symptoms are typical in crowded places. They don't happen when a woman is left alone. Another name for this condition is hysterical neurosis.

Nocturnal panic attacks

Panic attacks at night are more common in strong-willed and responsible women who manage to completely control themselves during the day. Before an attack, it is often difficult to fall asleep due to anxiety. Anxiety increases, and against its background a panic attack develops. Or a feeling of wild fear awakens a woman, and in this state she has difficulty understanding what is happening.

The causes of panic attacks in women at night, their symptoms do not differ from those during the day. But many people notice that they are much stronger in intensity. Nocturnal PAs usually develop in the first half of the night, before natural light appears. Often a woman mistakes such attacks as a reaction to nightmares that she does not remember, and does not seek treatment.

If the attacks are repeated, the woman cannot get enough sleep. Well-being worsens, apathy appears, attention drops, and problems appear at work. It becomes scary to go to bed. Somatic diseases worsen, neuroses and depression develop.

How an attack develops

Signs of a panic attack appear suddenly and, at first glance, simultaneously. But in reality, the PA mechanism develops in stages:

1. Under the influence of sudden fear or stress factor, the adrenal glands activate the production of adrenaline, which is a stress hormone.
2. An increase in its concentration in the blood constricts blood vessels, causes an increase in the frequency of contractions of the heart muscle, and increased breathing. Blood pressure rises.
3. Inhaling and exhaling more frequently minimizes the concentration of carbon dioxide in the body. This increases anxiety.
4. Due to the removal of carbon dioxide, the acidity in the blood drops. This manifests itself in dizziness, numbness in the arms and legs.
5. Peripheral vessels in muscles, skin, and adipose tissue go into spasm, the body mobilizes blood to vital organs - the heart, the brain. Tissues that receive less blood receive less nutrition and begin to accumulate lactic acid. With its penetration into the bloodstream and an increase in its content in the blood, according to recent studies, the intensity of the symptoms of PA increases.

The physical symptoms that appear increase anxiety, and the circle closes: strong anxiety generates intense symptoms, which stimulate even greater fear.

This is interesting! The panic attack algorithm is based on the natural mechanism of mobilization of organs and systems of the human body when faced with real danger. It increases the release of adrenaline so that under its action the vital systems receive more blood and oxygen, work more intensely and allow the person to resist the threat or escape.

First aid during an attack

It is advisable for an involuntary witness to a panic attack to understand how to act correctly so as not to aggravate the symptoms. First of all, it is important to hide your own excitement, even if watching a woman experience an attack causes severe anxiety. You need to calmly and confidently convince her that the condition will pass without causing harm. You can take your hand and look into your eyes. It is advisable to ensure a flow of fresh air into the room.

It’s better not to say cliched phrases like “I know how you feel,” “It’ll all pass soon,” or “You’re strong, you can handle it.” These phrases have the opposite effect, because the woman perceives her condition as unique, the sense of time during an attack is blurred, she feels weak and defenseless. The feeling that she is not understood and not sympathized with will only increase anxiety and make the attack more intense.

Under the influence of the fear that accompanies PA, muscles may tense and tension may arise in the body. Rubbing or massaging the neck, shoulders, ears, little fingers, and thumbs at the base will help to relax them. Measuring blood pressure and pulse rate, although not very informative for making a diagnosis, can tell you whether it is worth taking the medicine. For example, if your blood pressure is high, you can take an Anaprilin tablet. If your heart pain is very severe, you need to take aspirin and call an ambulance.

If a panic attack occurs when no one is around, you can help yourself. First of all, you need to bring your breathing to a normal rhythm. With PA, a person’s inhalation is delayed. It is important to quickly switch to slow belly breathing. To control the process, you need to place your hands on it, one above the other. Inhale for three slow counts, inflating your stomach. Hold the air for two counts, then exhale deeply for five counts. Repeat ten to fifteen times.

To cope with hyperventilation (intensive breathing), which increases the supply of oxygen to the lungs and reduces the content of carbon dioxide, you need to increase the supply of the latter. For this purpose, they usually breathe into a paper bag or, in the absence of one, into palms tightly folded into a hemisphere. You need to press the bag or hands tightly to your mouth so that air from outside cannot enter, and slowly inhale and exhale until the condition returns to normal.

Distraction techniques help relieve an attack faster. You can start counting objects, such as trees, cars around or outside the window. Punctuation marks in the text. It is useful to concentrate on everyday details, for example, start planning for tomorrow or remember in detail the recipe for preparing a complex dish. While at home, you can do routine work - iron clothes, wipe off dust, cook something. Reading poetry out loud and singing songs helps. You can turn it on and start watching a comedy film.

