Topic Panic attack or something else

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Different kinds of anxiety

According to this summary of a recent University of Illinois study of brain activity, there are two distinct varieties of anxiety: "anxious apprehension (verbal rumination, worry) and anxious arousal (intense fear, panic, or both)." In brief, those exhibiting anxious apprehension (which maps to a diagnosis of Generalized Anxiety Disorder) show increased activity in the left brain, while those exhibiting anxious arousal (which maps more to panic disorder) show increased activity in the right brain. From the article:

The researchers used functional Magnetic Resonance Imaging (fMRI) to map the brain areas with heightened neural activity during a variety of psychological probes.

As the researchers had predicted, the anxious apprehension group exhibited enhanced left-brain activity and the anxious arousal group had heightened activity in the right brain. The anxious apprehension group showed increased activity in a region of the left inferior frontal lobe that is associated with speech production. The anxious arousal group had more activity in a region of the right-hemisphere inferior temporal lobe that is believed to be involved in tracking and responding to information signaling danger.

Other studies using electroencephalographic (EEG) methods had found that patients diagnosed with generalized anxiety disorder and obsessive-compulsive disorder had heightened activity in the left brain, whereas patients with panic disorder, panic symptoms or those subjected to high stress situations exhibited enhanced activity in the right hemisphere.

An easy way to control panic attacks

Panic attack is an episode of sudden feeling of intense fear reaching the peak within 10 minutes and lasting for a period of a few hours. Diagnostic and Statistical Manual of Mental Disorders, 4^th Edition-Text Revised (DSM-IV-TR) published by the American Psychiatric Association lists the following thirteen mental and physical symptoms of panic attacks:

1. Feeling heartbeats in accelerated rate (palpitation)
2.      Sweating
3.      Trembling or shaking 
4.      Sensations of  smothering or shortness of breath
5.      Feeling of choking
6.      Pain or discomfort in the chest
7.      Nausea or abdominal distress
8.      Feeling dizzy, unsteady, lightheaded, or faint
9.      Strange feelings of unreality (de-realization) or curious feeling of  being  detached from one’s self (depersonalization)
10.              Fear of losing control or going insane
11.               Fear of impending death
12.                Sensations of numbness or tingling (Paresthesias)



A Woman in panic

13.                Sensations of chills or hot flushes (also known as hot flashes)

Panic attack on seeing a spider

Even though the DSM-IV-TR lists only 13 symptoms I have seen cases of panic attacks with the history of sudden feelings of neck soreness, hearing whistles in the ear (tinnitus), headache, and uncontrollable screaming or crying

Triggers of panic attacks

Many situations can trigger episodes of abrupt fear. A healthy normal person might experience a panic attack when confronted with sudden extreme danger. When an individual with phobia of spiders sees a spider in the room he/she might experience panic attack. Many, who experience a panic attack, mostly for the first time, fear they are having a heart attack or a nervous breakdown.

Panic disorder

Experiencing a panic attack has been said to be one of the most intensely frightening, upsetting and uncomfortable experiences of a person's life and may take days to recover from. If an individual experiences panic attacks spontaneously, at frequent intervals without any trigger or when not confronted with sudden extreme danger, the condition is called panic disorder.

Sufferers of panic disorder often report a fear or sense of dying, "going crazy," or experiencing a heart attack or "flashing vision," feeling faint or nauseated, a numb sensation throughout the body, heavy breathing, or losing control of themselves. These feelings may provoke a strong urge to escape or flee the place where the attack began. This feeling is caused by the “flight response”. The natural instinct of every animal dictates to flee from the scene of danger and this response is triggered by the stress hormones produced by the adrenal glands.

Often, the onset of shortness of breath and chest pain is the predominant symptoms; the sufferer incorrectly appraises this as a sign or symptom of a heart attack. This can result in the person’s experiencing a panic attack seeking treatment in an emergency room.

Difference between panic attack and generalized anxiety 

Panic attacks are distinguished from other forms of anxiety by their intensity and their sudden, episodic nature. They are often experienced in conjunction with anxiety disorders and other psychological conditions, although panic attacks are not usually indicative of a mental disorder.

