Agoraphobia
 Expectations anxiety
 Who is at Risk?
 Preparation Factors
 During Panic Attack Symptoms can be on
 Thought and Behavior of Patients with Panic Disorder and
 Treatment
Panic disorder, social and occupational functioning that cause serious problems, panic attacks, expectations tension, phobic avoidance, disability and health components, such as concerns about the decline and go repeat is a disease.
The main feature of this disorder emerged in the form of sudden fear period, characterized by physical symptoms, and unexpected panic attacks are repetitive. Panic disorder can be diagnosed patients at least two “unexpected panic attack” must have. Spontaneous panic attacks, the sine qua non for diagnosis is a prerequisite. The sympathetic and parasympathetic stimulation in panic attacks physical symptoms within the rapidly emerging as a severe fear of people, often living in fear of death. Other features of agoraphobia (fear of enclosed area) and anksiyetesidir expectations.

Agoraphobia: Panic attack or panic-like symptoms of the person’s assistance in the event of not receiving or would be difficult to escape being found in places and situations are defined in the form of anxiety hearing. Agoraphobia with panic disorder often develop as a secondary. However, a history of panic disorder without agoraphobia can be seen. People and places as possible, this situation is avoided. Avoiding too many places and situations Agorafobik contains. Among these, public transportation vehicles (buses, subways, airplanes, trains, ships, etc.), crowded environments (supermarkets, cinemas, market place, stadium, etc.), wait in a queue, closed places (elevators, etc.), to walk in the street, away from home to go home to stay alone, fields (fields, wide streets), high places, bridges are located. In agoraphobia go to work, doing housework in their social relations by creating difficulty in maintaining social and occupational functioning leads to deterioration. Alone can not leave the house heavy agorafobikler increasingly become dependent on someone else.

Expectations anxiety: people who had panic attacks do not want to relive those frightening memories. After a few attacks with the expectation that a new attack of anxiety and fear of expectations develop. There are three items anksiyetesinin expectations: 1 Had a panic attack and worried about who’s uncomfortable, intense thought of trying, 2 However, and this danger will be attacking belief and expectations, 3 Consisting in fear fear of bodily sensations. Patients after a while, and attacks that occurred during attacks they believe will take measures against disasters and begin to change some behavior.

Measures against the attacks of panic disorder:

1 – not to go to work from home not to go
2 – Home business, sports, travel, hiking, to abstain from sexual activity that requires exertion, such as
3 – During the attack, fainting, dying, and to take measures to be in bad: wear skirts instead of pants (legs lest appear), also do not carry more money, so not to wear (I do not get stolen)
4 – attack what they believed to cause not to eat or drink (tea, coffee, cola, cigarettes, some meals)
5 – to eat more than needed to prevent attacks
6 – from home while alcohol, drug, drug use
7 – what they think will prevent the next attack to move (water, alcohol, medicines, biscuits, sugar, cologne)
8 – During the attack, in addition to what they think would be necessary to move (his house, his wife’s address and telephone number, doctor’s address and phone)
9 – During the attack, for assistance, to spend the whole day in the garden of the hospital, the doctors routes, emergency services, pharmacy to choose the places
10 – Monitoring against loss and crazy house under lock and key in the blades to keep their children away to the balcony door, locked the door to keep out potential suicide may be a source of medicines, bleach, etc. to the material to keep under lock and key
Seen Frequency: The frequency of panic disorder in our country in various studies, 1.2% – 5.1 was found between. Panic disorder at any age with a maximum of We could start in the early 20s to late 30s and in years begin. All studies in women compared to men reported two to three times more than is shown. The prevalence of panic disorder progresses age decreases, over 65 years is very rare to be seen. Is a familial predisposition in panic disorder has been known previously. Relatives of patients with panic disorder with agoraphobia often have. Panic disorder in the relatives of the lifetime prevalence of panic disorder compared to 7-20 times higher than normal. Twin studies of panic disorder in the rate of disease for spouses of identical twins were found to be 31%.

Who is at Risk?
¨ 50 years under those
¨ Women
¨ Separated, divorced or widows,
¨ Education low ones,
¨ separation anxiety in the recent past, those living near the loss
Who suffered sexual abuse in childhood ¨,
¨ A family obligation than those who have
Living in the city in terms of ¨ panic attacks carry more risk.

Preparation Factors
1. Stressful life events: Patients are usually the first panic attack in the wake of stress, life events live. Some events have changed their way of life of patients (to move from one place, near death, his wife or girlfriend to leave) may be a trigger.
2. Early period of loss: the loss of early childhood (parents’ separation, divorce or death, etc.) in patients with panic disorder seen in more than has been reported.
3. Separation anxiety and school phobia: the separation occurred in the early period to be involved in the development anksiyetesinin panic and agoraphobia has been proposed.
4. Parental characteristics: Configuration findings in studies of panic disorder is familial genetic peculiarities of the transition is part of the social environment although it is understood that an important effect.
5. Personality characteristics: frequency in patients with panic dependency, inability to assert itself, such as insecurity and obsessional personality traits that are also found.

During Panic Attack Symptoms can be on
Suddenly, an intense fear with reason and a sense of restlessness occur. Highest level reached in 10 minutes into this intense tension;
¨ palpitations,
¨ heart rate or feel their heart beats is increased,
¨ Sweating, trembling or shaking,
¨ Shortness of breath or seem to be drowned,
¨ cessation of breathing, chest pain or feeling of distress,
¨ Nausea or abdominal pain,
¨ Dizziness, dizziness, fainting or falling be like,
¨ feelings or self separated from that Gerçekdışılık,
¨ or will lose control of fear of mad,
¨ fear of death,
¨ tingling sensations or numbness, chills, rigor, or flushing

accompanied by physical symptoms, such as at least four must be. Some of the physical symptoms often breathing is optional.
In addition to the plan, thinking skills, such as temporarily to lose.
Panic attacks usually lasts 10-30 minutes, rarely is extended to an hour.
Panic attacks can come at night to sleep. A person awakens from sleep with fear. This event can not even fall asleep frequently as residents are trying not to sleep.

Thought and Behavior of Patients with Panic Disorder and
The patients lived this situation “very scary terrifying and life of the worst experience” as they describe. Many patients with these symptoms, “paralysis of will, to love, lost control, or to be crazy to, heart attack, will, will die” in the form of comments. At that time, are doing the work to continue difficulty, or even can not continue. themselves a vital feeling in danger from the environment are trying to move away. panic attack seek medical help quickly causes. These patients to emergency services before, then often the general practitioners, cardiologists and neurologists to apply. Basic application to close to that person The physical symptoms are most irritating chest pain, numbness, etc.. panic disorder with other psychiatric disorders is a further reference to the emergency room is increasing.

Treatment
Experts in the treatment of this disorder is located within the patient’s conditions, disease severity, duration, disability by evaluating such factors as each individual patient are discussed. In addition, patients with panic disorder and to provide detailed information about the training is very important. The disease causes, symptoms, mechanisms of emergence of symptoms, course of treatment availability and treatment methods to understand the way it is told. Drug treatment is applied in cases when necessary. In addition, the effectiveness of psychotherapy in panic disorder has been displayed. In this method, detailed information and education can be done, panic symptoms and reduce physical sensations techniques (muscle relaxation and breathing control exercises) are taught. Sessions of the body sensations for catastrophic comments taken as false beliefs (negative automatic thoughts), the patient’s thought is an effort to restructure the format. Avoid situations where the patient can face the homework is given. Assignments of less fear of panic attacks can create conditions so severe situations rated. Patients face them slowly, insensitive replication are targeted.