By the way, forcing a smile on your face helps a lot. Facial expressions are closely connected to the brain, and depicting a positive emotion will force it to appear. Physical influence will help to distract attention from worries - a strong pinch, a prick with a sterile needle, even a slap in the face.

The most important thing during a panic attack is to find the strength in yourself to feel confident that there is no mortal danger, the panic will soon pass, the body will endure and begin to recover.

Treatment and prevention

To successfully treat outbursts of fear, you must follow the simplest rules.

The principle is to remain calm when an attack approaches; you should remember that you cannot engage in psychological manipulation.

Despite all the terrible symptoms, no one has yet lost their life from a vegetative crisis. If during an attack you do not take any hasty actions, but simply take a horizontal position, then in no more than an hour the panic will subside. If you feel an alarming state approaching, you must:

• take a contrast shower or rinse with cold water;
• drink a cup of warm sweetened water;
• take a comfortable lying position;
• try to breathe calmly into a bag or jar, inhaling and exhaling deeply;
• transfer attention from internal sensations to a third-party object, try to think about pleasant things, do crossword puzzles;
• Constantly recite any prayer by heart.

When an attack occurs, taking medications will not bring effective results, unless we are talking about mental pathologies. The use of sedatives only shortens the duration of the attack (validol, corvalol). Medicinal herbs and their sedative tinctures (valerian, peony, motherwort, hawthorn) will not relieve the crisis due to their weak tranquilizing effect. They can only be used in complex treatment with psychotropic drugs.

Diagnosis of pathology

Considering the similarity of the symptoms of acute anxiety attacks and many serious diseases, even an experienced doctor does not immediately clearly diagnose a panic attack. A detailed examination is necessary to exclude pathologies of the heart and blood vessels, brain tumors, bronchial asthma, internal bleeding, and mental illness.

If somatic disorders are not detected, the basis for confirming the diagnosis of panic attacks is their reoccurrence, spontaneity and unpredictable nature in the absence of a real threat to the patient. One or more symptoms characteristic of PA must be present. The frequency of attacks varies among patients: for some they occur weekly, while for others they occur at intervals of several months.

The criterion for making a diagnosis is also the state between attacks. In case of somatic diseases accompanied by attacks of acute anxiety (thyrotoxicosis, stroke), the anxious state does not persist after the end of the panic attack. But with panic disorder and between attacks, a state of fear and anticipation of repetition, fear of the place in which the panic attack occurred, or the situation, obsessive thoughts, anxiety about the future, depressive and hysterical manifestations are observed.

To make a correct diagnosis, the Spielberg scale is used, which determines the level of anxiety, and tests that help identify fears. The doctor also takes into account the patient’s medical history, stress and life changes.

Mental illness

In mental disorders, symptoms of anxiety are clearly emotionally charged. A person is consumed by causeless and pointless horror, paralyzing or overstimulating him. Mental pathology includes:

• phobias;
• depression;
• post-traumatic stress disorder.

Phobias and panic attacks have both similar and different symptoms. Both are caused by stress, but phobias are accompanied by fear of something (claustrophobia, agoraphobia, arachnophobia, etc.), and a panic attack is usually not justified. Phobias are the result of periodically recurring panic attacks.

Anxiety in depression is accompanied by a premonition of an impending catastrophe, fear of death, suffocation and tightness in the chest. It can be triggered by stress and emotional overload, as well as by improper treatment. In their essence, attacks of fear are not dangerous, but with depression they can lead to suicide, so hospitalization is necessary.

In peacetime, post-traumatic stress and disorders are rare and develop as a result of injuries received as a result of road accidents, natural disasters, after severe burns, and industrial accidents. Panic attacks in this case are caused by thoughts about a possible repetition of this terrifying event. Over time, this experience takes the main place in the patient’s life, and crises turn into panic disorders.

Treatment of panic attacks

Panic attacks cannot be ignored. They require treatment because they tend to get worse: they occur more frequently and last longer. A woman susceptible to attacks, who fears a sudden attack, is often in a bad mood, depressed, withdrawn, and may begin to avoid people. Such emotions can lead to the development of depression.

Treatment of panic attacks in women begins when their causes in the form of serious somatic diseases have not been identified and the diagnosis of PA is confirmed. Complex treatment is considered more successful - a combination of medications and psychotherapeutic methods.