Predisposing factors, causes, and triggers

Panic disorder has been found to run in families, and this may mean that inheritance plays a strong role in determining who will get it. However, many people who have no family history of the disorder develop it. The onset of panic disorder usually occurs in early adulthood, although it may appear at any age. It occurs more frequently in women and often in people with above average intelligence. Various twin studies where one identical twin has an anxiety disorder have reported an incidence ranging from 31 to 88 percent of the other twin also having an anxiety disorder diagnosis. Environmental factors such as an “overly cautious view of the world expressed by parents and cumulative stress over time have been found to be correlated with panic attacks”. (The Anxiety and Phobia Workbook   4^th edition by Edmund J. Bourne) 

A common physiological cause of panic attack is lowering of blood glucose level, a condition known as hypoglycemia. This may occur frequently in patients suffering from diabetes mellitus due to excess medication or medication without ample food intake. A condition called hyperthyroidism also causes frequent panic attacks. Consumption of some stimulant drugs such as Ritalin (methylphenidate) may cause panic like symptoms. Some antidepressant drugs also cause panic attacks as side effect. I have seen many alcohol addicts who experience panic attacks on dry days.  

Some psychological disorders such as obsessive compulsive disorder, post traumatic  stress disorder, and phobias frequently cause panic attacks. Many physical illnesses such as Wilson’s disease,  prolapse of the mitral valve of the heart,  pheochromacytoma  and inner ear disturbance known as labyrinthitis   are associated with panic attacks. 

Significant personal loss, including an emotional attachment to a romantic partner, life transitions, significant life change, and stimulants like caffeine or nicotine can act as triggers for a panic attack.

According to American self-help author and psychologist Edmund J.Bourne  lack of assertiveness  is a contributing factor in the continuance of the panic disorder. A growing body of evidence supports the idea that those that suffer from panic attacks engage in a passive style of communication or interactions with others. This communication style, while polite and respectful, is also characteristically un-assertive. This un-assertive way of communicating seems to contribute to panic attacks.

How to get rid of panic attacks?

The American Psychological Association says: “most specialists agree that a combination of cognitive and behavioral therapies is the best treatment for panic disorder. Medication might also be appropriate in some cases". The first part of therapy is largely informational; many people are greatly helped by simply understanding exactly what panic disorder is, and how many others suffer from it. Many people who suffer from panic disorder are worried that their panic attacks mean they are 'going crazy' or that the panic might induce a heart attack. Cognitive restructuring helps people replace those thoughts with more realistic, positive ways of viewing the attacks.

An easy way to control panic attacks

Force yourself to breathe slowly while counting to 20. Try to breathe in and out with every two seconds while counting to twenty. These slow, even and deep breaths will most likely distract us while making the panic attack run its course and totally bringing the stress down in those vital first 20 seconds. Concentrating on breathing slowly, making sure that you don’t rush yourself with the counting, taking all the time to concentrate, will most definitely work in slowing our heartbeat down thus alleviating the stress caused by all the adrenaline forcing us to react. This works mostly because you are able to create a distraction that will force your body not to react too rapidly to the attack, your brain will force itself to concentrate on other things other than the anxiety that forces you to react to the stress the panic is creating. When you count and breathe slowly, you concentrate on regaining control to your reactions, rather than letting the panic attack have control over you.

This technique can be most helpful in our everyday lives, once mastered, as it can greatly help you control your reactions in panic inducing situations, thus making it a tool to control your physical reactions in preventing the stress to overwhelm you.

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On securely falling back into the pit

Slipping back into a depressive period when you’ve been so stable for a good few years is like receiving a letter to warn you of your fate and then descending into hell with a parachute. 

It’s gentle, expected, and eerie. You know this place, you recognise these feelings, and you’re not so scared and alone as you were before. 

If I wasn’t depressed, I’d be frustrated that I am, once again, depressed. I’d be angry and confused as to why I’ve found myself back being hopeless and helpless after doing so well for so long. But I’m depressed, so I’m not feeling that at all. I’m just looking at those feelings having a strop over the other side of room and thinking, “I can’t be arsed to feel that tbh, it’s too much effort and I just don’t care.”

Finally being back in the senseless pit after feeling its slow, frustrating, confusing, and irritable presence for some weeks is almost a relief. Is that wrong?

