Autonomic dysfunction - from headaches to panic attacks

Today, many people suffer from attacks of unreasonable panic fear. It can occur suddenly - in the subway, at home, among a crowd of people or completely alone, early in the morning or late at night. Such attacks are called “panic attack” or “vegetative crisis”. In fact, panic attacks and their symptoms are quite diverse, and can manifest differently in different people.

As a rule, at first there is a slight uneasy feeling. Anxiety increases in a matter of minutes - from fear a person cannot move: get up, go outside, go to work. The heart beats faster, the hands sweat, dizziness, headache, nausea, tremors occur, and the arms or legs may even become numb. It seems to a person that he is about to lose consciousness, go crazy, or even die from a heart attack or stroke, and therefore he is afraid to move, so as not to fall in front of many people or, conversely, to be left without help. And so, he can wait for 30-60 minutes until the attack of fear subsides.

“One day I was tinkering with my car in the garage as usual. Suddenly, out of the blue, I felt numbness on the left side of my face and body. I couldn't move, it was like I was paralyzed. At the same time, I began to feel very thirsty - my throat was dry. I felt hot and cold, and I just lay down in the car and waited for it to end. After 30 minutes I was released. From then on, as soon as I approached the car, I felt bad, and if I got behind the wheel, everything swam before my eyes. In the end, I even had to quit my job as a car mechanic,” patient Arthur (46 years old).

It also happens that a person who suddenly has a panic attack, on the contrary, runs as quickly as possible into fresh air because he experiences an acute feeling of suffocation - and this helps him cope with the attack.

Some patients complain that they begin to experience anxiety when faced with a specific situation. For example, when you need to drive or go to work. If a person continues an action that irritates his nervous system, the intensity of the attack increases. If he stops the action and returns home, then the anxiety gradually fades away. Thus, many people who suffer from panic attacks and their symptoms have to quit work, study, and completely change their usual lifestyle. And this method also often helps them to significantly reduce the manifestations of panic disorder, but not get rid of it completely. In addition, not everyone can afford such drastic changes in life.

What to do if you experience regular attacks of panic?

Panic attack symptoms

People with panic disorder very often do not see a doctor for a long time and do not tell their loved ones about the existing problem. As a rule, a person either thinks that there is no problem, and he himself will be able to cope with his poor health, forcibly overcoming all the signs of a panic attack, or he is embarrassed by his “weakness,” or is completely afraid that he will be “sent to a mental hospital.” This is completely unnecessary. However, it is necessary to treat sudden and regular panic fear.

“When I first had a panic attack, I had to call an ambulance. They just gave me glycine and didn't tell me anything else. After that, I went through the entire cardiology center and passed all the tests. I was told that I was absolutely healthy. My family and friends thought I was faking it. I tried not to pay attention to the attacks, reassuring myself that when I came home everything would be fine. Sometimes he deliberately drove himself into a traffic jam in order to overcome his fear. Such a nightmare was happening that you could at least abandon the car and leave. Sometimes I did just that. I would drop my car off at the metro station and come and pick it up the next day. Although before this illness I generally tolerated traffic jams calmly,” patient Pavel (41 years old).

First, let’s look at the symptoms with which you can probably come to the doctor and say: “Doctor, I’m having panic attacks. What to do?"

Psycho-emotional component of a panic attack. Symptoms and signs:

- Sudden, unreasonable attacks of fear/anxiety/panic, lasting from several minutes to several hours

- Waiting for sudden death, waiting for an attack

- Intrusive thoughts (usually related to death)

— Blurred consciousness

- Feeling of derealization (“I am separate, the world is separate”, “the world through cellophane”, “like in an aquarium”)

- Constant feeling of anxiety

— Various phobias (agoraphobia, social phobia, etc.)

— Insomnia, “nightmare” dreams

— Decreased mood, tearfulness

- Irritability, aggressiveness

“In the summer of 2014, I realized that I regularly could not fall asleep until 5-6 o’clock in the morning. The stuffy summer aggravated my condition, I constantly experienced a feeling of lack of air, my heartbeat quickened, obsessive thoughts arose in my head: “What if I’m dying?” - panic grew, but I had no strength to move or call an ambulance. I lay there like that until the morning, when my eyes closed on their own from fatigue and constant tension. This happened several times a week,” patient Elena (28 years old, manager).