Drug therapy

Treatment with medications is to stop the attack and control its recurrence. Treatment is carried out with tranquilizers of the benzodiazepine group. Their advantage is the speed of impact. It takes no more than a quarter of an hour to achieve the effect. But they develop dependence, cause drowsiness and lethargy. Under their influence, it is difficult to concentrate attention, the speed of mental activity and movements suffers. It is not recommended to drive after taking this drug.

Some specialists prefer treatment with anxiolytics. They are prescribed both for stopping an attack and for long-term therapy. These drugs reduce the level of panic, have a sedative effect, and relax muscles.

If the patient has suicidal tendencies, tricyclic antidepressants are prescribed. They are taken for a long time, from six months to ten months. At the beginning of treatment, the dose is gradually increased, and after the decision to cancel is made, it is gradually reduced.

Less commonly, when vegetative symptoms dominate, the doctor may decide to prescribe MAO inhibitors. When taking them, foods that contain the substance tyramine - cheese, smoked meats, legumes, alcohol and some others - are excluded from the diet.

The most modern antidepressants are serotonin reuptake inhibitors. They have a high anti-panic effect and have few side effects. Their disadvantage is hyperstimulation of the nervous system during the first two-week period of use.

For cardiac pathology, beta blockers are often prescribed. By lowering heart rate and blood pressure, they also help relieve the effects of adrenaline.

If panic disorder is accompanied by depression, atypical antidepressants may help. They differ in their mechanisms of action and affect several neurotransmitters simultaneously.

Nootropic drugs are prescribed to those who are already being treated with antidepressants or tranquilizers. Under their influence, brain function, blood flow and metabolic processes in nerve tissues improve. They help increase stress resistance.

Psychotherapy

Many experts consider psychotherapy not just an integral part, but the basis for the treatment of panic attacks. There are many methods, the psychotherapist selects them according to the history and characteristics of the disease of a particular patient.

Cognitive behavioral psychotherapy is most often used. The goal of psychotherapeutic sessions is to change the patient’s thinking and her attitude towards anxiety. The psychotherapist explains the mechanism of attacks, teaches how to control fear, helps to master muscle relaxation techniques, meditative practices, and breathing techniques.

Psychoanalysis is less popular because this treatment requires a long time. It is chosen when the background for panic attacks is unfavorable factors in the client’s life (conflicts in the family and at work, moving to another city, childhood mental trauma, etc.).

To get rid of panic attacks, hypnotic influence on the client is widely used. Classic hypnosis can help in a short time. Having put the patient into a hypnotic trance, the hypnologist instills special settings aimed at freeing her from panic attacks. But this method is suitable only for hypnotizable patients. It also requires high motivation and trust in the hypnologist, and no fear of the hypnosis procedure.

Ericksonian hypnosis is considered gentler and is suitable for a larger number of clients. The hypnologist does not give clear instructions, but helps the patient focus on her inner experiences. An introduction to trance also occurs, but she does not lose the ability to communicate with a specialist. This method helps resolve a woman's internal conflicts. The psychologist can also teach her self-hypnosis techniques, and she will continue to work on her anxiety on her own.

When using the method of body-oriented therapy, work is done with the patient’s bodily sensations. A relaxation technique is used through preliminary muscle tension, various breathing exercises, and other relaxation methods. The impact on the body reduces the client’s anxiety level.

There is also family therapy, when the psychologist works not only with the main client, but also with his relatives. Some psychotherapists use methods of neuro-linguistic programming, desensitization, and gestalt therapy.

You can get rid of panic attacks from a specialist in this field, psychologist-hypnologist Nikita Valerievich Baturin.

Analyze what we feel

First of all, feelings of oppression, disappointment, self-pity, and shame torment those people whose plans have collapsed. Of course: I was going to the sea (to the mountains, to an alumni meeting, to a premiere or presentation, or other significant cultural event), but an attack of panic at the mere thought of immersion in water (climbing up, going out into an open space, appearing in a crowd) crossed everything out. And now the “victim” is gnawed by regret about missed opportunities and envy of those who “didn’t miss anything”; he feels like an insignificance, a loser, and renounces planning anything at all in the future. It is also possible that he is not the only one blaming himself for the fact that relationships with friends, his beloved, employer or business partners have been damaged. After all, it is impossible for them, “normal people,” to explain what really happened to him. And if the “panicker” begins to look for rational excuses, to explain to them why he “couldn’t” come and what he was doing, his conscience also torments him, because lying is always unpleasant (especially against the background of panic attacks, when everything is aggravated to the limit, and first of all, everything negative is acutely experienced).