Fear, unwilling to see people, chest tightness

When people are in a stable environment, they should feel calm and comfortable. If there are panic and anxiety, then it may be a manifestation of anxiety disorder, which is a symptom of neurasthenia. Patients are often moody and will lose control because of trivial matters. This disease can also lead to a decline in physical functions and very unstable physical signs. If premonitory symptoms such as panic and chest tightness occur, they should be treated promptly to avoid worsening of the condition.

Why do you often feel chest tightness and uneasiness?

In fact, one type of anxiety disorder is acute anxiety attack, also called panic attack or panic disorder. When the attack occurs, the patient will feel very scared. What is going on?

Panic disorder, also known as panic disorder, is an acute anxiety disorder characterized by recurrent and significant autonomic nervous system symptoms such as palpitations, sweating, tremors, accompanied by a strong sense of impending death or loss of control, and fear of unfortunate consequences. A panic attack is a sudden experience of fear. The symptoms are often the patient's own perception. In certain situations, the patient suddenly feels panic, loss of control, madness, collapse, as if death is approaching, terrified, and calls for help everywhere. At the same time, it is accompanied by severe autonomic dysfunction. The onset is fast and the end is also fast. The manifestations will be acute symptoms lasting for several minutes or dozens of minutes, and the attack is self-limited.

Four criteria for judging acute anxiety attacks

According to the diagnostic criteria of the International Classification of Diseases (ICD-10) developed by the WHO, panic disorder is diagnosed based on at least three attacks in a month, each lasting no more than two hours. Attacks significantly affect daily activities. During the interval between two attacks, there are no obvious symptoms except the fear of another attack, and there are the following four characteristics:

There is no real danger in the attack situation. I was reading in the study and driving to and from get off work normally. This is a normal living environment, there is no real danger.

It is not limited to known or foreseeable situations and excludes phobias of specific environments, such as claustrophobia, agoraphobia, and social phobia.

There are almost no anxiety symptoms during the intervals between panic attacks. Although one often worries about the next panic attack, there is no generalized anxiety, worry about everything, or restlessness.

Not the result of physical fatigue, a medical disorder such as hyperthyroidism, hypoglycemia, heart disease, or substance abuse.

A young man who came to see me had been seeing me for more than two months. He went to many local and military hospitals successively. Since the main symptoms of the attack were palpitations and rapid heart rate, of course the cardiology department was the first choice. At the same time, he also had chest tightness, shortness of breath, and severe breathing difficulties, so he also went to the respiratory department for a systematic examination.

Because his whole body trembled, became numb and stiff, and he even had convulsions during the attacks, he also visited the epilepsy center and the neurology department. In addition, he had symptoms of wanting to vomit but couldn't, and wanting to defecate but couldn't, so he went to see a gastroenterologist again.

Some people also suggested that he check if it was hyperthyroidism, endocrine disorder, etc., so he also went to the endocrinology department. When these departments did not have a clear diagnosis or special treatment, he went to see the Department of Traditional Chinese Medicine, Acupuncture, etc.

For heart examinations, I had countless conventional electrocardiograms, as well as 24-hour dynamic electrocardiograms, treadmill exercise electrocardiograms, step exercise electrocardiograms, and multiple cardiac color ultrasounds.

I had my lungs checked, had a chest X-ray and CT scan, and did a lung function test.

The brain was examined and a brain CT scan and brain MRI were performed. The electroencephalogram (EEG) was done four times, including a 24-hour dynamic EEG.

Blood pressure, blood lipids, blood sugar, pharyngoscopy, gastroscopy, etc., all possible tests were done, and the results were all normal.

But from then on his attacks became more and more frequent. They would occur suddenly at any time and in any circumstances without any warning. He was in great pain and nervousness, and still didn't know what disease he had or whether it could be cured. He said that he had not been to work for more than two months since the third attack. When he occasionally drove out, not only did he have to be accompanied by his wife or father, but he also had to check the map before going out to see if the road he was going to take was within a five-minute drive and whether there was a large hospital. If there was no large hospital, he would never dare to take that road. Although the young man continued to talk, I already had a clearer diagnosis in my mind. This was a very typical panic disorder, panic attack, or acute anxiety attack.

The characteristics of panic disorder are that the patient is conscious during the attack, which is short-lived, usually 5 to 20 minutes, reaching a peak within 10 minutes and rarely lasting more than 1 hour. The attack can be relieved on its own soon, or ended by yawning, urinating, or falling asleep. The mental state is normal between attacks. After an attack, the patient feels that everything is normal and can recall the course of the attack, but another attack may suddenly occur soon after.

It manifests as a severe feeling of suffocation, dying or mental loss of control, as if facing the end of the world and being terrified. It is often accompanied by severe symptoms of autonomic dysfunction.

The three main symptoms of panic disorder

First, cardiac symptoms, such as chest pain, tachycardia, and irregular heartbeat;

The second is respiratory symptoms, such as chest tightness and difficulty breathing;

The third is neurological symptoms, including headache, dizziness, vertigo, syncope and abnormal sensation. Panic disorder has an acute onset and is often mistaken for an organic disease because it is accompanied by obvious autonomic nervous system symptoms. Patients often develop sudden onset and are rushed to the emergency room of a general hospital.

Treatments for panic disorder

1. Drug treatment: If the patient has severe symptoms, he or she can take the doctor's prescribed medication as needed to alleviate the condition.

2. Psychotherapy Cognitive behavioral therapy has been proven to be effective in treating panic disorder and agoraphobia. Among them, exposure therapy requires patients to face or come into contact with situations that make them fearful and uneasy (for example, crowded streets). In addition, the patient refrained from engaging in habitual avoidance behaviors.

Although most psychotherapies have no so-called side effects, (exposure therapy) can be disturbing to patients, especially when they are faced with some frightening situations. However, these (anxiety) will gradually subside with time and practice. You must take care of your own health. If you don't treat a minor illness, it will develop into a major illness, which is both expensive and painful. No one can do it for you.