What causes panic attacks, and how can you prevent them? - Cindy J. Aaronson

Prevodilac: Ivana Vojnić Tunić Lektor: Milenka Okuka

The body becomes its own corset.

Telo postane sam svoj steznik.

Past, present, and future exist as a single force.

Prošlost, sadašnjost i budućnost postoje kao jedinstvena sila.

A swing without gravity soars to a terrifying height.

Zamah bez gravitacije uzdiže se do zastrašujuće visine.

The outlines of people and things dissolve.

Obrisi ljudi i stvari se razlažu.

Countless poets and writers have tried to put words

Bezbrojni pesnici i pisci pokušali su da opišu

to the experience of a panic attack—

napad panike -

a sensation so overwhelming, many people mistake it for a heart attack, stroke,

osećaj tako moćan da ga mnogi ljudi protumače kao infarkt, moždani udar

or other life-threatening crisis.

ili neko drugo po život opasno oboljenje.

Though panic attacks don’t cause long-term physical harm,

Iako napadi panike ne uzrokuju dugoročnu fizičku štetu,

afterwards, the fear of another attack can limit someone’s daily life—

nakon prvog, strah od sledećeg napada može da utiče na nečiju svakodnevicu

and cause more panic attacks.

i uzrokuje nove napade panike.

Studies suggest that almost a third of us

Istraživanja ukazuju da skoro trećina nas

will experience at least one panic attack in our lives.

iskusi barem jedan napad panike u životu.

And whether it’s your first, your hundredth,

Bilo da nam je prvi ili stoti,

or you’re witnessing someone else go through one,

ili posmatramo nekog drugog kako prolazi kroz njega,

no one wants to repeat the experience.

niko ne želi da se taj doživljaj ponovi.

Even learning about them can be uncomfortable, but it’s necessary—

Čak i učenje o njemu može biti neprijatno, međutim, ono je neophodno -

because the first step to preventing panic attacks is understanding them.

jer prvi korak u sprečavanju napada panike jeste njegovo razumevanje.

At its core, a panic attack is an overreaction to the body’s

U svojoj suštini, napad panike je prenaglašena reakcija organizma

normal physiological response to the perception of danger.

na normalni fiziološki odgovor tela na opasne situacije.

This response starts with the amygdala,

Taj odgovor započinje od amigdale,

the brain region involved in processing fear.

dela mozga zaduženog za obrađivanje osećanja straha.

When the amygdala perceives danger,

Kada amigdala oseti opasnost,ž

it stimulates the sympathetic nervous system,

ona stimuliše simpatički nervni sistem,

which triggers the release of adrenaline.

koji zatim pokreće lučenje adrenalina.

Adrenaline prompts an increase in the heart and breathing rate

Adrenalin ubrzava rad srca i disanja

to get blood and oxygen to the muscles of the arms and legs.

kako bi krv i kiseonik dospeli do mišića ruku i nogu.

This also sends oxygen to the brain, making it more alert and responsive.

Kiseonik takođe putuje do mozga, čineći ga budnijim i svesnijim.

During a panic attack,

Tokom napada panike,

this response is exaggerated well past what would be useful

taj odgovor je toliko prenaglašen da više nije koristan

in a dangerous situation,

u opasnoj situaciji,

causing a racing heart, heavy breathing, or hyperventilation.

izazivajući ubrzani rad srca, otežano disanje ili hiperventilaciju.

The changes to blood flow cause lightheadedness

Promene u krvotoku uzrokuju vrtoglavicu

and numbness in the hands and feet.

i utrnulost ruku i nogu.

A panic attack usually peaks within 10 minutes.

Napad panike uglavnom dostiže vrhunac u roku od 10 minuta.

Then, the prefrontal cortex takes over from the amygdala

Nakon toga, prefrontalni korteks preuzima posao od amigdale

and stimulates the parasympathetic nervous system.

i stimuliše parasimpatički nervni sistem.

This triggers the release of a hormone called acetylcholine

To pokreće lučenje hormona pod nazivom acetilholin

that decreases the heart rate and gradually winds down the panic attack.

koji usporava rad srca i postepeno privodi napad panike kraju.

In a panic attack, the body’s perception of danger

Pri napadu panike, percepcija opasnosti od strane organizma

is enough to trigger the response we would have to a real threat— and then some.

više je nego dovoljna da pokrene odgovor koji bismo imali u slučaju prave pretnje.

