Anxiety And Panic Attacks In Medical PatientsVijai P. Sharma, Ph.D Anxiety and panic attacks can occur in people with medical conditions who may or may not have an underlying anxiety disorder. Particularly vulnerable to anxiety and panic attacks are people suffering from such medical conditions as asthma, chronic obstructive pulmonary disease, heart disease, severe pain or medical obesity. During a panic attack, unless you were medically educated, you might think you were having a heart attack, lung failure, stroke or some other form of medical crisis. The fact is that such symptoms as the pounding heart, out-of-control breathing or sweating can also be caused by anxiety. However, the last think one would suspect is a panic attack when the symptom seem obviously so ominous and physical. Some feel an overwhelming sense of fear viewing it as a matter of life and death. Since anxiety can mimic major medical symptoms, it creates an additional "burden" for medical patients to differentiate between a real medical crisis and an anxiety attack. Even healthy people have a hard time differentiating between the two. When panic attacks begin to occur, the first few times, many non-medical individuals check in the hospital emergency room suspecting a heart attack. Only after being medically cleared and assured there is nothing wrong with their heart, it begins to dawn upon them the problem is not their heart, it's a panic attack. However, a person who indeed has a heart or a lung disease must always struggle to tease out if the symptoms stem from anxiety or from their medical condition. It gets even more complicated than that because sometime it's not just the anxiety or the medical condition, it is a combination of both and each one aids and abets the other. There is always some anxiety when one has a major medical condition. But the question is whether anxiety is in proportion to the seriousness of the situation and whether it is beneficial. Beneficial anxiety prompts you to take the required action and excessive anxiety helps nothing; it only complicates the medical condition. "Anxiety," "anxiety attacks," or "panic attacks;" so far I have been using these words interchangeably. But they are different. Anxiety is a "catch-all" term. Anxiety is simply tension or stress you experience in presence of an actual or anticipated threat. One may experience low-grade anxiety all the time and one may be known as a "worry wart." In "Dr. Sharma's Anxiety Checklist, there are 43 symptoms that cover a wide spectrum of anxiety disorders. But, only 13 out of the 43 are classified as symptoms of a panic attack according to the Diagnostic and Statistical Manual IV of Mental Disorders, briefly referred to as, DSM IV. According to DSM IV, you have a "panic attack" when you experience at least 4 out of the 13 symptoms, which have a sudden onset, rapidly build to a peak and are accompanied by an overwhelming sense of fear. If you experience fewer than four symptoms, some clinicians call it a "limited symptom panic attack." "Anxiety attack" is not a DSM IV term. When one has some of the panic symptoms but they don't meet the criteria of a panic attack, we refer to them as "anxiety attacks." I don't believe there is a precise definition of an "anxiety attack " upon which we all agree. Without further ado, here are the 13 symptoms of a panic attack: "Fear of dying" and "fear of losing control or going crazy," refer to one's thought process at the time. But the remaining 11 symptoms are the uncomfortable and unpleasant bodily sensations one experiences at the time. No wonder they APPEAR as a medical crisis on hand. Yet, in many cases, panic attack symptoms occur without a medical cause. If you are a medical patient and have panic attacks, you can train yourself to "smell" a panic attack coming and can even take measures to "nip it in the bud."
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Dr. Vijai Sharma
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