Q: I have had panic attacks for about a year now. I am a 45-year-old female. My doctor thinks they are due to an accumulation of stresses in my life, but I am not sure I agree because I have always coped with stress quite well in the past. What do you think? Is there any way of preventing panic attacks before they happen? They often happen when I am driving, so now I am scared to drive on my own. I never had a problem with this before and used to drive everywhere without any problems.
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A: Panic attacks occur without any warning and may last as long as 20 minutes. The symptoms include a rapid pulse, sweating, shaking, shortness of breath and hyperventilation, nausea, dizziness and feeling faint. The attacks leave you worn out and exhausted.
First, you should always rule out physical health problems, such as respiratory disorders like asthma, heart problems or an overactive thyroid gland. Doctors are not sure of the exact cause of panic attacks, but it seems to run in families and there may be some problems with the brain neurochemistry.
Stress may be a factor, but not always. Even though you say you have dealt with all your previous stresses, it is still possible that something is bothering you subconsciously. Often there is a conflict between two courses of action, and you do not want to make that decision because neither path is acceptable to you. Psychotherapy may be of assistance in relieving this stress.
Antidepressant medications may also be used to treat panic disorder even when there is no depression. Try to avoid taking tranquillizers because they are all addictive and difficult to stop without withdrawal symptoms.
You should force yourself to continue to drive on your own. If you feel a panic attack coming on, pull over to the side of the road and breathe into a brown paper bag. This will soon control the hyperventilation, which is the main reason you feel ill and light headed.
Try some relaxation techniques such as progressive relaxation of your muscles. Tense up each group of muscles and relax them in turn, starting with the toes and working up to your face. When you feel better, continue driving. The more you face up to your fear, the less it will become. This is a type of behaviour therapy.
Try to cut down on stimulant foods and drinks such as coffee or medications such as cold and sinus cures that contain pseudephedrine.
Clare Rowson is a retired medical doctor with a practice near Belleville, Ont. Her columns are intended for general information only. Individuals are encouraged to also seek the advice of their own doctor regarding medical questions and treatments.