We don't know for sure why this happens,

Ne znamo sa sigurnošću zašto se to dešava,

but sometimes cues in the environment that remind us

ali ponekad nadražaji iz okruženja koji nas podsećaju

of traumatic past experience can trigger a panic attack.

na traumatična iskustva mogu da pokrenu napad panike.

Panic attacks can be part of anxiety disorders

Napadi panike mogu biti i deo anksioznih poremećaja,

like PTSD, social anxiety disorder, OCD, and generalized anxiety disorder.

kao što su PTSP, socijalna fobija, OKP i generalizovani anksiozni poremećaj.

Recurring panic attacks, frequent worry about new attacks,

Učestali napadi panike, stalna briga o novim napadima

and behavioral changes to avoid panic attacks

i promene u ponašanju kako bi se napadi izbegli

can lead to a diagnosis of a panic disorder.

mogu da dovedu do dijagnoze paničnog poremećaja.

The two main treatments for panic disorder

Dva glavna tretmana za panični poremećaj

are antidepressant medication and cognitive behavioral therapy, or CBT.

uključuju antidepresive i kognitivno bihejvioralnu terapiju ili KBT.

Both have about a 40% response rate—

Oba imaju oko 40 posto verovatnoće uspeha,

though someone who responds to one may not respond to the other.

iako nekom kome odgovara jedna terapija, možda neće odgovarati druga.

However, antidepressant medications carry some side effects,

Međutim, antidepresivi nose sa sobom neka neželjena dejstva

and 50% of people relapse when they stop taking them.

i 50 posto ljudi se vrati na staro kada prestanu da ih koriste.

CBT, meanwhile, is more lasting, with only a 20% relapse rate.

KBT je, međutim, dugotrajnija terapija, sa samo 20 posto recidivizma.

The goal of CBT treatment for panic disorder is to help people learn

Cilj KBT tretmana za panični poremećaj jeste pomoći ljudima da nauče

and practice concrete tools to exert physical, and in turn mental,

i uvežbaju konkretne metode za fizičku, a posledično i mentalnu

control over the sensations and thoughts associated with a panic attack.

kontrolu nad senzacijama i mislima povezanim sa napadom panike.

CBT begins with an explanation of the physiological causes of a panic attack,

KBT započinje objašnjenjem fizioloških uzroka napada panike,

followed by breath and muscle exercises designed to help people

praćenim vežbama disanja i mišića, kreiranih sa ciljem da pomognu ljudima

consciously control breathing patterns.

u svesnom kontrolisanju ritma disanja.

Next comes cognitive restructuring,

Sledi kognitivno restrukturiranje

which involves identifying and changing the thoughts

koje se sastoji od identifikacije i promene misli

that are common during attacks—

koje su česte tokom napada -

such as believing you’ll stop breathing, have a heart attack, or die—

na primer, da ne možemo da dišemo, da ćemo doživeti infarkt ili umreti -

and replacing them with more accurate thoughts.

i njihovim menjanjem za ispravnije misli.

The next stage of treatment is exposure to the bodily sensations and situations

Sledeći korak tretmana jeste izlaganje ogranizma senzacijama i situacijama

that typically trigger a panic attack.

koje tipično izazivaju napad panike.

The goal is to change the belief, through experience,

Cilj je da se putem iskustva promeni uverenje

that these sensations and situations are dangerous.

da su te senzacije i situacije opasne.

Even after CBT, taking these steps isn’t easy in the grip of an attack.

Čak i nakon KBT, u kandžama napada nije lako preduzeti te korake.

But with practice, these tools can both prevent and de-escalate attacks,

Ali uz vežbu, ove metode mogu da spreče napade i umanje njihovu jačinu

and ultimately reduce the hold of panic on a person’s life.

i, na kraju krajeva, smanje uticaj panike na nečiji život.

Outside formal therapy,

Osim stručne terapije,

many panickers find relief from the same beliefs CBT aims to instill:

mnogi paničari pronalaze olakšanje u istim uverenjima koja KBT usađuje:

that fear can’t hurt you, but holding on to it will escalate panic.

strah ne može da te povredi, ali koncentrisanje na njega dovodi do panike.

Even if you’ve never had a panic attack,

Čak i ako nikada niste doživeli napad panike,

understanding them will help you identify one in yourself or someone else—

njegovo razumevanje pomaže vam da ga prepoznate kod sebe ili kod drugih -

and recognizing them is the first step in preventing them.

a prepoznavanje je prvi korak u njegovom sprečavanju.