Physiological component of a panic attack. Symptoms and signs:

— Dizziness, headache, heaviness in the head, noise in the head/tinnitus

- Lack of air, suffocation, shortness of breath

— Rapid heartbeat, feeling of interruptions in the heart, pain in the heart

- Nausea, abdominal discomfort

- Chills, fever, sweating

- Trembling in the arms, legs, body

- Muscle tension, numbness in limbs

— Gastrointestinal tract disorder

- Feeling tired, weak, lack of strength

“5 years ago I was unsuccessfully treated with antibiotics and after that I started having stomach problems. All these years I suffered from constant diarrhea. I contacted a parasitologist, gastroenterologist, immunologist and other specialists. Tests and clinical studies did not reveal any diseases. I tried to be treated with probiotics and prebiotics, but to no avail. Other symptoms also began to bother me: heaviness in the head, tension in the back and neck, anxiety for no reason, fear for one’s health, sometimes the heart was pounding wildly, in the morning after sleep there was slight dizziness and, of course, constant fatigue and weakness,” patient, Andrey (31 years old).

Important symptoms of panic attacks are also their systematicity and regularity. The interval between panic attacks can vary from a few minutes to several days or months, but their regular occurrence indicates that you are suffering from a panic disorder.

How does Afobazol work?

The drug is classified as a tranquilizer, but it should be noted that it stands out compared to its other counterparts.

Most members of this group act on benzodiazepine receptors. In this regard, there are some side effects of such drugs, such as: drowsiness, muscle atony, decreased concentration. Cases of addiction and withdrawal syndrome are common. But Afobazol acts very gently, bypassing all of the above complications. It has no effect on benzodiazepine receptors, acting directly on GABA-sensitive neurons and increasing their sensitivity.

GABA (gamma-aminobutyric acid) suppresses increased nervous excitability of the brain. This is the leading neurotransmitter that is responsible for inhibition processes in the central nervous system. It inhibits the action of acetylcholine and adrenaline, which cause emotional outbursts and pain. But at the same time, GABA activates the energy potential of brain tissue, stimulates blood circulation in it and the absorption of glucose and oxygen by cells, that is, it improves trophism or nutrition of the brain.

Afobazole reduces the activity of subcortical centers, such as the thalamus or hypothalamus, which are responsible for human emotions.

By taking Afobazole, you will protect your nervous system without falling into a stupor.

Panic attack. Emergency self-help.

First, learn how to manage your panic attacks yourself to control them and reduce the intensity of your panic attack symptoms.

Try practicing breathing techniques.

Breathe through your diaphragm (belly), in through your nose and out through your mouth slowly and calmly. For example, for 5 counts – inhale, for 10 – exhale.

“Some patients benefit from progressive muscle relaxation. If your muscles are very tense during a panic attack, try tightening your facial muscles: tense your jaw for 8 seconds - then relax, tense your lips for 8 seconds - relax. Repeat the exercise with your arms (palms, forearms) and switch to the next muscle group, for example, the calf muscles, the feet. Alternate tension and relaxation of all parts of the body will help relax the muscles and distract thoughts,” recommendations of a neurologist-vegetologist (“Clinical Center for Autonomic Neurology”).

During a panic attack, try to distract yourself and not think about the symptoms that are bothering you. Use psychological techniques. Visualize some place where you felt good: a house, a vacation spot, a cottage, a forest, a sandy beach - whatever your heart desires. And imagine in detail the entire environment that surrounds you there: a soft chair, a fluffy cat, the smell of pine trees, the crunch of branches under your feet, birdsong, warm sand, etc. Think in advance about where it would be better for you to “go” when you have another panic attack in order to distract your thoughts from its symptoms.

Keep a diary of panic attacks that you can refer to in critical situations. This way you can remind yourself that there is nothing to be afraid of, and the next panic attack will soon pass.

help yourself

At the moment when you are overtaken by an attack, it is very difficult to control yourself. But you can try to pull yourself together and help yourself get rid of it quickly:

1. Go out into the fresh air or open the windows, unbutton tight clothes. Pour cool water over your face.
2. It is important to switch to breathing. Try to breathe deeply, slowly and fully. To increase the level of carbon dioxide in the blood, breathe into a bag or cupped palms (imitate the position of breathing into them, trying to warm them up).
3. Try to think about something positive or talk to someone. Try counting to 100 or count passing cars or trees if fear catches you in transport or on the street. All this helps to shift attention away from anxious feelings. If the cause of alarm is a certain place, hurry to leave it.
4. To stabilize your body, place your hands on a stable surface or press your feet into the floor. This position will give you a feeling of confidence and control.
5. Keep telling yourself that this will all end now. The anxiety that arises will not harm you, it is simply a figment of your imagination.

If you witness an attack on someone, you can help the person cope with the problem. The main thing: do not panic yourself! You must be calm. And with your calmness set an example for him.

Talk to him, hug him on the shoulder or squeeze his hand. Show me how to breathe correctly. If conditions permit, give the person water or warm tea.

