SH3 mental health

8/7/2019 SH3 mental health

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Panic disorder1 is very different to everyday anxiety. Panic disorder is a condition that affects 1 2% of the

Australian and New Zealand populations each year. It usually begins during the teens or early twenties and women

are twice as likely as men to experience it.The exact causes of panic disorder are still unclear but there is some

evidence of a family tendency to nervousness and a link with major life events and stresses. What this means is

that if a member of the family has suffered from panic, there is an increased risk of you suffering from it, especially

when you are stressed. Often people with panic disorder have always thought of themselves as worry worts or

sensitive but this may not always be the case.Panic disorder involves recurrent, unexpected panic attacks. A panic

attack is a sudden period of intense fear or discomfort, in which four or more of the following symptoms reach a

peak within 10 minutes:2

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1. Ease anxiety, increase trust/relationship , likelihood of adherence. Emphasise biological nature reassures the

patient and destigmatizing. Recognised, treatable biological syndrome with good prognosis

2. Balance patient education and supportiveocunsellingwith beliefs of cause

Patients often focus on symptoms of the d/o: present with chest pain, dizziness, unexplained complaints. Physician

needs to decided how far to evaluate these symptoms

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SSRI: useful in recurring/persistent panic attacks/agoraphobia over several months

Bezos: sedation, reduced coordination, cognitive impairment, increased accidents proneness, dependence

Start with a low dose

TCA: s/e dry mouth, dizziness, nausea

Coombined with psychotherapeutic intervention and education symptom control, enhances effectiveness of drug

treatment

Breathing techniques, education onf physiologic changes of panic, expose volunterily to ppting events = treatment

program 12-15 sessions

Homework assignments, monitored compliance

Satisfactory response: drugs maintained 1-2 years to prevent relapse. Success rate of75-85%. Drug reduction

should be gradual

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Treats physical manifestations, avoidance behaviours

Decrease likelihood of symptom relapse following discont of pharmaco

Education: as stated, to disepll fears about the disorder

Cognitive therapy: identify triggers, understand the fears about panic symtoms, taught realistic interpreation of

fears /stiuations

Intero.. : become less frightened of symptoms

In vivo: face feared places

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Recognise, evaluate and shift patterns of unhelpful thinking and dysfunctional behaviours. Focus n the role of

dysfunctional thinking in the onset and maintenance of disorders

The way you thinkin influences how you feel about things addresses thoughs, assumptions and beliefs

CBT: identifies these and aims for modifications

Education about the physical symptoms of panic, the role of avoidance and the influence of thoughts and fears

Changing thoughts and fears about the physical symptoms of panic

Exposure to places where panic might occur

Exposure to the physical sensations of panic

Techniques to reduce over-breathing and anxiety symptoms

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Step 1. Identifying anxious thoughts

Hence the first step is to learn to identify what you are saying to yourself leading up to and during a panic attack.

Collect a sample of these thoughts and write them down. This may take some practice because at first it may seem

like you are just feeling things and not thinking anything at all. But human beings always think about and interpret

what happens to them. If you cannot identify what you are thinking try asking yourself what you believe is

happening to you, and notice whether you are judging what is happening as being awful or dangerous.

Step 2. Challenging your anxious thoughts

Once you have identified what you say to yourself leading up to and during a panic attack, the next step is to start

talking back. Look at the list of anxious thoughts you have written down.

Step 3 Generating alternative thoughts

Exposure

Graded and goals. Gradual confrontation.

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SH3 mental health