TREATING TEEN
Counselling and medications can lessen the chances of it happening again
Counselling, medications can lessen severe panic attacks, says columnist
Dear Dr. Wong: I am worried about our 16-year-old son. He has been a big-time worrier all his life. Last week, he had a severe panic attack. There were a few incidences in school that really bothered him. Shortly after he came home, he suddenly felt weak, his heart was beating so fast that he thought it was going to jump out of his chest; he was shaking and sweating.
His father took him to the emergency room. After an ECG and monitoring, the doctor sent him home with a referral to see a pediatrician. She said that our son may need medication. It was not his first panic attack, but it was the worst. We are not sure whether it is safe to start medicine on him, he is so young. Anxiety does run on his dad’s side of family.
Answer: Being cautious is a good human trait. It has prevented our ancestors from becoming the lion’s dinner and saved us from falling off the cliff.
The first time when we sat behind the wheel to learn to drive, most of us were nervous. This is good because it prevents us from driving too fast when we are unfamiliar with a new skill.
However, excessive worry, especially when it happens frequently, can prevent us from doing the necessary things in life and exploring unfamiliar environment or activities. It can prevent us from travelling, experiencing new foods and meeting new friends.
Being anxious does affect our nervous system as well as hormones in our body. Our adrenaline goes up, and stress hormone cortisol is increased in the circulation. They can increase our heart rate and blood pressure, as well as our blood sugar. When it happens frequently, it can jeopardize our health.
Anxiety is a mental health condition that is recognized more frequently nowadays than before. This is partly due to improved recognition; more people are comfortable to admit to it and seek help. Our society is contributing partly to its increase. In the world of technology, many young people are being bombarded by mean comments from friends or strangers on the internet. This can generate a lot of anxiety in their lives.
The trait that makes us cautious is passed on from one generation to another through the genes. The same is true for anxiety; we can often find someone in the family with anxiety also. it may not be as severe, but it is often there.
A traumatic experience can push a person who is normally cautious to severe anxiety. If someone breaks into a house and robs the owners, they can develop severe anxiety that may require intervention.
Panic attacks are episodes where people feel intense fear. Their heart is beating very fast, with sweating and shaking at the same time. They can have difficulty breathing; some may believe they are having a heart attack and are going to die. It is a very unpleasant feeling. Fortunately, these episodes don’t last very long, and a person can recover within minutes to hours.
Severe anxiety and panic attacks require medical attention. Counselling can help individuals to recognize things and events that trigger anxiety, as well as practise calming thoughts and deep breathing. However, counselling alone may not be enough.
Safe medications have been available to reduce anxiety and prevent panic attacks. These medications belong to the group called anti-depressants. They modulate the serotonin in our brain. They can reduce anxiety and treat depression. Like all medications, there can be side effects that require monitoring by a physician who is familiar with these medications. Children and teenagers have been treated safely and successfully with these medications.
If his condition is as severe as you described, he should be assessed and treated by a specialist in this field.
Dr. David Wong is a consultant pediatrician in Summerside and recipient of 2012 Distinguished Community Paediatrician Award of Canadian Paediatric Society. His column will appear in The Guardian on the last Tuesday of every month. If you have a question for Dr. Wong, mail it to Prince County Hospital, 65 Roy Boates Ave., Summerside, P.E.I., C1N2A9.