The main thing is not to get confused in this situation. Remember, your behavior can significantly alleviate the panicker’s condition.

Panic attacks. Difficulties in diagnosis.

People suffering from the symptoms of panic attacks usually do not know where to turn. They visit the offices of a therapist, cardiologist, endocrinologist, psychiatrist, psychologist, but doctors do not detect any disturbances in the functioning of the body. Of course, it is advisable to undergo all possible examinations and pass all the necessary tests in order to exclude the development of serious physiological abnormalities. However, if, in the end, they tell you that you are absolutely healthy, but anxiety, tachycardia, insomnia and other symptoms continue to torment you, then most likely you suffer from panic disorder, which means the problem lies in a disruption of the autonomic nervous system , which can only be identified by an experienced neurologist-vegetologist.

Some patients with signs of panic attacks are diagnosed with vegetative-vascular dystonia (VSD) and told that they will have to live with such symptoms all their lives, alleviating them with medications: antidepressants and tranquilizers.

“I went to all the doctors because there were a lot of symptoms: my heart, shortness of breath, blood pressure, my stomach, bones, muscles ached, I felt constant anxiety. At first, rare panic attacks grew into a daily norm. The neurologist prescribed Coaxil, but the pills made me feel worse. I drank Coaxil for three months and barely got off it. Then the therapist prescribed me adaptol. It made me feel better, but only while I was drinking it, and as soon as I stopped drinking, everything started all over again. Everything was useless until I learned from friends about the “Clinical Center for Autonomic Neurology”,” patient, Arthur (46 years old).

The deep misconception that VSD and panic attacks cannot be treated can be dispelled if you visit a doctor who specializes specifically in disorders of the autonomic nervous system. Panic attacks can be treated and diagnosed! The main thing is to know where and how this can be done.

Psychotherapy

Good results in the treatment of PA are achieved only with a combination of medication, pharmacotherapy and psychotherapy. The central task of the latter method is to gradually bring the patient to an awareness of the essence of the problem. Other goals of psychotherapy:

• identification and elimination of psychological intrapersonal conflicts;
• modification of previous inappropriate reactions to stress;
• developing healthy patterns and attitudes, attitudes and attitudes for learning mature adaptation mechanisms;
• working with self-control and adequate ways of responding;
• identifying the root causes of pathology.

In the cognitive behavioral approach, a psychotherapist or clinical psychologist teaches the patient techniques to control his own thought process. The client learns to understand his own condition and is able to identify factors that provoke anxiety. The nuances of the lifestyle and rhythm of life are examined.

Psychoanalysis helps to discover the subconscious, underlying causes of PA. Other approaches to the psychotherapy of panic disorder are classical or Ericksonian hypnosis, family consultations, and Gestalt direction. Psychotherapeutic relief of symptoms is the most effective method. Treatment takes from six months to 2-3 years. It takes effort from both the therapist and the patient.

Panic attacks. Modern diagnostic methods.

Only a qualified neurologist-vegetologist can diagnose panic disorder, which manifests itself as panic attacks, identify its symptoms and prescribe optimal treatment.

At the initial examination, the vegetarian doctor must examine the patient’s normal reflexes, his muscular system, sensory organs, cognitive functions (memory, speech, perception), assess the general psycho-emotional state of the patient, taking into account all his complaints in order to collect a complete picture of the disease.

Next, there are several methods for diagnosing autonomic nervous disorder. One of them is the study of heart rate variability.

The patient performs a simple load: first he lies on his back, and after a few minutes he gets to his feet. In this way, we simulate a standard everyday situation when the minimum load is placed on our body. During this time, sensors attached to the patient's chest record the rhythm of his heart, and the doctor then compares the changes in rhythm in both positions. Such a study shows how adapted the human body is to the usual minimum load, which our autonomic nervous system normally copes with every day without the slightest difficulty.

How it works?

In a healthy state, our body responds adequately to any “stress”, any load (mental, physical, emotional). Therefore, when a healthy person gets up, the sympathetic part of the autonomic nervous system is activated in his body and the hormone adrenaline is produced, which means the heartbeat quickens. When a person lies down, his body should normally be in the mood for rest and relaxation. At the physiological level, this manifests itself as follows: the parasympathetic department of the autonomic nervous system becomes active and the hormone acetylcholine is released, which extinguishes the activity of adrenaline, and a phase of relaxation and replenishment of the body’s reserves begins.

But in patients with symptoms of panic attacks, an abnormal change in heart rhythms is observed: that is, when a person lies down, his pulse quickens and becomes faster and faster. That is, when a person gives his body the command to tune in to rest, the body understands the opposite - and prepares to run a short distance race. This is why people with disorders of the autonomic nervous system so often cannot sleep at night and never feel rested and alert.