I expected this. My life for the first four months of this year was training for, and then running, a marathon. Have I mentioned, etc. I knew the abrupt change to my lifestyle after it was over would be tricky, if not tough. I knew I’d be moving flat immediately after (for a month - we have a long changeover which hasn’t actually been as much of a relief as we wanted) and I knew I’d be last-minute fundraising and preparing for the MoonWalk (15 miles through London at night) which is this Saturday, just three weeks after the London Marathon, because really why not. 

I also knew I’d be going on holiday to Salzburg with my mum between moving flats and doing the MoonWalk, and Riga with Ryan the weekend after our final move-in weekend, which is also his birthday. 

The above is all happening within the same month. I knew this. I know this. It is not a surprise, and nor is this location back to the pit. All of that is a lot for anyone to deal with, let alone a person who is a little fragile. 

I’d heard of the post-marathon blues. Feeling down after a marathon is totally normal and expected, but I didn’t really notice it. I didn’t have time to, I was busy. But my fitness level and diet changed immediately, and I know that what you put into your body, and what you do with your body, affects your mood, so maybe that could be a reason I’m back here at Flat 0, 3 Cries A Night Road, Boredom, DPR SSN. 

Or maybe it’s the fact that on top of everything above, I’ve had to cope with one cancer scare and one cancer diagnosis this week, a frustrating ex-landlady and even more frustrating companies who aren’t making this flat move any easier for us. 

I’m also on my period. Maybe it’s that. 

I could spend hours, days analysing why I feel like I’m living deep inside my body unable to communicate, use my senses, make much sense of what’s happening around me, or care. About anything. But there’s not much point. The point now is to deal with it and wait the bullshit out. I know it won’t last, I know things will get better. I know all this. There are a lot of things I know about my mental health now, and I'm grateful and privileged to know them. 

I know I’m in a depressive episode when:

• My anxiety behaviours are nowhere to be seen.
• Any attempt at self care is met with boredom and effort.
• I can’t concentrate/am clumsy/make constant mistakes.
• I don’t enjoy anything. I wasn't particularly enthralled about going on holiday.
• I cry at everything.
• I have a constant buzzing noise in my ears.
• My tongue feels numb.
• I can’t talk to anyone. I don’t know how. The connections in my brain are fucked.
• I see very little point in doing anything. 
• I sleep a lot. 
• I hear nothing on the outside but everything inside my body. Food digesting, skin cells growing.
• I just. Don’t. Care.

I know the things that will help me are:

• Constant communication from friends where:
• replies aren’t expected 
• how I’m feeling isn't mentioned
• stupid jokes are made
• random hairdresser-style nonsense is babbled 
• you RT my shit even if it's not funny 
• Food, whether I want it or not.
• Water, whether I want it or not.
• Hugs, but only if I want them. 
• Little verbal communication.
• Fresh air to try and kickstart my senses again. Even if it’s sticking my head out the window.
• Listening to good music. I listen to music way more when I'm like this. Send me good music.
• Just waiting it all out until the ladder appears for me to climb out the pit.

I’m still ok. I’m not in crisis, nor do I need serious support. I’m still stable. This experience of the pit is a very different one to the years I spent in it before. I’m still strong, important, and brave. I’m still incredibly aware of my sense of self; my mental health has just slipped between a gap in the fence. I’m a little fragile, a little unable, and just a little bit exhausted. 

I’m going to make myself comfy down here.

---

If you're struggling with your mental health and need support, you can visit:

• The Mix, if you're under 25. Call their free helpline on 0800 808 4994.
• Mind. Call their infoline on 0300 123 3393 or text 86463.
• Samaritans if you're having suicidal thoughts. Call 116 123.

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Pornography Addiction

Pornography addiction is a conceptual model assessing behavioral addiction characterized by compulsive, repeated use of pornographic material until it causes serious negative consequences to one's physical, mental, social, or financial well-being.^]However, the existence of pornography addiction has been hotly contested by scientists and clinicians.Addiction to Internet pornography is also a form of cybersex addiction.

Problematic Internet pornography viewing is viewing of Internet pornography that is problematic for an individual due to personal or social reasons, including excessive time spent viewing pornography instead of interacting with others. Individuals may reportdepression, social isolation, career loss, decreased productivity, or financial consequences as a result of their excessive Internet pornography viewing impeding on their social life

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