Anxiety attacks, causes, symptoms and treatment

Anxiety attacks, causes, symptoms and treatment

Currently there are many people who have anxious symptoms that are generated or enhanced by everyday pressures. Work stress, generalized anxiety, panic attacks, agoraphobia, depression, hypertension and gastritis They are the most frequent.

Unemployment that does not yield; In many cases, low wages and the dreaded recession are part of the Argentine socio-economic reality that conspires against our daily hopes. It is perceived in each place or group with which contact is made. And this situation could not stop affecting our body and mental state: the consultations to doctors, psychiatrists and psychologists for symptoms related to stress, anxiety and worries increase daily and with them, the consumption of anxiolytics and antidepressants.

All specialists agree that the majority of patients currently present with symptoms that are generated or enhanced by daily pressures. They are the most frequent: anxiety and sleep disorders, panic attacks, depression, high blood pressure, tachycardia, gastritis, muscle contractures and skin eczema.


  • 1 What are anxiety or panic attacks?
  • 2 What is panic?
  • 3 Characteristics of crises
  • 4 How are distress crises classified?
  • 5 When crises are a disorder ...
  • 6 Age, sex, causes and evolution
  • 7 How are panic attacks treated?

What are anxiety or panic attacks?

According to the American Psychiatric Association, the crisis of anguish or panic attacks (panic attaks) and the agoraphobia are manifestations that may appear in the course of a series of anxiety disorders such as: distress disorder with or without agoraphobia; agoraphobia with no history of distress disorder; the specific phobia; social phobia; obsessive-compulsive disorder; posttraumatic stress disorder; acute stress disorder; generalized anxiety disorder; the disorder due to medical illness; and substance induced anxiety disorder.

Anxiety crises are characterized, according to DSM V (Diagnostic and Statistical Manual of Mental Disorders) by “sudden onset of symptoms of apprehension, fear, fear or terror, usually accompanied by a feeling of imminent death”.

But it is clear that in each of the aforementioned disorders, if the living conditions or stress factors (internal or external) worsened, the fearsome panic attacks could appear.

These crises can be repeated periodically caused great limitation in daily activities for fear of suffering a new episode, creating anticipatory anxiety.

What is panic?

It is an experience of intense fear or terror, which generates a sensation of lack of control that is perceived as leading to fainting, madness or death itself.. These experiences, together with a series of symptoms that I will later describe, occur suddenly; they reach their maximum peak at 10 minutes and can last from 20 to 30 minutes; they produce an urgent need to escape; but they only occur in predisposed people. Panic crises often lead to job impairment, which will be reflected in absenteeism, decreased productivity and consequent unemployment.

Characteristics of the crises

For us to talk about "crisis of panic" At least 4 of the following 13 symptoms should appear, which we will group, following Dr. A. Cía in:

A. Physiological or somatic symptoms

  1. Palpitations or tachycardia.
  2. Sweating
  3. Tremors or shaking
  4. Feeling of choking or breathlessness or hyperventilation
  5. Choking sensation
  6. Thoracic oppression or discomfort
  7. Nausea or abdominal discomfort
  8. Instability, dizziness (lightheadedness) or feeling faint

B. Cognitive symptoms

  1. Derealization (feeling of unreality) or depersonalization (feeling of being separated from oneself)
  2. Fear of going crazy or getting out of control
  3. Affraid to die

C. Physiological or somatic symptoms

  1. Paresthesia (tingling or numbness)
  2. Chills or suffocations

When the seizures have less than 4 symptoms, they are “limited” symptomatic seizures.

How are distress crises classified?

Depending on the context in which they appear, they are classified as:

  1. Unexpected or spontaneous: are those in which the beginning of the crisis is not related to environmental stimuli that can be interpreted as causal or triggers. They usually occur in distress disorder with or without agoraphobia.
  2. Situational: In them the distress crises appear almost immediately after exposure to a frightening stimulus or by their imaginary anticipation alone. They usually occur in social phobia (during a party or before arriving) and in specific phobias (when seeing a snake, a spider, etc.).
  3. More or less related to certain situations: Sometimes they appear in front of exposure to stimuli that are probably anxious, such as traveling on a plane or on a train. It usually occurs in agoraphobia.

When crises are a disorder ...

To talk about “panic disorder”, recurrent unexpected panic attacks must occur and one of them must be followed by one or more of the following symptoms:

A. Persistent concern about the possibility of new crises.
B. Concern about the consequences of the attacks.
C. Change in behavior related to crises.

Most panic disorders lead to agoraphobia, that is, more or less or permanent fear of being alone, helpless or unable to receive help in the face of a panic attack and not being able to escape from the situation. Those who suffer from agoraphobia have a number of limitations such as stopping work, studying or leading a full life. That is why agoraphobia usually goes into depression and with it increases the risk of suicide.

Age, sex, causes and evolution

Panic disorder can appear in any social class, culture or race, but it will always be prevalent in women in a 3 to 4 ratio.

It usually begins between the ages of 25 and 30, but in some cases the age of onset is adolescence.

Its appearance depends (for Dr. Julio Moizeszowicz) on:

  1. Neurobiological factors: psychic traumas due to physical or sexual abuse before the age of five would alter the neurobiological pattern in genetically predisposed individuals, leaving as a sequel a "reactive somatic vulnerability".
  2. A story of behavioral inhibition with difficulties in the game.
  3. Tendency to social isolation.
  4. Difficulty of separation in childhood.
  5. Adolescence with symptoms of social phobia.
  6. Adulthood with symptoms or with panicose aura.

The upbringing of the panicky was marked by parents who would have had an overprotective attitude but with little care in regard to the expression of emotions and a real emotional approach.

The percentage (prevalence) of people affected by this disorder for life, ranges between 2 and 5%. That is, in Argentina, more than 1 million people could suffer from it, taking into account that the majority are underdiagnosed.

The evolution is usually chronic, disabling and tend towards hypochondria and depression if not treated properly.

How are panic attacks treated?

First of all starting from an early diagnosis; but it must be taken into account that due to the variety of symptoms, the abruptness with which they occur and the predominance of their somatic character, it can take around 7 years to reach a correct diagnosis. The treatment must be comprehensive and it is advisable to bring together at least one psychiatrist who indicates the most appropriate medication according to the case and a psychologist trained in anxiety disorders that work as a team.

In addition to this it is essential to inform the patient and his family group about the characteristics of the disease so that they know how to control the attacks and collaborate with the treatment. It will be necessary to prevent crises by informing that they are triggered by:

  • Psychological triggers: intrapsychic conflicts, over-demand, stress.
  • Physical triggers: excessive physical activity and exaggerated consumption of addictive substances (such as coffee, alcohol, amphetamines, cannabis, barbiturates and cocaine, which by withdrawal or deprivation generate withdrawal) or medications that produce anxiety .

The possibility of indicating complementary therapies such as relaxation exercises or meditation is not ruled out.

The remission can last up to a couple of years although the results begin to be noticed after a few months.

Related tests
  • Depression test
  • Goldberg depression test
  • Self-knowledge test
  • how do others see you?
  • Sensitivity test (PAS)
  • Character test