Thus, the doctor concludes that the harmonious functioning of the sympathetic and parasympathetic parts of the nervous system is disrupted. This means you can move on to the next stage of the examination.

Among the innovative methods for diagnosing panic disorder are studies of the autonomic nervous system using infrared thermography. In an infrared image, a thermal imager clearly shows in which nodes (ganglia) of the autonomic nervous system the work is disrupted. It is with these vegetative nodes that the neurologist-vegetologist will subsequently work.

“Serious scientific research over the last decade has shown the high reliability and reliability of thermography. This allows this method to be used in medical practice to make a diagnosis in complex cases,” James Mercer, Professor, President of the European Thermography Society (EAT).

After treatment, you can take a repeat infrared photo, in which you will notice progress from the completed course. Areas with abnormal temperatures (bright red or dark blue) will change color in the image because their temperature regime is closer to normal.

Consequences

Panic disorder, if the diagnosis is correct, does not go away “on its own.” Sometimes the intervals between attacks are quite long - up to 1-3 months. But without adequate treatment, the time interval between attacks gradually decreases.

Looking at panic attacks separately, researchers conclude that they do not pose a threat to life. But repeated PA without treatment will lead to the formation of depressive disorder, phobias, and neurosis. Over time, a person becomes a hypochondriac, stress resistance suffers, and increased suspiciousness arises.

Letting a disorder take its course is a health hazard. After a few months, the quality of life decreases noticeably. Mental and physical capabilities decline, and performance suffers. People who do not treat mental problems have problems in the area of ​​social adaptation.

Panic attacks symptoms and treatment

To successfully treat panic attacks, an integrated approach is required; one of the modern treatment methods is complex physiotherapy. The treatment is aimed at the root cause of the disorder, which is rooted in the physiological disruption of the body. Psychotherapy can also be used as a method of treating panic attacks, but only as an auxiliary link. In some cases, a psychotherapist can alleviate the condition and reduce the severity of panic neurosis.

One of the clinics in Moscow that specializes directly in disorders of the autonomic nervous system is the Clinical Center for Autonomic Neurology. The clinic’s doctors have extensive experience working with panic attacks: they know how their symptoms manifest themselves and what treatment will be optimal in a given case. As part of a comprehensive physiotherapy course, you can be offered:

— undergo a course of intravenous laser therapy

— infrared laser therapy

— magnetic therapy

— as well as a course of color pulse correction of suprasegmental autonomic disorders (color therapy)

All methods are aimed at working directly with damaged vegetative nodes.

The targeted effect on the nerve nodes in its effect on the body is reminiscent of acupuncture in oriental medicine (acupuncture), but the action of the laser is much more accurate and is based on science, and not on ancient intuitions, especially since it is supported by thermal imaging images that show the localization of the vegetative node in the human body accurate to the millimeter.

“I underwent 2 courses of acupuncture with symptoms of panic attacks. After the first course, which lasted a month, I felt better - I just sighed. But a month later I had to return. Another month after the second course, my body completely returned to its previous deplorable state. The effect faded away again. Acupuncture gave me only temporary relief. The effect of the laser was incomparably more effective,” patient Alexander (43 years old).

For most patients, it is enough to undergo one course of comprehensive physical therapy to feel significantly better, and after a recovery period that lasts from 4 to 6 months, to completely get rid of all symptoms of panic attacks. In more advanced cases, several courses may be required. However, noticeable improvements are noticeable after the first treatment session.

“During laser therapy sessions, I felt relaxed and even fell asleep. After the first sessions, the anxiety noticeably subsided and my head cleared. Panic attacks after completing the course of treatment became rare and short-lived. There was one case of exacerbation in the subway, but the doctor warned me that this was possible during the recovery period. I happily completed the second course of treatment a year later and now I feel even better than when I didn’t have panic attacks yet,” patient Sergei (34 years old).

Is it possible to overcome forever

To overcome panic disorder forever, long-term work with a psychotherapist, taking a course of medications, and the patient’s efforts are required. It is important to find the root cause of anxiety - it is often hidden deep in the subconscious. Next, you need to learn how to independently smooth out the symptoms during an attack.

The nuances of therapy depend on the severity of the disorder, its duration, severity and personal characteristics of the body. It is believed that the most severe PAs occur in those patients who perceived the first attack as a fatal catastrophe. The sooner treatment begins, the faster and easier it will be. Full recovery occurs in the presence of two factors - a competent treatment regimen and a lot of effort from the patient.