Panic Attacks in Perimenopausal Women
What is Perimenopause?
Perimenopause is the time that happens in every woman's life prior to entering menopause. The actual age ranges from the 30's to the 50's. Some women have very little symptoms, while other women have many painful and sometimes debilitating symptoms. Sometimes those symptoms include panic attacks. Panic attacks can happen out of the blue, or in relationship to stressful events. A first time panic attack can send a woman to the hospital believing she is having a heart attack!
Perimenopause is a natural process that occurs as a woman's fertile years decline. The actual time it takes varies and can be as few as 5 years or as many as 15 years. During this time women often report feeling "hot flashes", night sweats and difficulty sleeping. Other women report increasing emotional difficulties during the week prior to and just after their menses. Many women report cessation of symptoms once they enter menopause.
What are Panic Attacks?
Panic attacks can be extremely frightening, but are not life threatening. They consist of physical and emotional components. The brain reacts to subtle changes. Some research suggests Carbon Dioxide (CO2) levels may rise and cause the brain to signal it's distress. This in turn causes the autonomic nervous system (ANS) to kick in. The ANS stimulation causes adrenaline and noradrenaline to be released which continues the stimulation of the ANS. The ANS has two main branches, the sympathetic and parasympathetic branches. The adrenaline and noradrenaline stimulate the sympathetic branch causing the "fight or flight" response. The natural antidote to this is the parasympathetic branch. This branch destroys the adrenaline and noradrenaline, but it takes a little time. Most panic attacks last anywhere from 10-40 minutes. Panic can't continue forever. Your body does not have an unlimited supply of adrenaline, so it must end.
- NIMH · Panic Disorder
Panic disorder is an anxiety disorder and is characterized by unexpected and repeated episodes of intense fear accompanied by physical symptoms that may include chest pain, heart palpitations, shortness of breath, dizziness, or abdominal distress.
What Treatments are Available?
Treatment can depend on the actual triggers for panic. For women in perimenopause, the panic attacks could be strongly linked to hormonal changes. If you experience panic attacks primarily around your menses and have been noticing other signs of menopause at this time (i.e. hot flashes, night sweats, mood swings) then you should also consult your gynecologist for a check up. Some women are able to find relief form taking birth control pills. If you do not want to take the pill due to other health concerns there are other options available. Eli Lilly, the makers of Prozac have come out with Sarafem. Sarafem is the same medication as Prozac, just packaged differently. The medication is marketed for women suffering from Pre-Menstrual Dysphoric Disorder (PMDD). This is on the same path as perimenopausal symptoms. Women could save a lot of money by asking their physician for the generic version, fluoxetine. Most of the Selective Serotonin Reuptake Inhibitor (SSRI) medications work for panic attacks.
Sometimes the reason for panic attacks in the perimenopausal phase is more than just hormonal. A lot of women have been under a lot of stress and perhaps some have had a particularly difficult time in previous years. Post Traumatic Stress Disorder (PTSD) that has been somewhat mild in the past, may become more prominent during this time. PTSD can be caused by any event that caused intense fear, horror or actual threat to an individual's life. The effects may not show until other stressors are introduced. Therapy is usually helpful at this point.
There are different types of therapy available. Cognitive Behavioral Therapy (CBT) is a therapy that encourages the person to pay attention to the negative thoughts and beliefs they hold. Then taking those negative thoughts and changing them into more positive ones. Eye Movement Desensitization and Reprocessing (EMDR) therapy encourages the person to recall the past disturbing incidents and reprocess them by using either a moving light or alternating hand buzzers. Eventually, once the incident no longer holds the same intense feelings, the feelings associated with the incident can be replaced with a better, more positive affirmation. Both types of therapy are effective with PTSD and are covered by insurance.
Life Gets Better
Panic attacks feel horrible. The only person who knows what it feels like is the person experiencing the attack. Not everyone has the exact same symptoms, and trying to explain what you feel to loved ones is frustrating. See your physician and discuss your options for treatments. If you do not get relief in a couple of months, ask for a change in the treatment, be assertive about your needs. Do not let anyone make you feel like you are an "emotional female." You do not have to suffer. Keep telling yourself that there is an end to panic attacks, and you will see it happen. Be well.
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