I HAD SEVERE CHEST PAIN, BREATHLESSNESS AND PALPITATIONS; DOCTOR SAYS HEART IS FINE! WHAT IS GOING ON?

Mr. X, a 40 year old businessman was rushed to the emergency with chest pain, breathlessness and severe palpitations at 11 pm in the night. He was sitting comfortably at his home after returning from work when he suddenly experienced intense anxiety and palpitations. The feeling was intense and came out of nowhere. Mr. X felt as if he was having a heart attack and would not survive. His family members took notice and brought him to the hospital. At the hospital an extensive battery of blood and various other tests including ECG and echocardiography were performed. 

Surprisingly all tests turned out to be normal! The cardiologist suggested that Mr. X seek an appointment with a psychiatrist. Mr. X and his family were baffled! A consultation with psychiatrist? For what?

Well not so surprising for a psychiatrist, IT WAS A PANIC ATTACK!

What exactly is a panic attack? Why does it happen? How can it be treated? Well that is what we have on the agenda today!

A panic attack is a brief period of intense anxiety, usually arising out of the blue, suddenly, with a sense of impending doom, dying, losing control or 'going mad'. The intense anxiety typically lasts for a few minutes only, although mild anxiety may persist. It is associated with chest pain, breathlessness, sweating and sometimes brief periods of unresponsiveness (not unconsciousness). Patients are typically terrified and are rushed to the hospital. After one episode, persons may fear the occurrence of another episode, so-called anticipatory anxiety.
        Panic attacks may occur repeatedly or just once; they may occur in any situation or specific situations only; they may occur in situations with no objective danger, in situations with perceived danger (as in phobias) or in situations having actual danger. When they occur repeatedly in situations with no objective danger, it is termed as panic disorder.

          Panic disorder may or may not be associated with other phobias such as agoraphobia, wherein the person fears crowded places, travelling alone and situations from which 'escape may be difficult.'

So why does this happen? 

Well it is an example of body's alarm system gone wrong! Like a damaged fire alarm that goes off without fire or smoke, scaring people in the premises, sometimes the human body's physiological mechanisms go haywire, producing a panic attack!

So is it treatable?

Interestingly, as terrifying as the symptoms may seem, response to treatment is often rapid and dramatic. The disorder is rather easily controlled by medications although psychotherapy can also be used.

Hmmm, a rather abrupt end to a rushed emergency admission!

So, that was about panic attacks and anxiety, folks!

Please let me know if there is any specific issue that you want me to address. Write in at stayhappy.prakash@gmail.com

So until next time, STAY HAPPY!

Dr. Sathya Prakash, MD, Dip. CBT

Consultant Psychiatrist, Psychotherapist and Behavioural Sciences Expert

lybrate.com/dr.sathyaprakash

icliniq.com/drsathya

Are "psychiatric medications" harmful?

Hello everybody!
Today let me discuss yet another topic that is of utmost importance and the one about which clients frequently inquire - should one take psychiatric medications? Are they safe? What if they cause some irreversible damage?

Okay, so are psychiatric medications harmful? Any medication prescribed improperly has the potential to cause harm and psychiatric medications are no different. It is often said that it is the dose that differentiates a life saver from a poison. I would like to go further and say that medications can be harmful if taken in excessive doses, too many kinds of medications are taken together in an irrational manner; or wrong medications, which are not indicated in a particular condition, are needlessly taken. But it also means that if medicines are taken in a proper manner, they are not only harmless but also extremely beneficial, and this too, applies for psychiatric medications.

Thus while improperly taken medications can be dangerous, not taking appropriate medications where it  is necessary is also equally dangerous if not more!

So, the important points to consider before going for medications for a psychiatric condition are:

• Consult only a legitimate, licensed practitioner
• Discuss the various options, harms and benefits with the health provider
• Gain some basic understanding about the condition and treatment being provided
• Ask for important side effects (if any) that one should watch out for, or report anything that may seem suspicious or worrying
• Do not search for all possible side effects on the internet
• Why? Data on side effects are continually collected and updated based on reports from all over the world. Many a time the lists of side effects contain those symptoms that may be subjective, unconfirmed, non-specific, and reported very rarely. And of course, as with everything on the internet, legitimacy or correctness of information cannot be guaranteed! Finally, you can chose to search for what you want and ignore what you don't on the internet, giving you a biased picture. For all these reasons, it becomes an anxiety provoking exercise for those who may be already very anxious! counterproductive isn't it?
• Make an informed decision and stop brooding over it!

Finally, please remember that any decision must be based on a risk vs benefit evaluation. For psychiatric medications too, if the benefits far outweigh the risks, then what is stopping one from taking it?!

Hope this has been helpful,

Until next time,

STAY HAPPY!

Dr. Sathya Prakash, MD, Dip. CBT

Consultant Psychiatrist, Psychotherapist and Behavioural Sciences Expert

For more details, write in at stayhappy.prakash@gmail.com

icliniq.com/drsathya

lybrate.com/dr.sathyaprakash