What is panic, and what is it especially not? Koen Schruers, psychiatrist and professor at Maastricht University explains in A doctor speaks: Panic and how to deal with it. “In panic, the danger comes from within the body.”
Puck van der Mark1 July 2023, 03:00
One moment there is nothing wrong, the next moment you suddenly and very quickly feel a series of physical complaints coming on. Your heart races, you sweat and your lungs seem to have shrunk in content. Add to that complaints such as nausea, chills and a dry mouth and you get a good picture of what happens to someone with a panic attack.
All this is accompanied by the feeling of losing control, going crazy or even dying. The complaints come on within a minute, last about fifteen minutes and then slowly fade away.
There is no reason, says Koen Schruers. “That’s the strange thing about it and also very typical of panic attacks. You can sit quietly in front of the TV or even be in a nightmare sleep and suddenly be attacked.”
That is why Schruers uses a different definition of panic than what people talk about it in the vernacular. “People quickly talk about panic if they are afraid of an upcoming exam, for example. In that case I speak of fear, a reaction to an unpleasant or threatening condition that is relatively far away, in time or in space. In panic, the danger really comes from within the body.”
About one in four people has had a panic attack at some point. 3 to 4 percent of the population actually has a panic disorder. Schruers: “We speak of a panic disorder as soon as the panic attacks begin to affect daily life. People with panic disorder have had several attacks and are so afraid of having another attack that they start to show avoidance behavior.”
“Some have relatively mild complaints, where they still leave the house, but only under certain conditions, such as having a telephone or a strip of pills in their pocket. But it can also take extreme forms.”
Do you have an example?
“I recently spoke to a student from the Randstad. He had had severe panic attacks for over a year. He was so afraid of having panic attacks that he no longer dared to go to class and go out with his friends.”
“His world was getting smaller and smaller and he became depressed as a result. That was really a young man in the prime of his life who was completely taken out of his normal life by a relatively simple complaint.
“I once treated a former top athlete who avoided any form of exercise because he was afraid that a higher heart rate and faster breathing would trigger a panic attack. But the record holder for avoidance behavior among my patients was a woman who hadn’t left home alone in over 20 years.”
How does a panic disorder arise?
“That is the key question. Why does someone have a panic attack for the first time at a certain point in their life? No one has an explanation for that. We do know the factors that increase the risk of having an attack. First of all, some people are more prone to panic attacks.”
“That is genetically determined, but also depends on upbringing: how people learn to deal with threatening situations. And then the circumstances also play a role. People who experience an increased level of stress for longer periods, months to years, are much more at risk.”
Are there any specific groups that are more at risk?
“Certainly. Young adults are most likely to suffer from panic attacks. This is mainly due to the period in which they find themselves, in which all kinds of changes take place and there are expectations that they think they have to meet. The risk is also two times higher in women than in men. This probably has to do with the female hormones, which have already been shown to influence the symptoms.”
Is it treatable?
“Yes, most people get off relatively easily. The number 1 therapy is exposure therapy. In doing so, we provoke a panic attack by having people breathe air enriched with carbon dioxide. They then get the symptoms associated with a panic attack. Then we let that happen, so that people experience that it will pass by itself.”
“Is that fun? No. But that’s not dangerous either. After this, we will practice the situations they avoid under supervision and we will give them more and more independence.”
So if you see someone having a panic attack, you shouldn’t do anything?
“That’s right, you can only wait and reassure. And please don’t come running with a paper bag to breathe in. So it really has no effect at all. In fact, if someone closes the bag completely and breathes into it, it actually makes the panic attack worse, for the same reason we use air enriched with carbon dioxide to induce a panic attack. In practice, someone never closes such a bag completely and it therefore has no effect.”
Why and for whom did you write this book?
“I’m sure everyone has someone in their circle of acquaintances who suffers from panic. Yet few people know what panic really is, which is why it often takes a long time for people with panic disorder to find the right help. Often they first undergo all kinds of expensive examinations and sometimes they even end up with self-proclaimed alternative therapists, all without results.”
“And that while good treatment is available in the Netherlands. The book is therefore actually intended for both the layman and the doctor or psychologist who want to learn more about panic. In the hope that it will be noticed more often and treated in the right way.”
Psychiatrist and professor Koen Schruers: ‘Most of them get off relatively easily. The number 1 therapy is exposure therapy. In doing so, we provoke a panic attack.’ Image Katja Waltmans
Koen Schruers
1966, Hasselt, Belgium
Koen Schruers studied medicine at KU Leuven and subsequently trained as a psychiatrist there. He did his PhD research at Maastricht University on the neurobiology of panic. He is now a professor at the same university, where he conducts research into the mechanisms behind psychiatric disorders. He is also head of it Academic Center for Anxiety, Compulsion, and Trauma (ACADT)and as a psychiatrist he treats people with severe panic, anxiety and compulsive disorders.
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2023-07-01 01:00:02
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