Methods to prevent panic attacks

By Dr. Stefano Casali

Additional causes

We must not forget that there are also some medical situations that can lead to anxiety symptoms: anemia, mitral valve prolapse, cardiac arrhythmias, vestibular dysfunction, premenstrual syndrome, some menopausal symptoms, diabetes, hypoglycemia, disorders of thyroid and parathyroid, asthma and some systemic infections. Numerous medicines can aggravate a state of anxiety. Some substances such as caffeine, nicotine and other products used as stimulants, pseudoephedrine (a decongestant) [18], theophylline (a bronchodilator used in the therapy of asthma or chronic bronchitis), some antihypertensives and alcohol withdrawal they can precipitate a panic attack.

In a similar way, concomitant psychological stresses, such as work problems, economic worries, relationship difficulties, previous experiences or devaluation-type thoughts (such as doubting one's own abilities or feeling that one is not in control of the situation) can increase the chances of onset of panic. Some research has found that chronic concerns predispose more to anxiety reactions and involve greater difficulty in the ability to relax than those that individuals who are less prone to concerns or obsessive ruminations have. [19]

Numerous researches discuss the use of drugs to prevent panic attacks and many people who practice scuba diving have been prescribed drugs such as imipramine, propanolol, paroxetine, fluoxetine or alprazolam, which are used in the therapy of d disorder. anxiety and panic attacks. These same studies acknowledge concerns about divers' use of certain medicines, especially if they have a tendency to give drowsiness or because they could in any way damage the diver's awareness of the environment [20]. A variety of non-pharmacological techniques for treating anxiety have also been used, for which there are few contraindications and in some people, such as those that have side effects to drugs, they may be preferable. The main ones are: systematic desensitization, implosion techniques, cognitive-behavioral technique and hypnosis. Understanding the mechanisms of anxiety helps to understand how these techniques can work.

Systematic desensitization

This is the most consolidated technique over time and most used by behavior therapists; was developed by the South African psychiatrist Joseph Wolpe. It is used above all for the treatment of phobias and consists in helping the client to relax and, therefore, gradually to face the situation or the feared objects. It has its roots in the behavioral theory of learning which is based in its substantive aspects on the principle that every action is followed by a reaction. In the situation we are talking about, a stimulus (entering the water) involves a response (avoidance and anxiety). The theorists of behaviorism argue that if fear can be conditioned or learned, it could even be unlearned with a small commitment. By neutralizing the stimulus that causes anxiety with another non-anxiety-inducing or causing a feeling incompatible with anxiety, such as relaxation, the person should be able to overcome the original source of anxiety. For example, a student is motivated to dive but experiences anxiety as soon as he has finished preparing the equipment and is about to dive. The mere thought of diving in open water causes shortening of the breath, tachycardia and profuse sweating. To overcome this state, the subject learns relaxation techniques, such as breath control and alternating tension and relaxation of muscle groups to arrive at an awareness of the difference between being tense and being relaxed. The pupil develops a hierarchy of thoughts and behaviors that produce anxiety, ranging from those that produce the minimum state of anxiety (being on the edge of the pool) to those that produce a bigger one (staying in the pool with the complete equipment) up to those that give the maximum anxiety (being immersed at the bottom of the pool). People can go through a series of mental exercises, like imagining getting closer to the water, carefully preparing their equipment with great care, then going to the pool. Some subjects can, instead, choose to carry out a series of exercises, such as walking in the pool, breathing through a regulator standing in the water that reaches the belt, kneeling with the only head under water. A combination of the two methods can also be carried out. Based on the individual motivations of the students, the patience of the instructors, the dive masters and the dive buddy, the diving candidate should be able to significantly reduce his anxiety to the point of experiencing the pleasure of diving. As a result of this, every dive that has been successfully conducted tends to reinforce the positive aspects of recreational diving.