Recently, panic disorder has become a familiar word for the general public as many broadcasters and celebrities have suffered from panic disorder during difficult times. Panic disorder is a disease, and what should be done with the latest treatments, and patients try to explain how they can wisely overcome it when they are treated.
1. Panic disorder overview and clinical pattern Panic disorder is a representative anxiety disorder that causes various inconveniences due to the fear of losing consciousness or dying with various physical symptoms related to anxiety.
A variety of physical symptoms can include cardiac hyperpnea, shortness of breath, suffocation, chest pain or chest discomfort, abdominal discomfort, dizziness, unstable, or collapse, loss of control over oneself, or a likely feeling of madness, or fear of death, abnormalities, or fever. The nerves responsible for tension, excitement, anxiety, and risk coping in our body are the sympathetic nervous system, and the excitement of the sympathetic nervous system itself is not a pathological phenomenon, but a natural phenomenon that occurs in everyday life. Naturally, stress increases, and nerves become tense ahead of important tasks, which is excessive and if you are afraid of it, the sympathetic nervous excitement is amplified, making it more painful. When such severe anxiety occurs frequently, the patient becomes afraid of physical symptoms of anxiety itself and shows symptoms of avoidance to run away from related situations. After experiencing severe panic symptoms on the subway, they are afraid of the subway and avoid crowded places. If these symptoms of avoidance become common and chronic, it can be a major obstacle to life itself by staying at home, not going out, or quitting the job. In many cases, this fear and shrinking life are bigger problems than the panic symptoms themselves. Therefore, it is important to know that panic disorder is early on after panic symptoms develop and to provide appropriate treatment quickly.
2. Drug treatment for panic disorder When panic symptoms are frequent and severe, or when panic symptoms are feared to occur even in daily life when panic symptoms are not severe, drug treatment is necessary.
There are two main types of drugs used to treat panic disorder, including antidepressants and anti-anxiety drugs. Many patients ask why they take antidepressants when the panic disorder is not depression. Although antidepressants were first developed to treat depression, it is necessary to make patients understand that antidepressants are also used as major treatments for panic disorder because they have no dependence concerns. Anti-anxiety drugs are very effective in immediately reducing anxiety, but that’s why dependency problems always come with side effects. Since anti-anxiety drugs are not particularly toxic, taking anti-anxiety drugs for a long time does not often cause major health problems, but the problem of taking drugs for a long time and fear of stopping them due to dependence is the biggest. Considering dependency and prescribing anti-anxiety drugs without a treatment plan in a department other than the department of mental health care also has many problems. However, if panic symptoms are severe or patients have already taken anti-anxiety drugs before, they have no choice but to use anti-anxiety drugs. Accordingly, several guidelines for drug treatment for panic disorder recommend independent treatment of antidepressants when anxiety symptoms are not severe or as an initial treatment. If anxiety symptoms are severe or if anti-anxiety drugs are necessarily needed, the strategy is to prescribe antidepressants and anti-anxiety drugs together at the beginning of treatment, and when the anxiety symptoms improve to some extent, the strategy is most used. However, antidepressants do not immediately appear like anti-anxiety drugs, but slowly appear after weeks of steady drug use, so proper education and psychotherapy principles are needed to help patients endure the period.
3. As described above, drug use is effective in treating panic disorder, but there are limitations of drugs such as lack of effectiveness or side effects, and avoidance symptoms of panic disorder are often not treated with medication alone, so panic disorder requires psychotherapy and other non-pharmacological treatments.
A typical psychological treatment for panic disorder is cognitive-behavioral therapy. Cognitive-behavioral therapy for panic disorder consists of education on panic and autonomic nervous system action, distorted cognitive reconstruction of physical symptoms, and exposure therapy to cope with avoidance symptoms, which can be said to learn, learn, and practice how to overcome the fear of physical symptoms. The physical symptoms of panic disorder are not symptoms of disease, but rather intense physical feelings caused by overactivation of the autonomic nervous system. Fear of this physical feeling is the key psychological mechanism of the patient. Patients can have a fear of various body feelings. There is a wide variety of fears, including severe fear of dizziness, severe fear of palpitations, and severe fear of a feeling of pulling the back of the neck. In most cases, this physical feeling is linked to catastrophic thoughts about health. If you feel dizzy, you can collapse and lose your mind, if your heart beats severely, you can die of heart disease, or if your back neck is pulled, you will suddenly have a stroke, and this idea causes avoidance and continues to play a role in maintaining the vicious cycle of panic disorder. Cognitive-behavioral therapy is to help overcome these fears and distorted thoughts and to develop new coping behaviors and practice them by exposing them to various situations that patients are avoiding. Recently, many programs and applications have emerged to learn cognitive behavioral therapy techniques through computers, and technologies for conducting exposure therapy through virtual reality have been developed and are being commercialized, making the most active combination of high-tech and psychotherapy. Biofeedback treatment, which is also translated into biofeedback as treatment other than psychotherapy, has a therapeutic effect. Biofeedback treatment improves the ability to manage one’s body and autonomous nervous system in a healthy direction by conducting breathing training and muscle relaxation training while watching changes in his ECG, breathing, and muscle tension measurements through a monitor. Panic disorder is a very painful disease for the patient himself, and if it becomes chronic, it can cause major impairment in the patient’s living function, but it is also a disease that can be treated relatively easily and can return to daily life quickly. As treatment is being conducted not only through the latest drug treatment and psychotherapy but also through combining various technologies, panic disorder is a disease that can be overcome if properly diagnosed and treated by mental health medicine.
