Psychology of fear. What is a panic?
The criterion for disorders such as panic reactions are spontaneous, sporadic and intense periods of anxiety, usually lasting less than an hour. These panic attacks are often twice a week, this disorder in susceptible individuals, although they may occur less frequently and more often. The term "panic attack" and "vegetative crisis' is equally used to refer to nearly identical conditions. Panic attack (vegetative crisis) - are the most vivid and dramatic manifestation of the syndrome of vegetative dystonia.

In turn, the autonomic dystonia syndrome (IRS) may arise and develop under the influence of multiple factors, such as hereditary-constitutional factors, physiological changes (the effect of acute or chronic stress), hormonal changes (during puberty, postpartum, and menopause), organic physical disease (psychosomatic illnesses such as hypertension, heart disease, peptic ulcer disease, asthma, other somatic diseases), and organic diseases of the nervous system (eg, irregularities in the integrative systems of the brain, limbico-reticular complex and the hypothalamic region, brain stem structures) , occupational diseases (hard work is psychologically or physically), neurosis, mental disorders (particularly depression).

All these factors create the primary prerequisite for the development of SVD, which can further complicate the emergence of panic attacks (PA).

Sigmund Freud at the end of the last century, describes the "disturbing attack" in which there was a sudden alarm was not triggered by any ideas, and was accompanied by respiratory failure, cardiac and other bodily functions. Such states are described by Freud in the "anxiety neurosis" or "anxiety neurosis". The word "panic" has its origin on behalf of the Greek god Pan.

According to myths, emergent Pan aroused such horror that the man headlong rush to escape, not to the road, not realizing that the escape could threaten him with death. The concepts of surprise and the unexpected appearance of an attack may have crucial importance for understanding the origin (pathogenesis) PA.

The term "panic attack" was now recognized throughout the world due to the classification of the American Psychiatric Association. Members of this Association in 1980, it was suggested the new guidelines for diagnosing mental disorders - DSM-III-R, which was based on specific, mostly phenomenological criteria. The latest version of the manual (DSM-IV) diagnostic criteria for PA are:

Recurrence of seizures, in which intense fear or discomfort in combination with 4 or more of the following symptoms develop suddenly and reach their peak within 10 minutes:

• Ripple, palpitations, rapid pulse
• Sweating
• Chills, tremors
• Feeling lack of air, shortness of breath
• Shortness of breath, choking
• Pain or discomfort in the left half of the chest
• nausea or other discomfort (eg, uriesthesia)
• The sense of vertigo, imbalance, lightness in the head or presyncope
• Feeling de-realization, depersonalization
• Fear of going mad or make an uncontrolled action
• Fear of death
• Numbness or tingling sensations (eg, grow cold extremities)
• Waves of heat or cold

The emergence of the PA is not due to the direct physiological effects of any substance (eg, drug addiction or drug administration) or somatic diseases (eg, thyrotoxicosis).

Thus, seizures, consisting of four or more symptoms are panic attacks.

Often, panic attacks accompanied by agoraphobia. The term "agoraphobia" was introduced in 1971 to describe patients who were afraid and did not venture to appear in public without being accompanied by friends or relatives. The word has Greek origin and means "fear of the place where the trade. The coincidence of agoraphobia and panic attacks was noted by Sigmund Freud in 1885, the importance of this observation was re-opened when it was discovered that treatment with tricyclic andidepressantami many patients with panic attacks and agoraphobia associated with a significant improvement in both symptom.

DSM-IV identifies as two major subtypes of panic disorder - agoraphobia with and without agoraphobia. The following are diagnostic criteria for panic disorder with agoraphobia:

Meets diagnostic criteria for disorders such as panic reactions.

Agoraphobia: the fear is in places or situations from which it is difficult to get out (or it is inconvenient), and in which assistance is not provided in the event of a panic attack. As a result of these fears may limit the patient leaving home or need to be accompanied, or find some other ways to cope with agoraphobia despite intense anxiety.

Typical situations in which there is agoraphobia are: when the patient resides outside the home alone, is in the crowd in the queue or on the bridge, rode the bus, train, car. Added to this is that most patients avoid travel in the subway, because there are more stuffy than other modes of transport, and trains often stop in the tunnel. Psychology of Fear