Panic attacks (PA) are characterized by a wave of powerful and sudden anxiety. They can be the result of an unpleasant experience, such as getting stuck in an elevator, or they can happen out of the blue. Many people experience PA at least once in their lives. Some are haunted by them again and again. Frequent PAs can be disruptive and debilitating. PAs are very frightening, so in between, people worry a lot about their recurrence and consider strategies to avoid them. If you have encountered PAs and are afraid of their return, this information will be useful to you. People with panic disorder have recurring panic attacks, worry about their return, and try to take various actions to prevent their recurrence. FEAR OF PANIC RETURN - this is how panic disorder can be defined. Sometimes the steps people take to deal with panic attacks are more harmful than helpful. They range from relatively harmless (for example, always carry a bottle of water with you in case...) to the formation of dependence on sedatives and medications. People with panic disorder try to avoid situations and activities that may lead to panic. Example of the most common trigger situations: driving, crowded places, public transport, physical activity, small rooms and large open spaces. Such avoidance can lead to agoraphobia. Agoraphobia is accompanied by intense fear and leads to avoidance of situations in which people feel as if they will not be able to easily leave the premises or will not be given adequate help if needed. A similar fear applies to elevators, unfamiliar places, and noisy crowds of people. People with severe agoraphobia may feel so anxious that they are unable to leave the house. SIGNALS OF PANIC ATTACK Physical: feeling like you can't breathe heart palpitations sweating tremors/shaking tension and chest pain nausea dizziness tingling/numbness Emotional: derealization and depersonalization fear of loss of control fear of heart attack/stroke feeling like you're going crazy believing you're going to die CAUSES OF PANIC ATTACK PA is caused by a reaction "fight or flight" appearing in response to a threat. such behavior allows us to cope with danger or escape from it. Previously, this danger could have been a wild animal or, for example, weather phenomena. In today's world, we usually fear financial difficulties, public speaking, or even having another panic attack. When the fight or flight response occurs in the body, it is accompanied by changes such as: - increased heart rate; - sweating; - rapid shallow breathing. These physiological manifestations are useful in case of a real threat to life and health; however, in other situations they are intimidating. Because PAs are truly terrifying, most people tend to avoid the situations in which they usually occur and do everything to protect themselves from them, such as always keeping a cell phone handy in case they need help. Although these behaviors reduce anxiety in the short term, they usually make panic disorder worse. HOW TO COPE WITH PANIC DISORDER? Panic condition is quite easy to treat. Basic tools: Self-education is a very important stage that helps people understand the causes of panic attacks. Understanding the mechanism of their actions allows you to stop being afraid of the above symptoms, such as fear of going crazy, having a heart attack, etc. In addition, this will allow people to gain control over their body and mind, increase the well-being of the body. The most important points: - PA is very common - PA is NOT a sign of physical illness - No one in history has NEVER gone crazy or died as a result of PA - The fight or flight response is safe - PA can be successfully treated - Recovery is the RULE, not the exception Cognitive Behavioral Therapy (CBT) Helps:-identify the moments when you experience PA - Develop tolerance to unpleasant panic syndromes - Overcome the fear of a recurrence of PA - Resume those activities that a person begins to ignore due to the fear of PA drug therapy * Drug treatment is not the basis of therapy in the fight against PA. This is due to the fact that such fears are difficult to overcome by avoiding them without facing them head on. However, PA often coexists with other disorders: for example, depression or agoraphobia; in such a case, the use of medications is advisable. Additionally, medication treatment may be helpful in reducing anxiety levels. By reducing stress and anxiety and developing new behavior patterns, you can cope with panic attacks. * All medications can only be taken on the recommendation of a doctor. Self-medication is dangerous. STRATEGIES TO COMBAT PANIC Cognitive People with panic disorder may be very sensitive to physical symptoms that resemble panic disorder, such as body tingling, dizziness, and rapid heartbeat. This is due to the fact that they believe such reactions are determined by the oncoming panic attack. As a result, many develop the habit of “scanning” their body for unusual sensations. People also often mistakenly believe that panic attacks will trigger a heart attack or insanity. In addition, they often underestimate their ability to cope with panic, for example, they worry that they will not be able to calm down on their own or get outside help. Cognitive strategies are designed to help people change their habitual way of thinking . By becoming familiar with the possibilities of overcoming destructive judgments, people can reduce their anxiety about upcoming PAs and cultivate a sense of self-confidence. Behavioral The most common patterns developed in people suffering from PA: - avoidance (missing new and important experiences due to the fear of PA, for example, refusal to attend a concert of a favorite band due to fear of being in a crowd) - ensuring safety (expressed in choice behavior that seems less alarming to a person, for example, asking a friend to come over so as not to end up on the street alone. The choice of such behavior options is very comfortable for a short period of time, but in the long term it makes it impossible to overcome your behavioral fear. the strategy involves stopping avoidance in order to build self-confidence and resistance to anxious situations. OVERCOMING ANXIETY SYMPTOMS Deep breathing to calm the feeling of panic, try to inhale for 3 seconds, exhale for more than 3 seconds. Observe the breath as the air enters your nose. , throat, chest, stomach. Feel the exhalation. Repeat the breathing cycle for at least 3 minutes or until the panic symptoms are completely relieved.2. Shift your attention People with panic disorder have a habit of focusing on their body's reactions to track the symptoms of panic. Try to notice the moment when you start paying attention to your body's reactions. Remind yourself that panic is not dangerous. Try to shift the focus of attention to some events outside . 3. Switch from unpleasant emotions and thoughts People with panic disorder tend to exaggerate negative aspects and downplay their ability to deal with unpleasant symptoms. Try to look at yourself from the other side: make a list. Add to it a list of your strongest qualities - perhaps with the help of friends or loved ones. Always have it with you and re-read it as soon as bad thoughts come to mind. List those events that you think you were able to cope with much better than you expected. Add them to your list. Re-read when you feel unsure that you can cope with the situation; remember the situations when you encountered PA and were able to overcome them with dignity. Try to rationalize your!