QUESTION: How do I manage panic attacks at work? Please offer tips
Your question has allowed me to answer another question that is often asked by lay people. Many want to know, what is the difference between fear and anxiety, and many want to know if they are the same thing.
For the sake of clarity, therefore, fear is the emotional response to a real or perceived imminent threat. The important thing to note is that the threat is imminent.
Anxiety, on the other hand, is an emotional response to that which is anticipated in the future as opposed to it being current or imminent.
In this instance, one might be anxious about losing a job if the new government fails to deal with the fuel crisis while the other person will feel fear because a group of people pretending to be police officers have entered his bedroom at 3am.
The interface between mental health and cardiology is perhaps best illustrated by answering your question, and I will do this by telling you about a patient I saw many years ago, at the request of a colleague.
For several months, a successful 40-year-old man had presented to the accident and emergency department of a top hospital. Each time he had ended up in the ICU, because he had clear symptoms of a heart attack, and the doctors who received him had done the right thing in taking him there.
At every visit, he had presented with complaints of a pounding heart that was racing, he was trembling, shaking and sweating profusely. His wife was herself in a state of great fear and was screaming and shouting for help.
It was however the fear of losing control and chest discomfort, which had started suddenly that convinced the doctors to take urgent action and hence the transfer to ICU. Within a few hours, the doctors would get the results of the different tests and things would not add up.
None of the blood results supported a diagnosis of a heart attack and there was no evidence that heart muscle damage had taken place. By the following day, the patient was seating up, chatting and ready to get on with life, but was always a little embarrassed by this turn of events.
This was after all a false alarm. The usual cries by his wife and family started after the second and third panic attacks. It was at this point that the cardiologist who had seen the patient in the first instance was called in and he sent the patient to us with the diagnosis of panic attacks.
Reluctantly the family agreed to let the patient come into our care and over several months of medication and Cognitive Behaviour Therapy we were able to work through the condition.
You might want to know that panic disorder is treatable and in the case of the man we saw, remained well for many years.
Dr Njenga is a psychiatrist and mental health consultant who has authored several scientific papers and books